Enteral feeding tube placement success with intravenous metoclopramide administration in ICU patients.

OBJECTIVE

The purpose of this study was to determine if intravenous push metoclopramide would facilitate immediate transpyloric passage of a small-bore feeding tube without fluoroscopy or endoscopy.

DESIGN

Prospective, randomized trial.

PATIENTS

One hundred five medical and surgical ICU patients at a community teaching hospital.

INTERVENTIONS

Patients were randomized to receive 10 mg of metoclopramide 10 min before tube insertion or no medication.

MEASUREMENT

Successful placement was stated as radiologically verified transduodenal tube location.

RESULTS

A 54% success rate was shown with administration of the drug with 46% success for the control. Chi square analysis of the success rate showed no significant relationship between administration of metoclopramide and successful tube placement (p = 0.38). Increasing years of physician training was the only variable associated with successful placement (p = 0.003). No association was found between successful tube placement and presence of endotracheal tube, tracheostomy, or cervical immobility, nor any interaction of metoclopramide with these variables.

CONCLUSION

Intravenous metoclopramide, 10 mg, administered 10 min prior to intubation with a small-bore feeding tube (10F), was ineffective in facilitating transpyloric intubation.