Erythromycin and position facilitated placement of postpyloric feeding tubes in burned patients

Background: One of the main difficulties encountered in enteral nutrition i n critically ill patients is the impaired gastric emptying: while the small bowel is ready the stomach is still 'lazy'. This paper describes a simple bedside method for postpyloric feeding tube placement, using a gastric prok inetic agent, erythromycin, and patient positioning. Methods: In eight crit ically ill, burned patients a gastric feeding tube was placed in a reverse Trendelenburg, right lateral decubitus position. A dose of 250 mg of erythr omycin was administered intravenously. Results: In 13 out of 14 attempts, t he tube passed into the duodenum, a success rate of 92%. Conclusions: Combi ning the prokinetic effects of erythromycin with proper patient positioning allows a rapid bedside transpyloric placement of feeding tubes. Copyright (C) 2000 S. Karger AG, Basel.