Erythromycin to promote bedside placement of a self-propelled nasojejunal feeding tube in non-critically ill patients having pancreatitis: a randomized, double-blind, placebo-controlled study.

ABSTRACT

BACKGROUND: Postpyloric enteral feeding often requires endoscopic or fluoroscopic placement of a feeding tube. Self-propelled feeding tubes are designed to facilitate spontaneous migration into the jejunum. This study aimed to assess the rate of success and time to migrate a self-propelled feeding tube to jejunal position using erythromycin, a prokinetic agent. METHODS: Non-critically ill patients with pancreatitis who required jejunal enteral feeding were included. A self-propelled nasoenteric feeding tube was placed into the stomach using either placebo or erythromycin. At 24 and 48 hours after initial placement, an abdominal x-ray was taken to determine the position of the tube. RESULTS: Forty subjects were included and randomized. After 48 hours, there was no difference in the rates of success between placebo 56% (9/16) and erythromycin 50% (10/20) (P = .71). CONCLUSIONS: Self-propelled feeding tubes migrated into the jejunum in 53% of the subjects within 48 hours. However, this study failed to determine any benefit of erythromycin in terms of success or time to migrate to jejunal position using a self-propelled feeding tube. Selection of subjects without impaired motility and tachyphylaxis may have contributed to clinical failure of erythromycin as a prokinetic agent in this study.