The Clinical Effects of Proactively Using Low Dose Versus Standard Dose Crushed Erythromycin Tablet on Early Enteral Nutrition in Mechanically Ventillated Critically Ill Patients

Objectives: Feeding intolerance is a common problem in mechanically ventilated critical ill patients and it is usually manifested by elevation in gastric residual volume (GRV) prior to the next scheduled feeding. The objective of this study is to test the outcome differences between Group I (patients used Erythromycin at standard prokinetic dose of 250 mg TID) and Group II (patients used Erythromycin at low dose of 125 mg TID) in terms of GRVs and nutritional intakes. Methods: We conducted a retrospective study in our institution at King Hussein Medical Hospital (KHMH). Patients were excluded if he/she discharged or died before completed 1 week of admission and if GRV was below 100 ml or was exceeded 200 ml at any time during study. One sample and independent sample T-test were conducted to determine the Mean±SD of GRVs between Group I and Group II. Results: The mean overall age was 57.50±9.02 years. 89 subjects (71.2%) were male and 36 subjects (31.2%) were female. Although Group II had a significantly higher GRV0 than Group I ((205.57±19.33 ml vs 193.73±16.07 ml, respectively) that led to significantly lower nutritional intake (577.71±77.33 ml/day vs 625.02±64.15 ml/day), Group I had a significantly higher ∆GRV1-7 than Group II (-90.95±13.05 ml vs -66.59±6.26 ml, respectively) with mean difference of -24.36±1.80 ml. Conclusion: Crushed erythromycin crushed tablet (250 mg TID) was more effective than low dose erythromycin (125 mg TID) in reducing GRV from baseline and in increasing and maintaining nutritional status