Erythromycin and Position Facilitated Placement of Postpyloric Feeding Tubes in Burned Patients

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Background:One of the main difficulties encountered in enteral nutrition in 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 prokinetic agent, erythromycin, and patient positioning.Methods:In eight critically ill, burned patients a gastric feeding tube was placed in a reverse Trendelenburg, right lateral decubitus position. A dose of 250 mg of erythromycin was administered intravenously.Results:In 13 out of 14 attempts, the tube passed into the duodenum, a success rate of 92%.Conclusions:Combining the prokinetic effects of erythromycin with proper patient positioning allows a rapid bedside transpyloric placement of feeding tubes.

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