Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study
BackgroundFeeding intolerance is commonly experienced during enteral feeding, necessitating cessation. Metoclopramide may be given to assist gastric emptying, but patients experience adverse effects and gradual loss of efficacy. Prucalopride, a safer prokinetic, may play a role in gastric emptying....
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Frontiers Media S.A.
2024-11-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1413246/full |
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| author | Eman Mohamed Elmokadem Dina Khaled Abou El Fadl Nermin Eissa Najla Abdulaziz Alnassar Ahmed M. Bassiouny Amir Eskander Hanna Samy Nouran Omar El Said |
| author_facet | Eman Mohamed Elmokadem Dina Khaled Abou El Fadl Nermin Eissa Najla Abdulaziz Alnassar Ahmed M. Bassiouny Amir Eskander Hanna Samy Nouran Omar El Said |
| author_sort | Eman Mohamed Elmokadem |
| collection | DOAJ |
| description | BackgroundFeeding intolerance is commonly experienced during enteral feeding, necessitating cessation. Metoclopramide may be given to assist gastric emptying, but patients experience adverse effects and gradual loss of efficacy. Prucalopride, a safer prokinetic, may play a role in gastric emptying. Therefore, the current study aimed to assess its effectiveness and safety in feeding intolerance developed in critically ill patients.Materials and MethodsIn this prospective randomized double-blinded study, patients with feeding intolerance were randomized to receive 2 mg prucalopride enterally once daily or 10 mg metoclopramide intravenously every 6–8 h for 7 days. Patients were monitored for treatment failure, successful feeding, gastric residual volume (GRV), and the development of medication-related adverse effects.ResultsA total of 70 patients (35 in the metoclopramide group and 35 in the prucalopride group) completed the study. The average daily GRV in the prucalopride group was significantly lower compared to the metoclopramide group (p=<0.001) on day 7. Additionally, the percentage change in GRV from day 1 to day 7 showed a greater significant change in the prucalopride arm versus the metoclopramide arm (p=<0.001). The treatment groups were comparable in terms of ICU length of stay (p = 0.094). Moreover, there was a significantly higher successful caloric intake in the prucalopride group compared to the metoclopramide group on day 7 (p = 0.039).ConclusionPrucalopride administration in enterally fed patients with feeding intolerance may reduce GRV and improve feeding success rates compared to metoclopramide treatment. The use of prucalopride was found to be tolerable and safe in critically ill patients.Clinical Trial Registrationclinicaltrials.gov, identifier NCT05496179 |
| format | Article |
| id | doaj-art-2a25b9532b884fff9751a7c556e2b512 |
| institution | OA Journals |
| issn | 1663-9812 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj-art-2a25b9532b884fff9751a7c556e2b5122025-08-20T02:12:54ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-11-011510.3389/fphar.2024.14132461413246Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded studyEman Mohamed Elmokadem0Dina Khaled Abou El Fadl1Nermin Eissa2Najla Abdulaziz Alnassar3Ahmed M. Bassiouny4Amir Eskander Hanna Samy5Nouran Omar El Said6Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, EgyptDepartment of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, EgyptDepartment of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab EmiratesHuman Nutrition and Dietetics, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab EmiratesFaculty of Medicine, Ain Shams University, Cairo, EgyptCritical Care Department, El Matarya Teaching Hospital, Cairo, EgyptDepartment of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, Future University in Egypt, Cairo, EgyptBackgroundFeeding intolerance is commonly experienced during enteral feeding, necessitating cessation. Metoclopramide may be given to assist gastric emptying, but patients experience adverse effects and gradual loss of efficacy. Prucalopride, a safer prokinetic, may play a role in gastric emptying. Therefore, the current study aimed to assess its effectiveness and safety in feeding intolerance developed in critically ill patients.Materials and MethodsIn this prospective randomized double-blinded study, patients with feeding intolerance were randomized to receive 2 mg prucalopride enterally once daily or 10 mg metoclopramide intravenously every 6–8 h for 7 days. Patients were monitored for treatment failure, successful feeding, gastric residual volume (GRV), and the development of medication-related adverse effects.ResultsA total of 70 patients (35 in the metoclopramide group and 35 in the prucalopride group) completed the study. The average daily GRV in the prucalopride group was significantly lower compared to the metoclopramide group (p=<0.001) on day 7. Additionally, the percentage change in GRV from day 1 to day 7 showed a greater significant change in the prucalopride arm versus the metoclopramide arm (p=<0.001). The treatment groups were comparable in terms of ICU length of stay (p = 0.094). Moreover, there was a significantly higher successful caloric intake in the prucalopride group compared to the metoclopramide group on day 7 (p = 0.039).ConclusionPrucalopride administration in enterally fed patients with feeding intolerance may reduce GRV and improve feeding success rates compared to metoclopramide treatment. The use of prucalopride was found to be tolerable and safe in critically ill patients.Clinical Trial Registrationclinicaltrials.gov, identifier NCT05496179https://www.frontiersin.org/articles/10.3389/fphar.2024.1413246/fullprokineticfeeding intolerancegastric residual volumeprucalopridecritical illness |
| spellingShingle | Eman Mohamed Elmokadem Dina Khaled Abou El Fadl Nermin Eissa Najla Abdulaziz Alnassar Ahmed M. Bassiouny Amir Eskander Hanna Samy Nouran Omar El Said Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study Frontiers in Pharmacology prokinetic feeding intolerance gastric residual volume prucalopride critical illness |
| title | Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study |
| title_full | Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study |
| title_fullStr | Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study |
| title_full_unstemmed | Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study |
| title_short | Comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness: a randomized double-blinded study |
| title_sort | comparison of enteral prucalopride versus intravenous metoclopramide for feeding intolerance in patients with critical illness a randomized double blinded study |
| topic | prokinetic feeding intolerance gastric residual volume prucalopride critical illness |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1413246/full |
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