NDLI: Cisapride decreases gastric content aspiration in mechanically ventilated patients

Content Provider	Springer Nature : BioMed Central
Author	Pneumatikos, John Koulouras, Basil Frangides, Christ Goe, Dian Nakos, George
Abstract	Objective To determine the effect of the prokinetic agent cisapride in theprevention of aspiration of gastric contents. Design A prospective randomized two-period crossover study. Setting Fourteen-bed polyvalent intensive care unit in a UniversityHospital. Patients Eighteen intubated, mechanically ventilated patients who wereseated in a semirecumbent position were studied. Method Tc-99 m sulfur colloid (80 megabecquerels) was administered vianasogastric tube on 2 consecutive days. Patients randomly received cisapride(10 mg, via nasogastric tube) one day and a placebo the other. Bronchialsecretions were obtained before and for 5 consecutive h after Tc-99 madministration. The radioactivity was measured in a standard amount (1ml) ofbronchial fluid using a gamma counter and expressed as counts per min (cpm)after correction for decay. Results Sixteen out of 18 (88%) patients had increased radioactivity inbronchial secretions. The radioactivity increased over time both with andwithout cisapride, although it was lower in patients receiving cisapride thanin those receiving a placebo. The cumulative bronchial secretion radioactivityobtained when patients received cisapride was significantly lower than whenpatients received a placebo: 7540 ± 5330 and 21965 ± 16080 cpm,respectively (P <0.05). Conclusion Our results suggest that aspiration of gastric contents existseven in patients who are kept in a semirecumbent position. Moreover, cisapridedecreases the amount of gastric contents aspiration in intubated andmechanically ventilated patients and may play a role in the prevention ofventilator associated pneumonia. Cisapride, even with the patient in thesemirecumbent position, did not completely prevent gastric contentaspiration.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc305.pdf
Ending Page	5
Page Count	5
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc305
Journal	Critical Care
Issue Number	1
Volume Number	3
Language	English
Publisher	BioMed Central
Publisher Date	1999-03-16
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine cisapride mechanical ventilation aspiration pneumonia VAP
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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