Year: 2014
Type: article
Abstract: To the Editor: With respect to the article by Casaer and Van den Berghe (March 27 issue) 1 on nutrition in the acute phase of critical illness: we suggest the use of the peripherally acting μ opiate antagonist methylnaltrexone bromide (Relistor, Salix Pharmaceuticals) to facilitate enteral nutrition in patients in the intensive care unit (ICU) who are receiving mu opiates for analgesia and sedation.2,3 This agent has been approved for the treatment of opioid-induced constipation in patients with advanced illness who are receiving palliative care when standard agents prove inadequate.However, we and others have used it in critically ill patients in the burn unit, the cardiovascular unit, and the medical ICU to facilitate upper and lower gastrointestinal motility.4,5 In our own retrospective study, 4 six of seven patients without bowel motility for 3 to 5 days had almost instant restoration of bowel function after the subcutaneous administration of methylnaltrexone -3.5 days before eight patients who received conventional therapy.There was also a clinically significant effect on gastric residuals.We believe that there is justification for a prospective study designed to determine whether methylnaltrexone facilitates feeding in these critically ill patients.
Source: Lirias
Authors: Casaer, Michael P., Van den Berghe, Greet
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7030644892