scholarly journals A Double-Blind Randomized Clinical Trial Comparing the Effect of Neostigmine and Metoclopramide on Gastric Residual Volume of Mechanically Ventilated ICU Patients

2016 ◽  
Vol 24 (6) ◽  
pp. 385 ◽  
Author(s):  
Afshin Baradari ◽  
Abbas Alipour ◽  
Abolfazl Firouzian ◽  
Laleh Moarab ◽  
Amir Zeydi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Double Blind ◽  
Icu Patients ◽  
Mechanically Ventilated

scholarly journals Comparing the Effect of Neostigmine and Metoclopramide on Gastric Residual Volume of Mechanically Ventilated Patients in Intensive Care Unit: A Double-Blind Randomized Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Alireza Rahat-Dahmardeh ◽  
Sara Saneie-Moghadam ◽  
Masoum Khosh-Fetrat
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Randomized Clinical Trial ◽  
Normal Saline ◽  
Residual Volume ◽  
Gastric Residual Volume ◽  
Double Blind ◽  
Icu Patients ◽  
Mechanically Ventilated

Introduction. The gastric residual volume (GRV) monitoring in patients with mechanical ventilation (MV) is a common and important challenge. The purpose of this study was to compare the effect of neostigmine and metoclopramide on GRV among MV patients in the intensive care unit (ICU). Methods. In a double-blind randomized clinical trial, a total of 200 mechanically ventilated ICU patients with GRV > 120   ml (6 hours after the last gavage) were randomly assigned into two groups (A and B) with 100 patients in each group. Patients in groups A and B received intravenous infusion of neostigmine at a dose of 2.5 mg/100 ml normal saline and metoclopramide at a dose of 10 mg/100 ml normal saline, within 30 minutes, respectively. GRV was evaluated 5 times for each patient, once before the intervention and 4 times (at 3, 6, 9, and 12 hours) after the intervention. In addition, demographic characteristics including age and gender, as well as severity illness based on the sequential organ failure assessment score (SOFA), were initially recorded for all patients. Results. After adjusting of demographic and clinical characteristics (age, gender, and SOFA score), the generalized estimating equation (GEE) model revealed that neostigmine treatment increased odds of GRV improvement compared to the metoclopramide group ( OR = 2.45 , 95% CI: 1.60-3.76, P < 0.001 ). However, there is a statistically significant time trend (within-subject differences or time effect) regardless of treatment groups ( P < 0.001 ). Conclusion. According to the results, although neostigmine treatment significantly improved GRV in more patients in less time, within 12 hours of treatment, all patients in both groups had complete recovery. Considering that there was no significant difference between the two groups in terms of side effects, it seems that both drugs are effective in improving the GRV of ICU patients.

scholarly journals Evaluation of the Efficacy of Methylprednisolone Pulse Therapy in Treatment of Covid-19 Adult Patients with Severe Respiratory Failure: Randomized, Clinical Trial

2020 ◽  
Author(s):  
Ramin Hamidi Farahani ◽  
Reza Mosaed ◽  
Amir Nezami-Asl ◽  
Mohsen chamanara ◽  
Saeed Soleiman-Meigooni ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Respiratory Failure ◽  
Randomized Clinical Trial ◽  
Oral Prednisolone ◽  
Control Group ◽  
Severe Respiratory Failure ◽  
Double Blind ◽  
Clinical Trial Registration ◽  
Icu Patients ◽  
Methylprednisolone Pulse

Abstract Background: Covid-19 is now global concern and widely spread to the world due to high mortality among the nations we tried to evaluate the efficacy of methylprednisolone pulse in COVID-19 patients with severe respiratory failure.Methods: This study was phase2, double-blind, randomized, clinical trial in adults with COVID-19 (aged ≥18 years old) admitted to the intensive care unit (ICU) of *. Patients with intermediate or severe COVID-19 with PaO2/FiO2 less than 300 and progressive disease unresponsive to standard treatments admitted to ICU. Patients were randomly allocated in either control or investigation group. The control group received recommended regimen for COVID-19. The investigation group received the recommended regimen plus Methylprednisolone (1000mg/day for three days) and oral prednisolone 1mg/kg with tapering of dose within ten days. Results: A total of 29 ICU patients with intermediate or severe COVID-19 pneumonia recruited in this study. Fourteen patients (4 female, ten male) allocated in the investigation group, and 15 patients (6 female, nine male) assigned to the control group. The participant’s average age was 64.03±13.545 (case: 61.07±12.83, control: 66.80±14.03). The patients with methylprednisolone pulse had significantly higher systolic (P=0.018) and diastolic (P=0.001) blood pressure, meanwhile, the Glasgow coma scale (GCS) of methylprednisolone group was considerably (P<0.001) higher, and by the improvement in SpO2 of methylprednisolone group none of these patients needed mechanical ventilation.Conclusion: This study demonstrated methylprednisolone pulse in COVID-19 severe respiratory failure dramatically improves the clinical condition of patients including, GCS, and SpO2 of patients.Clinical Trial Registration Number: IRCT20200406046963N1

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