Evaluating Neostigmine Effect on Reducing Gastric Residual Volume as Compared With Metoclopramide and Ondansetron

NCT ID: NCT05342818

Last Updated: 2022-10-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-15

Study Completion Date

2022-10-17

Brief Summary

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One big problem in mechanically ventilated ICU patients is delayed gastric emptying. Delayed gastric emptying in these patients, causes intolerance and high gastric residual volume (GRV) that can lead to abdominal distention, vomiting, increased aspiration risk and consequently increased the length of hospital stay.

In this study, investigators will evaluate Neostigmine's effect in reducing GRV in mechanically ventilated patients and compare its effect with metoclopramide and Ondansetron

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Detailed Description

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It has been shown that delayed gastric emptying and high GRV in critically ill patients are associated with increased mortality in these patients. Different kinds of drugs including metoclopramide, erythromycin and cisapride are used, but none of them had conclusive evidence of better effects on each other. Moreover, complications such as dysrhythmia and extrapyramidal side effects limit the use of these drugs.

Another drug that can be used to increase gastric emptying in critically ill patients is neostigmine. Although several studies have evaluated the efficacy of neostigmine on postoperative ileus, very few studies have evaluated the effect of this drug on GRV in ICU patients.

The aim of the current study will be to compare the effects of Neostigmine on gastric residual volume in mechanically ventilated patients in the intensive care unit. A comparative controlled study by Ondansetron.

Conditions

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Delayed Gastric Emptying

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Group N

patients will receive an intravenous infusion of neostigmine in a dose of 2.5 mg in 100 ml of normal saline within 20 minutes once daily

Group Type EXPERIMENTAL

Neostigmine

Intervention Type DRUG

will be given by infusion in 20 minutes once daily by a nurse blinded to the study drugs

Enteral feeding nutrition

Intervention Type OTHER

The type and rate of enteral feeding nutrition will be the same for all patients (180ml/3h). All patients have a 30-degree head-up position

Sequential Organ Failure Assessment (SOFA) score

Intervention Type OTHER

SOFA score will be performed on all patients before the beginning of the study

Group O

patients will receive an intravenous infusion of 8 mg of ondansetron in 100 ml of normal saline once daily for 20 minutes

Group Type EXPERIMENTAL

Ondansetron 8mg

Intervention Type DRUG

will be given by infusion in 20 minutes once daily by a nurse blinded to the study drugs

Enteral feeding nutrition

Intervention Type OTHER

The type and rate of enteral feeding nutrition will be the same for all patients (180ml/3h). All patients have a 30-degree head-up position

Sequential Organ Failure Assessment (SOFA) score

Intervention Type OTHER

SOFA score will be performed on all patients before the beginning of the study

Group M

patients will receive metoclopramide in a dose of 10 mg in 100 ml of normal saline once daily for 20 minutes by infusion

Group Type EXPERIMENTAL

Metoclopramide Injection

Intervention Type DRUG

will be given by infusion in 20 minutes once daily by a nurse blinded to the study drugs

Enteral feeding nutrition

Intervention Type OTHER

The type and rate of enteral feeding nutrition will be the same for all patients (180ml/3h). All patients have a 30-degree head-up position

Sequential Organ Failure Assessment (SOFA) score

Intervention Type OTHER

SOFA score will be performed on all patients before the beginning of the study

Interventions

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Neostigmine

will be given by infusion in 20 minutes once daily by a nurse blinded to the study drugs

Intervention Type DRUG

Ondansetron 8mg

will be given by infusion in 20 minutes once daily by a nurse blinded to the study drugs

Intervention Type DRUG

Metoclopramide Injection

will be given by infusion in 20 minutes once daily by a nurse blinded to the study drugs

Intervention Type DRUG

Enteral feeding nutrition

The type and rate of enteral feeding nutrition will be the same for all patients (180ml/3h). All patients have a 30-degree head-up position

Intervention Type OTHER

Sequential Organ Failure Assessment (SOFA) score

SOFA score will be performed on all patients before the beginning of the study

Intervention Type OTHER

Other Intervention Names

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Neostigmine injection Dansetron injection primperan injection Enteral feeding SOFA score

Eligibility Criteria

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Inclusion Criteria

* Mechanically ventilated ICU patients
* With nasogastric tube feeding
* Gastric Residual Volume \>120 mL (3hours after the last gavage)

Exclusion Criteria

* History of diabetes
* Heart block
* Bradycardia (heart rate \<60/min)
* Systolic blood pressure less than 90 mm Hg
* Renal insufficiency
* Using any prokinetic agents such as erythromycin or cisapride within 8 hours before study initiation
* Recent surgery (10 days or less) on the stomach or digestive system
* pregnancy and lactation
* Occurrence of extrapyramidal side effects
* Gastrointestinal (GI) bleeding
Minimum Eligible Age

25 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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AHMED ABDELAZIZ SHAMA

LECTURER OF ANESTHESIA AND SURGICAL ICU

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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AHMED A SHAMA, MD

Role: PRINCIPAL_INVESTIGATOR

Lecturer and consultant of anesthesia and surgical ICU in Tanta University and Faculty of Medicine

Locations

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Sharurah Armed Forces Hospital

Sharurah, , Saudi Arabia

Site Status

Countries

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Saudi Arabia

Other Identifiers

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IRC112/04/22

Identifier Type: -

Identifier Source: org_study_id

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