P445 - PREFERENCES ON THE USE OF PROKINETIC AGENTS IN ADULT INTENSIVE CARE UNIT PATIENTS – AN INTERNATIONAL SURVEY

P445

PREFERENCES ON THE USE OF PROKINETIC AGENTS IN ADULT INTENSIVE CARE UNIT PATIENTS – AN INTERNATIONAL SURVEY

V. Crone^1,*, M. H. Møller², M. Krag³ on behalf of The PATIENCE collaborators

¹Intensive Care, Holbæk Hospital, Holbæk, ²Intensive Care, ³Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital- Rigshospitalet, Copenhagen, Denmark

Rationale: Feeding intolerance is common in intensive care unit (ICU) patients receiving enteral nutrition, yet it remains poorly defined, with a reported prevalence ranging from 2% to 75%. Prokinetic agents are administered to enhance nutrition uptake; however, preferences for their use among ICU doctors are unknown.

Methods: We conducted an international electronic survey targeting ICU doctors. It included 76 questions on symptoms used to assess feeding intolerance, the use of prokientic agents, and willingness to participate in a future randomised trial. Participation was voluntary and the survey was approved by the Legal Department of Scientific Research in the Region of Zealand.

Results: We received 830 responses from 17 countries, with an overall response rate of 29%. Missing data for the main questions was below 2%. Most respondents were specialists working in mixed ICUs. The majority (90%) reported assessing feeding intolerance in their clinical practice, but only 36% considered it well-defined. Gastric residual volume > 500 mL and vomiting were the most frequently used indicators of feeding intolerance.

Metoclopramide was the preferred prokinetic agent (54%), followed by erythromycin (42%). Four out of five respondents considered using combination therapy, primarily a combination of metoclopramide and erythromycin (89%). Concerns about side effects were reported across all agents, with extrapyramidal symptoms and QT prolongation being the most common.

A majority (91%) of respondents supported a future randomised trial comparing prokinetic agents to placebo.

Conclusion: This international survey found large variations in the reported symptoms used to assess feeding intolerance. Metoclopramide was the preferred prokinetic agent, followed by erythromycin. Most respondents supported a future randomised trial.

Disclosure of Interest: V. Crone: None declared, M. Møller Grant / Research Support from: The Department of Intensive Care at Rigshospitalet-Copenhagen University Hospital has received funding from the Novo Nordisk Foundation and Sygeforsikringen “Denmark” outside the submitted work., M. Krag: None declared