Abstract
Some critically ill patients occasionally have delayed gastric emptying by impaired gastric peristalsis. We report the effectiveness of rikkunshito for improvement of delayed gastric emptying in three critically ill patients. Case 1: A 63-year-old woman underwent mechanical ventilation because of severe pneumonia following treatment of Wegener's granulomatosis. Rikkunshito was administered because gastric contents discharged via nasogastric tube increased to 500 ml·day−1 and persisted for a few days. About three days after administration of rikkunshito, regurged gastric volume was reduced. Case 2 and 3 underwent replacement of thoraco-abdominal aortic aneurysm. In the postoperative period under mechanical ventilation, the volume of nasogastric drainage increased to 250∼500 ml·day−1 shortly after enteral feeding had been started via jejunal or gastric tube. About 2 days after administration of rikkunshito, the volume of nasogastric drainage was reduced in these patients. In all three cases, the amount of gastric contents discharged via a nasogastric tube was decreased after administration of rikkunshito, and subsequently enteral nutrition was successfully performed. Rikkunshito has been demonstrated to have beneficial pharmacological effects such as improvement of the gastric peristalsis and increases in blood flow and defensive factors of gastric mucosa. Therefore, it is thought that administration of rikkunshito is effective for improving delayed gastric emptying in critically ill patients.
