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CRITICAL CARE AND TRAUMA

Reversal of Opioid-Induced Gastric Dysfunction in a Critically Ill Burn Patient After Methylnaltrexone

From the Department of Anesthesia and Critical Care, The University of Chicago, Chicago, Illinois.

Address correspondence and reprint requests to Jonathan Moss, MD, PhD, Department Anesthesia and Critical Care, The University of Chicago, 5841 S. Maryland Ave., MC 4028, Chicago, IL 60637. Address e-mail to jm47{at}midway.uchicago.edu.

Peripheral-acting mu opiate receptor antagonists have been extensively studied for the treatment of opiate-induced constipation in advanced illness for the prophylaxis of postoperative ileus. We document the first intensive care patient to receive methylnaltrexone in an attempt to facilitate enteral nutrition. Gastric residuals markedly decreased and enteral feeding increased after administration of IV methylnaltrexone. The patient's ileus resolved coincident with the first injection.