Evidence map›Paper›PMID 27412108›Full record

Trial reportBMJ open2016

Protocol for a randomised control trial of methylnaltrexone for the treatment of opioid-induced constipation and gastrointestinal stasis in intensive care patients (MOTION).

Parind B Patel, Stephen J Brett, David O'Callaghan, Aisha Anjum, Mary Cross, Jane Warwick, Anthony C Gordon

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Parind B PatelCentre for Perioperative Medicine and Critical Care Research, Imperial College Healthcare NHS Trust, London, UK Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK.
Stephen J BrettCentre for Perioperative Medicine and Critical Care Research, Imperial College Healthcare NHS Trust, London, UK Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK.
David O'CallaghanCentre for Perioperative Medicine and Critical Care Research, Imperial College Healthcare NHS Trust, London, UK.
Aisha AnjumImperial Clinical Trials Unit, Faculty of Medicine, School of Public Health, Imperial College London, London, UK.
Mary CrossImperial Clinical Trials Unit, Faculty of Medicine, School of Public Health, Imperial College London, London, UK.
Jane WarwickWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
Anthony C GordonCentre for Perioperative Medicine and Critical Care Research, Imperial College Healthcare NHS Trust, London, UK Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK.
Imperial College London · GBImperial College Healthcare NHS Trust · GBUniversity of Warwick · GB

Funding

Department of Health PB-PG-0613-31073
6 · The paper itself

Abstract

introductionGastrointestinal dysmotility and constipation are common problems in intensive care patients. The majority of critical care patients are sedated with opioids to facilitate tolerance of endotracheal tubes and mechanical ventilation, which inhibit gastrointestinal motility and lead to adverse outcomes. Methylnaltrexone is a peripheral opioid antagonist that does not cross the blood-brain barrier and can reverse the peripheral side effects of opioids without affecting the desired central properties. This trial will investigate whether methylnaltrexone can reverse opioid-induced constipation and gastrointestinal dysmotility.

methodsThis is a single-centre, multisite, double-blind, randomised, placebo-controlled trial. 84 patients will be recruited from 4 intensive care units (ICUs) within Imperial College Healthcare NHS Trust. Patients will receive intravenous methylnaltrexone or placebo on a daily basis if they are receiving opioid infusion to facilitate mechanical ventilation and have not opened their bowels for 48 hours. All patients will receive standard laxatives as per the clinical ICU bowel protocol prior to randomisation. The primary outcome of the trial will be time to significant rescue-free laxation following randomisation. Secondary outcomes will include tolerance of enteral feed, gastric residual volumes, incidence of pneumonia, blood stream and Clostridium difficile infection, and any reversal of central opioid effects. ETHICS AND DISSEMINATION: The trial protocol, the patient/legal representative information sheets and consent forms have been reviewed and approved by the Harrow Research Ethics Committee (REC Reference 14/LO/2004). An independent Trial Steering Committee and Data Monitoring Committee are in place, with patient representation. On completion, the trial results will be published in peer-reviewed journals and presented at national and international scientific meetings. TRIAL REGISTRATION NUMBER: 2014-004687-37; Pre-results.

Indexed as

AdultAnalgesics, OpioidBlood-Brain BarrierConstipationCritical CareFemaleGastrointestinal MotilityHumansLaxativesMaleNaltrexoneNarcotic AntagonistsQuaternary Ammonium CompoundsAnalgesics, OpioidLaxativesmethylnaltrexoneNaltrexoneNarcotic AntagonistsQuaternary Ammonium Compounds

Identifiers

PMID27412108
PMCPMC4947806
OpenAlexW2466795905

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.