Increased output

a. Poor gastric emptying (no obstruction). Try metoclo-pramide, 0.1 mg/kg per dose to a maximum of 5 mg IV every 6 hours. Erythromycin can also be used.

b. Distal obstruction. Continue NG suction; consider further evaluation or surgery, or both, to relieve obstruction.

c. Ileus. Patience and a period of observation are necessary, especially if this occurs in the immediate postoperative period. Correct electrolyte abnormalities, including hypokalemia, with IV therapy. Continue NG suction. Look for an intra-abdominal abscess if ileus persists, especially if patient has fever.

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