Prokinetic drugs have been recommended to increase EN tolerance in critically ill patients, but this is also a controversial issue [31–33]. In this study, metoclopramide was used as a prophylactic measure to increase diet tolerance and decrease aspiration risk in all the patients. Nevertheless, the study was not designed to test the hypothesis that prophylactic prokinetic treatment is beneficial in these situations. Prophylactic use of prokinetic drugs from the onset of EN in all the cases remains speculativeandcouldnotberecommendedasaclinicalroutine. Nevertheless, we cannot exclude a beneficial effect of metoclopramideinimprovingdiettoleranceinourpatients.