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Safety and Tolerance of Enteral Nutrition in the Medical and Surgical Intensive Care Unit Patient Receiving Vasopressors.

Authors
  • Sabino, Kim M1
  • Fuller, Julie1
  • May, Scott1
  • Wakefield, Dorothy2
  • 1 Trinity Health Of New England, Saint Francis Hospital and Medical Center, Hartford, Connecticut, 06105, USA.
  • 2 Center on Aging, UConn Health, Farmington, Connecticut, 06030, USA.
Type
Published Article
Journal
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
Publication Date
Feb 01, 2021
Volume
36
Issue
1
Pages
192–200
Identifiers
DOI: 10.1002/ncp.10548
PMID: 32643840
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Multiple societal guidelines recommend enteral nutrition (EN) be initiated within 24 to 48 hours of admission to the intensive care unit (ICU) once a patient is hemodynamically stable. Gastrointestinal intolerance and occurrence of bowel ischemia have been a concern for patients receiving vasopressors while concurrently receiving luminal nutrients. The study objective was to determine whether patients receiving vasopressors while concomitantly receiving enteral nutrients had more incidences of bowel ischemia and intolerance than those receiving EN without vasopressor agents. This retrospective study included 319 medical and surgical ICU patients from a level 1 trauma center. The patients were either receiving vasopressors simultaneously with EN (n = 178) or EN alone (n = 141). Data regarding gastric residual volume (GRV), new abdominal pain, emesis, and bowel ischemia were collected. There were more patients who had elevated GRV in the group that received vasopressors than patients who did not (20% vs 7%; P-value < .01). There were no differences between rates of bowel ischemia, emesis, or new abdominal pain between the 2 groups. Based on our findings, EN is generally well tolerated and safe for those patients simultaneously receiving vasopressors. © 2020 American Society for Parenteral and Enteral Nutrition.

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