Enteral nutrition in critically ill patients with severe hemodynamic failure after cardiopulmonary bypass.

Details

Serval ID
serval:BIB_1D5E5640EEB9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Enteral nutrition in critically ill patients with severe hemodynamic failure after cardiopulmonary bypass.
Journal
Clinical nutrition (Edinburgh, Scotland)
Author(s)
Berger M.M., Revelly J.P., Cayeux M.C., Chiolero R.L.
ISSN
0261-5614
Publication state
Published
Issued date
2005
Peer-reviewed
Oui
Volume
24
Number
1
Pages
124-32
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
BACKGROUND & AIMS: The study was designed to investigate and quantify nutritional support, and particularly enteral nutrition (EN), in critically ill patients with severe hemodynamic failure. METHODS: Prospective, descriptive study in a surgical intensive care unit (ICU) in a university teaching hospital: patients aged 67+/-13 yrs (mean+/-SD) admitted after cardiac surgery with extracorporeal circulation, staying 5 days in the ICU with acute cardiovascular failure. Severity of disease was assessed with SAPS II, and SOFA scores. Variables were energy delivery and balance, nutrition route, vasopressor doses, and infectious complications. Artificial feeding delivered according to ICU protocol. EN was considered from day 2-3. Energy target was set 25 kcal/kg/day to be reached stepwise over 5 days. RESULTS: Seventy out of 1114 consecutive patients were studied, aged 67+/-17 years, and staying 10+/-7 days in the ICU. Median SAPS II was 43. Nine patients died (13%). All patients had circulatory failure: 18 patients required intra-aortic balloon-pump support (IABP). Norepinephrine was required in 58 patients (83%). Forty patients required artificial nutrition. Energy delivery was very variable. There was no abdominal complication related to EN. As a mean, 1360+/-620 kcal/kg/day could be delivered enterally during the first 2 weeks, corresponding to 70+/-35% of energy target. Enteral nutrient delivery was negatively influenced by increasing dopamine and norepinephrine doses, but not by the use of IABP. CONCLUSION: EN is possible in the majority of patients with severe hemodynamic failure, but usually results in hypocaloric feeding. EN should be considered in patients with careful abdominal and energy monitoring.
Keywords
Aged, Cardiopulmonary Bypass, Critical Illness, Energy Intake, Energy Metabolism, Enteral Nutrition, Female, Hemodynamics, Humans, Intensive Care, Intensive Care Units, Length of Stay, Male, Middle Aged, Nutritional Requirements, Prospective Studies, Severity of Illness Index, Treatment Outcome
Pubmed
Web of science
Create date
24/01/2008 17:03
Last modification date
20/08/2019 12:53
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