Auburn University, Harrison School of Pharmacy, Department of Pharmacy Practice, Auburn, AL 36849, USA.
Nutr Clin Pract. 2012 Aug;27(4):521-6. doi: 10.1177/0884533612448480. Epub 2012 Jun 11.
Critical illness is associated with many complications that affect both medical and nutrition aspects of patient outcomes. Early enteral feeding is the preferred method of nutrition for patients in the intensive care unit due to apparent benefits in this patient population. However, these patients are also at risk for complications related to enteral nutrition (EN), which may be potentiated with the addition of vasopressors often used in the setting of hemodynamic instability. The clinician is often confronted with the decision of when to proceed with EN in critically ill patients who require vasopressors for hemodynamic support. This article reviews the effects of vasopressors on gastrointestinal blood flow, discusses complications associated with vasopressor use during EN, and proposes important considerations to determine the safety of EN in hemodynamically unstable patients requiring vasopressor support.
危重病与许多并发症相关，这些并发症影响患者的医疗和营养状况。由于在这类患者人群中具有明显益处，早期肠内喂养是重症监护病房患者首选的营养供给方式。然而，这些患者也存在与肠内营养（EN）相关的并发症风险，而在血流动力学不稳定的情况下经常使用血管加压素可能会加剧这些风险。临床医生经常面临这样的决策：对于需要血管加压素来支持血流动力学的危重病患者，何时开始进行 EN。本文综述了血管加压素对胃肠道血流的影响，讨论了在 EN 期间使用血管加压素相关的并发症，并提出了一些重要的考虑因素，以确定需要血管加压素支持的血流动力学不稳定患者进行 EN 的安全性。
