Trinity Health Of New England, Saint Francis Hospital and Medical Center, Hartford, Connecticut, 06105, USA.
Center on Aging, UConn Health, Farmington, Connecticut, 06030, USA.
Nutr Clin Pract. 2021 Feb;36(1):192-200. doi: 10.1002/ncp.10548. Epub 2020 Jul 9.
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.
多项社会指南建议，一旦患者血流动力学稳定，应在入住重症监护病房（ICU）的 24 至 48 小时内开始肠内营养（EN）。同时接受血管加压素和肠道营养的患者，胃肠道不耐受和发生肠缺血一直是一个关注点。本研究的目的是确定同时接受血管加压素和肠内营养的患者与接受无血管加压素的 EN 的患者相比，是否更易发生肠缺血和不耐受。
这是一项回顾性研究，纳入了来自 1 级创伤中心的 319 名内科和外科 ICU 患者。这些患者要么同时接受 EN 和血管加压素治疗（n = 178），要么单独接受 EN（n = 141）。收集了胃残留量（GRV）、新腹痛、呕吐和肠缺血的数据。
接受血管加压素的患者中，GRV 升高的患者比例高于未接受血管加压素的患者（20% vs 7%；P 值<.01）。两组之间肠缺血、呕吐或新腹痛的发生率没有差异。
根据我们的发现，对于同时接受血管加压素的患者，EN 通常耐受良好且安全。
