Enteral Nutrition Safety With Advanced Treatments: Extracorporeal Membrane Oxygenation, Prone Positioning, and Infusion of Neuromuscular Blockers.
TLDR
In this paper, the safety and efficacy of enteral nutrition in critically ill patients receiving extracorporeal membrane oxygenation, prone positioning, and infusion of neuromuscular blockers is evaluated.Abstract:
This review aims at assessing the safety and efficacy of enteral nutrition in critically ill patients receiving extracorporeal membrane oxygenation, prone positioning, and infusion of neuromuscular blockers. Existing data from randomized controlled trials demonstrate the survival benefit of early enteral nutrition in critically ill patients. Observational data have demonstrated that enteral nutrition in patients receiving extracorporeal membrane oxygenation, prone positioning, and infusion of neuromuscular blockers is generally safe. However, these patients are at increased risk for gastrointestinal complications from enteral nutrition because of critical illness-induced gastrointestinal dysfunction; associated shock; the concomitant use of vasopressor agents, sedatives, and narcotics; possibly mesenteric circulatory compromise; and regurgitation associated with prone positioning. Therefore, early enteral nutrition is generally recommended in these patients in the absence of severe gastrointestinal dysfunction or shock. To reduce the complications, early nutrition should be advanced gradually (trophic feeding or permissive underfeeding), the bed should be tilted to a maximum of 30°, and concentrated nutritional formulae and the use of prokinetics may be considered to treat enteral feeding intolerance. Physicians should be vigilant about monitoring for early signs of acute mesenteric ischemia, which should lead to holding enteral feeding. Parenteral nutrition may be utilized in patients who cannot receive enteral nutrition or are unable to reach their nutrition goals by the end of the first week.read more
Citations
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Factors associated with acute mesenteric ischemia among critically ill ventilated patients with shock: a post hoc analysis of the NUTRIREA2 trial
Gaël Piton,A. Le Gouge,Julie Boisramé-Helms,Nadia Anguel,Laurent Argaud,Pierre Asfar,Vlad Botoc,Anne Bretagnol,L. Brisard,Hoang-Nam Bui,Emmanuel Canet,Delphine Chatelier,Louis Chauvelot,Michael Darmon,Vincent Das,Jérôme Devaquet,Michel Djibré,Frédérique Ganster,Maité Garrouste-Orgeas,Stéphane Gaudry,Olivier Gontier,Samuel Groyer,Bertrand Guidet,Jean-Etienne Herbrecht,Yannick Hourmant,Jean-Claude Lacherade,Philippe Letocart,Frédéric Martino,Virginie Maxime,Emmanuelle Mercier,Jean-Paul Mira,Saad Nseir,Jean-Pierre Quenot,Jack Richecoeur,Jean-Philippe Rigaud,Damien Roux,David Schnell,Carole Schwebel,Daniel da Silva,Michel Sirodot,Bertrand Souweine,Nathalie Thieulot-Rolin,François Tinturier,Patrice Tirot,Didier Thevenin,Guillaume Thiery,Jean-Baptiste Lascarrou,Jean Reignier +47 more
TL;DR: Among critically ill ventilated patients with shock, enteral nutrition (EN) should be delayed or introduced cautiously in case of low cardiac output requiring dobutamine and/or in cases of multiple organ failure with high SAPS II score, as well as among critically ill patients requiring vasopressors.
Journal ArticleDOI
Nutritional Management Of Individuals With Obesity And Covid-19: Espen Expert Statements And Practical Guidance
Rocco Barazzoni,Stephan C. Bischoff,Luca Busetto,Tommy Cederholm,Michael Chourdakis,Cristina Cuerda,Nathalie M. Delzenne,Laurence Genton,Stéphane M. Schneider,Pierre Singer,Yves Boirie +10 more
TL;DR: The European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing clinical practice guidance for nutritional management of COVID-19 patients with obesity in various clinical settings.
Journal ArticleDOI
Nutritional management of individuals with obesity and COVID-19: ESPEN expert statements and practical guidance
TL;DR: The European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing clinical practice guidance for nutritional management of COVID-19 patients with obesity in various clinical settings as mentioned in this paper .
Journal ArticleDOI
Nutrition therapy in the critically injured adult patient: A Western Trauma Association critical decisions algorithm.
Jennifer L. Hartwell,Kimberly A. Peck,Eric J. Ley,Carlos V.R. Brown,Ernest E. Moore,Jason L. Sperry,Anne G. Rizzo,Nelson G. Rosen,Karen J. Brasel,Jordan A. Weinberg,Marc de Moya,Kenji Inaba,Ann J. Cotton,Matthew J. Martin +13 more
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Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position
Jéssica Alves de Paula,Estela Iraci Rabito,Sandra R Justino,L.S. Leite,Danielle Maia Dantas,Jéssica Sayume Makiyama da Silva,Larissa Farinha Maffini,Odery Ramos Junior +7 more
TL;DR: In this paper , the effectiveness and complications of enteral nutrition in the prone position, as well as clinical outcomes were analyzed, and a prospective cohort study with patients in EN and coronavirus disease 2019 (COVID-19), on mechanical ventilation (MV), which whom needed or not PP.
References
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Prone Positioning in Severe Acute Respiratory Distress Syndrome
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Journal ArticleDOI
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TL;DR: In patients with severe ARDS, early administration of a neuromuscular blocking agent improved the adjusted 90-day survival and increased the time off the ventilator without increasing muscle weakness.
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Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.).
Robert G. Martindale,Stephen A. McClave,Vincent W. Vanek,Mary McCarthy,Pamela R. Roberts,Beth Taylor,Juan B. Ochoa,Lena M. Napolitano,Gail Cresci +8 more
TL;DR: These guidelines offer basic recommendations that are supported by review and analysis of the current literature, other national and international guidelines, and a blend of expert opinion and clinical practicality that are directed toward generalized patient populations.
Journal ArticleDOI
ESPEN guideline on clinical nutrition in the intensive care unit
Pierre Singer,Annika Reintam Blaser,Mette M. Berger,Waleed Alhazzani,Philip C. Calder,Michael P Casaer,Michael Hiesmayr,Konstantin Mayer,J.C. Montejo,Claude Pichard,Jean-Charles Preiser,Arthur R. H. van Zanten,Simon Oczkowski,Wojciech Szczeklik,Stephan C. Bischoff +14 more
TL;DR: Particular conditions frequently observed in intensive care such as patients with dysphagia, frail patients, multiple trauma patients, abdominal surgery, sepsis, and obesity are discussed to guide the practitioner toward the best evidence based therapy.