Medicina Intensiva  (English Edition) Medicina Intensiva  (English Edition)
Med Intensiva 2015;39:40-8 - Vol. 39 Num.1 DOI: 10.1016/j.medine.2014.04.005
Review
Enteral nutrition in the hemodynamically unstable critically ill patient
Nutrici??n enteral en el paciente cr??tico con inestabilidad hemodin??mica
J.L. Flordel??s Lasierraa,, , , J.L. P??rez-Velab, J.C. Montejo Gonz??lezb
a Servicio de Medicina Intensiva, Hospital Universitario Severo Ochoa, Legan??s, Madrid, Spain
b Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
Received 25 February 2014, Accepted 04 April 2014
Abstract

The benefit of enteral nutrition in critically ill patients has been demonstrated by several studies, especially when it is started early, in the first 24–48h of stay in the Intensive Care Unit, and this practice is currently advised by the main clinical guidelines. The start of enteral nutrition is controversial in patients with hemodynamic failure, since it may trigger intestinal ischemia. However, there are data from experimental studies in animals, as well as from observational studies in humans that allow for hypotheses regarding its beneficial effect and safety. Interventional clinical trials are needed to confirm these findings.

Resumen

El beneficio de la nutrición enteral en el paciente crítico ha sido demostrado en varios estudios, especialmente si esta es iniciada precozmente, en las primeras 24-48h de ingreso en la Unidad de Cuidados Intensivos, y en la actualidad esta práctica es recomendada por las principales guías de práctica clínica. El inicio de nutrición enteral en el paciente crítico con inestabilidad hemodinámica es una decisión controvertida, fundamentalmente debido al potencial riesgo de isquemia intestinal asociado a su empleo. Sin embargo, existen datos procedentes de estudios animales y de estudios observacionales en humanos que permiten plantear la hipótesis sobre su efecto beneficioso y seguridad. Son necesarios ensayos clínicos de intervención que establezcan una relación causa-efecto.

Keywords
Enteral nutrition, Shock, Critical illness
Palabras clave
Nutrici??n enteral, Shock, Paciente cr??tico
Med Intensiva 2015;39:40-8 - Vol. 39 Num.1 DOI: 10.1016/j.medine.2014.04.005
Cookies Policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.