Timing of Enteral Nutrition for Critically Ill Patients on Vasopressor Support: A Systematic Review
Keywords:
enteral nutrition, vasopressors, hemodynamically unstable, critical illness, early feedingAbstract
Background: Research on enteral nutrition in the critically ill population has demonstrated a general consensus that adequate nutrition improves overall patient outcomes. However, controversy exists regarding the timing of enteral feeds and whether it is better to initiate within the first 48 hours of ICU admission or after. This study aims to identify the benefits versus risks associated with the timing of enteral feeds for critically ill patients on pressor support.
Methods: The literature review was conducted in October 2023 to identify more potential benefits or risks from early enteral nutrition (EEN) interventions for critically ill patients on vasopressor support. Databases utilized for article identification included PubMed, Google Scholar, and the Journal of Parenteral and EN (JPEN) by ASPEN. All articles were reviewed for relevance, classified by study type, and graded using quality criteria checklists. A plus/positive grade was the final step in article qualification.
Results: Forty-five articles met the criteria. Of those, twenty-five were utilized based on inclusion and exclusion criteria. Further investigation narrowed down our results to twelve articles for our systematic review.
Conclusion: This systematic review of the literature indicates that critically ill patients who are hemodynamically stable and receiving early enteral nutrition support will have a shorter length of stay in the ICU, lower levels of inflammatory markers, a lower risk of debility, a lower 28-day mortality rate, and a lower readmission rate to the ICU.
