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Vasoactive and Inotropic Support, Tube Feeding, and Ischemic Gut Complications After Cardiac Surgery
Author(s) -
Ong Chin Siang,
Brown Patricia M.,
Yesantharao Pooja,
Zhou Xun,
Young Allen,
Canner Joseph K.,
Quinlan Munirih,
Brown Evan F.,
Sussman Marc S.,
Whitman Glenn J.R.
Publication year - 2020
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1769
Subject(s) - medicine , inotrope , cardiac surgery , vasoactive , anesthesia , surgery , cardiology
Background Vasoactive and inotropic support (VIS) may predispose cardiac surgery patients to ischemic gut complications (IGCx). The purpose of this study was to describe the effect of VIS on the manner in which we deliver tube feeds (TFs) and determine its relationship with IGCx in cardiac surgery patients. Methods We reviewed cardiac surgery patients at a single institution and examined the effect of VIS (none, low, medium, high) on TF administration and evaluated IGCx. Results Of 3088 cardiac surgery patients, 249 (8%) required TFs, comprising 2151 total TF‐days. Increasing VIS was associated with decreased amounts of TF administered per day ( P = .001) and an increase in time that TF was held per day ( P < .001). High VIS was associated with less intact, more semi‐elemental/elemental formula use ( P < .001) and increased use of gastric route ( P < .001). Of all cardiac surgery patients, 11 of 3125 suffered IGCx (0.4%), with a mortality of 73%. Of the 3 receiving TF, 2 IGCx were focal and consistent with acute embolus, whereas one was diffuse, on high VIS and an intra‐aortic balloon pump. Of the 8 IGCx in the patients not receiving TF, 5 were focal, whereas 3 were diffuse and not embolic ( P = .21). Conclusions Despite 32% of TF‐days on moderate to high VIS, non‐embolic IGCx were not increased compared with patients not receiving TF. As delivered at this institution, TF in even those requiring moderate to high inotropic and pressor support were not associated with an increase in attributable IGCx.