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Vasoactive Substances and Their Effects on Nutrition in the Critically Ill Patient
Author(s) -
Allen John M.
Publication year - 2012
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533612443989
Subject(s) - medicine , critically ill , intensive care medicine , inotrope , enteral administration , parenteral nutrition , vasoactive , cardiology
Critically ill patients often require specialized nutrition via the enteral route. The benefits of enteral feeding, particularly early in the care of the critically ill patient, are well documented. Controversy exists regarding the provision of enteral nutrition (EN) in critically ill patients with hemodynamic instability who require vasopressors or inotropes. Concerns center on the potential for gut ischemia that may develop in the face of an imbalance between oxygen supply and demand. Current guidelines offer some guidance as to when to it is safe to initiate enteral feeding in patients on vasopressors, but the decision on when to start EN in hemodynamically unstable patients requiring vasoactive substances remains a clinical dilemma for most critical care practitioners. This review focuses on the effects of vasoactive substances such as pressors and inotropes on the gastrointestinal tract, as well as their use in combination with EN.