特邀述评：术后患者血管升压支持期间的肠内营养

Nutr Clin Pract. 2016 Feb;31(1):14-7.

Feeding the Postoperative Patient on Vasopressor Support: Feeding and Pressor Support.

Bruns BR, Kozar RA.

R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland, USA.

Initiating enteral nutrition in the postoperative patient can be challenging. Postoperative ileus and bowel edema, bowel anastomosis, and intra-abdominal pathology contribute to the reluctance and inability to achieve adequate nutrition in this patient population. The addition of vasopressors confounds the difficulties. Clinical data are sparse but suggest that most postoperative patients requiring vasopressor therapy can be safely initiated and advanced on enteral nutrition. Consideration of the vasopressor agent being utilized and its dose is imperative, as are individual patient characteristics. Temporal changes in the dosage should be closely monitored, as increasing doses may reflect worsening clinical status that can be due to intestinal ischemia. Well-designed prospective trials are clearly necessary to address this controversial topic.

KEYWORDS: critical care; critical illness; enteral nutrition; intensive care units; nonocclusive bowel necrosis; postoperative care; vasoconstrictor agents; vasopressors

PMID: 26703957

DOI: 10.1177/0884533615619932