Enteral nutrition and hepatosplanchnic region in critically ill patients - friends or foes?
Physiol Res
; 52(1): 31-7, 2003.
Article
in En
| MEDLINE
| ID: mdl-12625804
ABSTRACT
Enteral nutrition (EN) is a preferred way of feeding in critically ill patients unless obvious contraindications such as ileus or active gastrointestinal bleeding are present. Early enteral nutrition as compared to delayed EN or total parenteral nutrition decreases morbidity in postsurgical and trauma patients. The hepatosplanchnic region plays a pivotal role in the pathophysiology of sepsis and multiple organ dysfunction syndrome. The beneficial effects of EN on splanchnic perfusion and energy metabolism have been documented both in healthy volunteers and animal models of sepsis, hemorrhagic shock and burns. By contrast, EN may increase splanchnic metabolic demands, which in turn may lead to oxygen and/or energy demand/supply mismatch, especially when hyperemic response to EN is not preserved. Therefore, the timing of initiation and the dose of EN in patients with circulatory failure requiring vasoactive drugs are a matter of controversy. Interestingly, the results of recent clinical studies suggest that early enteral nutrition may not be harmful even in patients with circulatory compromise. Nevertheless, possible onset of serious complications, the non-occlusive bowel necrosis in particular, have to be kept in mind. Unfortunately, there is only a limited number of clinically applicable monitoring tools for the effects of enteral nutrition in critically ill patients.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Critical Illness
/
Enteral Nutrition
/
Liver
Type of study:
Prognostic_studies
Limits:
Animals
/
Humans
Language:
En
Journal:
Physiol Res
Journal subject:
FISIOLOGIA
Year:
2003
Type:
Article
Affiliation country:
Czech Republic