J Clin Nutr.
2016 Dec;8(3):77-83. 10.15747/jcn.2016.8.3.77.
Enteral Nutrition Support in Coronary Care Unit Patients Receiving Extraocorporeal Membrane Oxygenation: An Observational Case Study
- Affiliations
-
- 1Department of Dietetics, Samsung Medical Center, Seoul, Korea.
- 2Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea. yhmoon@ewha.ac.kr
- 3Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 4Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 5Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- KMID: 2368593
- DOI: http://doi.org/10.15747/jcn.2016.8.3.77
Abstract
- PURPOSE
Enteral feeding remains controversial in patients receiving extracorporeal membrane oxygenation (ECMO), particularly in those treated with a high-dose vasopressor. This study examined the safety and feasibility of enteral nutritional support for patients undergoing ECMO in a cardiac care unit (CCU).
METHODS
Adult patients admitted to the CCU undergoing ECMO from January 2014 to May 2015 were included. Patients with <48 hours of support, undergoing ECMO at another hospital, and inaccurate medical records were excluded.
RESULTS
Among the 14 patients undergoing ECMO in the CCU, 2 patients were diagnosed with malnutrition and the others were in the normal state in the initial assessment. On the other hand, they had the malnutrition risk factors (anorexia, weight loss, fluid retention, and hypermetabolic state). Thirteen patients received enteral nutrition and 1 patient had possible oral intake. The average initiation day of enteral nutrition was 2.0±1.6 days on ECMO. The mean duration of enteral nutrition was 5.2±4.9 days and the target goal was achieved within 3 days. There were no serious adverse effects for enteral nutrition but 3 patients had gastrointestinal problems (diarrhea and anorexia), and gastrointestinal bleeding occurred in 1 patient. In 1 case, enteral nutrition had to be stopped due to the prone position. Overall, 5 patients were cured, 3 patients recovered through heart transplantation, and 6 patients died.
CONCLUSION
Most CCU patients receiving ECMO were well nourished but had the malnutrition risk factors in progress. These results suggest that enteral feeding might be safe and feasible in patients treated with ECMO but there were minor side effects.
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