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2024, Number 1

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Med Crit 2024; 38 (1)

Tolerance of continuous enteral diet compared with intermittent enteral diet in patients with shock and vasopressor use

Rodríguez VML, Medina BJC, Cruz ECN, Bravo SE

Language: Spanish
References: 19
Page: 8-13
PDF size: 275.66 Kb.


ABSTRACT

Introduction: state, norepinephrine is the first-choice vasopressor. Early enteral nutrition has been shown to improve the clinical course of patients and has been proven safe when used with vasopressors. However, there are different modalities of enteral nutrition (continuous and intermittent feeding), and it is currently unknown which modality of enteral feeding has better tolerance in patients on vasopressors. Objective: to establish the difference in tolerance between continuous enteral feeding and intermittent enteral feeding in patients on vasopressors. Material and methods: all patients admitted to the intensive care unit with norepinephrine requirements at doses of 0.1-0.3 μg/kg/min and enteral feeding within the first 24 hours were included. The two study groups consisted of those receiving continuous nutrition and intermittent nutrition. Both groups were followed for five days, with observations of enteral feeding intolerance. Statistical analysis was performed using the χ2 test, univariate analysis with RR and 95% CI, and multiple logistic regression analysis. Results: a total of 58 patients were analyzed. There was no difference in enteral feeding tolerance between the two groups (24.1% vs 17.2%, p = 0.520, RR 1.4, 95% CI 0.50-3.9). The main symptom of intolerance was gastric residue (75%), and an increase in mortality was reported in patients with enteral feeding intolerance (p = 0.019, RR 3.84, 95% CI 1.24-11.8). The use of dual vasopressors was a risk factor associated with enteral feeding intolerance (OR 8.9, 95% CI 2.20-12.14). Conclusions: there is no difference in tolerance between intermittent enteral feeding and continuous enteral feeding in patients with shock and the use of norepinephrine.


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