Initiating enteral nutrition in patients with severe acute heart failure during mechanical circulatory support

• Published in: Clinical nutrition open science 2022-04, Vol.42, p.27-35
• Main Authors: Saijo, Takeshi, Yasumoto, Koji, Ryomoto, Kayoko, Momoki, Chika, Habu, Daiki
• Format: Article
• Language: English
• Subjects: Acute heart failure; Complications; Critically ill; Enteral nutrition; Hemodynamic; Mechanical circulatory support
• ISSN: 2667-2685; 2667-2685
• DOI: 10.1016/j.nutos.2022.01.005

While a number of observational studies of enteral nutrition (EN) during mechanical circulatory support (MCS) have been conducted, fewer have looked into severe acute heart failure (AHF), specifically. This retrospective observational study investigated patients admitted to a single cardiac care unit from January 2014 to March 2020 for AHF and requiring invasive mechanical ventilation within 72 hours of admission. We investigated clinical outcomes and EN complications in the group of patients for whom EN was initiated during MCS (MCS group). The primary outcome was 30-day mortality. Forty-seven patients in the MCS group met the inclusion criteria. The 30-day mortality rate was 32% (15) in the MCS group. The number of patients with EN complications were 24 [51%] in the MCS group. Multivariate analysis revealed that no association found between EN initiation during MCS and the 30-day mortality rate and EN complications. (OR:0.94, 95% CI:0.27–3.23, P = 0.922, OR:1.29, 95% CI:0.31–5.29, P = 0.724, respectively). EN can be selected as the feeding route during MCS, because the adverse events and intolerance associated with EN initiation is not increased when the patients with severe AHF were made hemodynamically stable using MCS.