Vasopressors and Nutrition Therapy: Safe Dose for the Outset of Enteral Nutrition?

医学 重症监护医学 重症监护室 梅德林 药方 重症监护 血管活性 肠外营养 病危 肠内给药 医学营养疗法 内科学 护理部 政治学 法学
作者
Luís Henrique Simões Covello,Marcella Giovana Gava-Brandolis,Melina Gouveia Castro,Martins Fidelis Dos Santos Netos,William Manzanares,Diogo Oliveira Toledo
出处
期刊:Critical Care Research and Practice [Hindawi Limited]
卷期号:2020: 1-7 被引量:12
标识
DOI:10.1155/2020/1095693
摘要

Background and Aims . Patients with hemodynamic instability need to receive intensive treatment as fluid replacement and vasoactive drugs. In the meantime, it is supposed to initiate nutritional therapy within 24 to 48 hours after admission to the intensive care unit (ICU), as an essential part of patient’s intensive care and better outcomes. However, there are many controversies tangential to the prescription of enteral nutrition (EN) concomitant to the use of vasopressor and its doses. In this way, the present study aimed to identify what the literature presents of evidence to guide the clinical practice concerning the safe dose of vasopressors for the initiation of nutritional therapy in critically ill patients. Methods . This review was carried out in PubMed, ProQuest, Web of Science, and Medline databases. The descriptors were used to perform the search strategy: Critical Care, Intensive Care Units, Vasoconstrictor Agents, and Enteral Nutrition. Inclusion criteria were patients of both genders, over 18 years of age, using vasoactive drugs, with the possibility of receiving EN therapy, and articles written in English, Portuguese, and Spanish. In addition, exclusion criteria were case reports, non-papers, and repeated papers. Results . 10 articles met our inclusion criteria. Conclusion . It was observed that there are many controversies about the supply of EN in critically ill patients using vasopressor, especially about the safe dose, and it was not possible to identify a cutoff value for the beginning therapy. Despite the drug doses, clinical signs are still the most important parameters in the evaluation of EN tolerance.

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