Nutrition Support in the Open Abdomen.

Area of Science:

• Critical care medicine
• Surgical intensive care units (ICUs)
• Gastroenterology

Background:

• Early enteral nutrition (EN) is standard in surgical ICUs for reducing septic complications.
• Open abdomen management, due to damage control surgery or abdominal compartment syndrome, presents unique challenges for EN initiation.
• Concerns exist regarding EN's impact on bowel distention, abdominal closure, and aspiration risk in open abdomen patients.

Purpose of the Study:

• To review the current evidence on the utility and timing of EN in critically ill patients with an open abdomen.
• To provide clinical guidance for physicians managing these complex patients.
• To address theoretical concerns about initiating EN in open abdomen scenarios.

Main Methods:

• Review of recent studies investigating EN in open abdomen patients.
• Analysis of clinical concerns including bowel distention, abdominal closure, and aspiration.
• Synthesis of evidence to formulate clinical recommendations.

Main Results:

• Recent studies explore the feasibility and benefits of EN in open abdomen patients.
• Evidence addresses concerns about exacerbating bowel distention and aspiration.
• The review aims to clarify the role of EN in this patient population.

Conclusions:

• EN can be beneficial for critically ill patients with an open abdomen.
• Careful consideration and recent evidence guide the safe initiation of EN.
• This review offers practical guidance for physicians in managing nutrition for these challenging cases.