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Optimizing Nutrition Delivery in Critically Ill Patients on Vasopressors
1Department of Anesthesiology, Duke Clinical Research Institute, Duke University Hospital, DUMC, BOX 3094, MAIL #412301 Erwin Road 5692 HAFS, Durham, NC 27710, USA.
The Surgical Clinics of North America
|April 17, 2026
Summary
Early enteral nutrition (EN) for critically ill patients on vasopressors is debated. Evidence suggests trophic EN may be safe post-resuscitation, but higher doses risk complications.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Clinical Nutrition
Background:
- Early enteral nutrition (EN) in critically ill patients receiving vasopressors is controversial.
- Concerns include potential gut ischemia and feeding intolerance.
Purpose of the Study:
- To review current evidence on the safety and efficacy of early EN in critically ill patients on vasopressors.
- To provide practical recommendations for feeding strategies.
Main Methods:
- Review of observational studies and randomized controlled trials.
- Analysis of evidence regarding vasopressor dose, resuscitation status, and feeding tolerance.
Main Results:
- Trophic EN may be safe and beneficial in patients post-resuscitation with low-to-moderate norepinephrine doses.
- Full-dose EN with higher vasopressor doses is associated with increased gastrointestinal complications.
Conclusions:
- An individualized, cautious approach to EN is recommended.
- Gastric-only trophic feeding with slow advancement and monitoring is advised during resuscitated shock.
Keywords:
Critical illnessEnteral nutritionIntensive care unitNorepinephrineNutritionSeptic shockVasopressorsMore Related Videos
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