Feasibility of Early Enteral Nutrition in Patients Under Mechanical Circulatory Support

This study aimed to evaluate whether early enteral nutrition can be administered without increasing gastrointestinal complications in patients receiving mechanical circulatory support.

This retrospective observational study was conducted at a tertiary hospital in Japan. We consecutively included adult patients supported with intra-aortic balloon pumping alone or with both intra-aortic balloon pumping and veno-arterial extracorporeal membrane oxygenation who remained in the intensive care unit for > 1 week between January 2010 and December 2019. Patients were divided into an early group (enteral nutrition initiated within 48 h of admission) and a late group (enteral nutrition initiated after 48 h). The study endpoints were the amount of energy administered in each group and the frequency of gastrointestinal complications.

Fifty-five patients were eligible, including 16 in the early group and 39 in the late group. Time from admission to enteral nutrition initiation was 1.5 (1-2) days in the early group and 4.5 (3-6.5) days in 24 late-group patients who received enteral nutrition. Energy administered per ideal body weight increased earlier in the early group and differed significantly from Day 2 to Day 5, whereas no significant difference was observed after Day 6. No significant differences were found in gastrointestinal complications or mortality between groups; mortality was 7 patients (35%) in the early group and 17 patients (44%) in the late group.

These findings suggest that early enteral nutrition may be a feasible option in carefully selected patients receiving mechanical circulatory support during intensive care.