• Luis Daniel Umezawa Makikado, José Luis Flordelís Lasierra, José Luis Pérez-Vela, Lara Colino Gómez, Enrique Torres Sánchez, Borja Maroto Rodríguez, Primitivo Arribas López, and Juan Carlos Montejo González.
• Intensive Care Medicine Service, Hospital Universitario 12 de Octubre, Madrid, Spain. luis_umezawa@hotmail.com
• Jpen Parenter Enter. 2013 Mar 1;37(2):281-4.

BackgroundDespite its benefits, early enteral nutrition (EN) is considered controversial in critically ill patients with severe hemodynamic failure.ObjectiveTo evaluate the tolerance and safety of early EN in a consecutive group of patients receiving venoarterial (VA) extracorporeal membrane oxygenation (ECMO) for severe hemodynamic failure.Materials And MethodsProspective observational study performed in a cardiac surgical intensive care unit (ICU) during a 1-year period. All adult patients receiving VA ECMO for severe hemodynamic failure unresponsive to conventional therapies were included. Nutrition support was provided during the study period following the established ICU nutrition protocol. Energy target was 25 kcal/kg, to be reached over 4 days. Nutrition tolerance was defined as the ratio of delivered nutrition to target nutrition, expressed as a percentage. Special interest was made to detect possible adverse effects attributable to EN. The authors performed a descriptive statistical analysis.ResultsOf 553 patients admitted in the cardiac surgical ICU during the study period, 7 were treated with ECMO. EN was the only nutrition source. More than 70% nutrition tolerance was achieved within the first week in all cases. No serious adverse events that could be attributable to EN were noted.ConclusionThe present study shows that, under proper medical supervision, early EN is possible and safe in patients with severe hemodynamic failure receiving VA ECMO. No serious adverse events were attributable to EN. More studies are warranted to confirm these findings.

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