Feasibility of Early Enteral Nutrition in Patients Under Mechanical Circulatory Support.

Aim: This study aimed to evaluate whether early enteral nutrition can be administered without increasing gastrointestinal complications in patients receiving mechanical circulatory support. Methods: 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. Results: 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. Conclusion: These findings suggest that early enteral nutrition may be a feasible option in carefully selected patients receiving mechanical circulatory support during intensive care.