Association between early enteral nutrition and clinical outcome in patients with severe acute heart failure who require invasive mechanical ventilation. Issue 2 (8th May 2021)

• Record Type: Journal Article
• Authors: Saijo, Takeshi; Yasumoto, Koji; Ohashi, Makoto; Momoki, Chika; Habu, Daiki
• Is Part Of: JPEN, Journal of parenteral and enteral nutrition. Volume 46:Issue 2(2022)
• Page Start: 443
• Page End: 453
• Publication Date: 2021-05-08
• Subjects: acute heart failure -- critically ill -- early enteral nutrition -- length of stay -- nutrition therapy; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; 615.85484
• DOI: 10.1002/jpen.2118
• Languages: English
• ISSNs: 0148-6071

Abstract

Abstract: Background: This study aimed to examine the association between early enteral nutrition (EEN) and clinical outcome in patients with severe acute heart failure (AHF). Methods: This retrospective observational study enrolled consecutive patients with AHF who required continuous invasive mechanical ventilation (IMV) for >48 h and were admitted to a single‐center cardiac care unit (CCU). The primary outcome was CCU length of stay (LoS). We compared patients who were initiated on EN within 48 h of intubation (EEN group) with those who were initiated on EN after 49 h of intubation (delayed EN [DEN] group). Multivariate logistic regression analysis was performed to determine independent factors for primary and secondary outcomes. CCU LoS and IMV time were categorized using the median. Results: We included 86 patients with AHF (EEN group, n = 56; DEN group, n = 30) who met the inclusion criteria. The median CCU LoS was significantly shorter in the EEN group (10 [8–15] days) than in the DEN group (15 [12–26] days, P = .007). Multivariate analysis indicated that time to EN initiation was an independent factor for CCU LoS (odds ratio [OR], 8.39; 95% confidence interval [CI], 2.18–32.20; P = .002), IMV time (OR, 4.84; 95% CI, 1.37–17.20; P = .015), and incidence of infection (OR, 2.73; 95％ CI, 1.04–7.18; P = .042). Conclusion: EEN (within 48 h of intubation) for patients with severe AHF who require continuous IMV might be associated with reduced CCU LoS, IMV time, and incidence of infection.