title: Enteral nutrition in the hemodynamically unstable critically ill patient.
abstract: The benefit of enteral nutrition in critically ill patients has been demonstrated by several studies, especially when it is started early, in the first 24-48h of stay in the Intensive Care Unit, and this practice is currently advised by the main clinical guidelines. The start of enteral nutrition is controversial in patients with hemodynamic failure, since it may trigger intestinal ischemia. However, there are data from experimental studies in animals, as well as from observational studies in humans that allow for hypotheses regarding its beneficial effect and safety. Interventional clinical trials are needed to confirm these findings.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Severo Ochoa, Leganés, Madrid, España. Electronic address: makalyconru@hotmail.com.
authors.forename: J L
authors.initials: JL
authors.lastname: Flordelís Lasierra
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Pérez-Vela
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Montejo González
mesh_terms: D000818:Animals; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D016207:Cytokines / Q000502:physiology; D004734:Energy Metabolism; D004750:Enteral Nutrition; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D023421:Models, Animal; D064887:Observational Studies as Topic; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012769:Shock / Q000503:physiopathology / Q000628:therapy; D013152:Splanchnic Circulation
chemical_list: D016207:Cytokines
keywords: Critical illness; Enteral nutrition; Nutrición enteral; Paciente crítico; Shock