title: Is enteral feeding tolerated during therapeutic hypothermia?
abstract: OBJECTIVE
  To determine whether patients undergoing therapeutic hypothermia following cardiac arrest tolerate early enteral nutrition.
  
  
  METHODS
  We undertook a single-centre longitudinal cohort analysis of the tolerance of enteral feeding by 55 patients treated with therapeutic hypothermia following resuscitation from cardiac arrest. The observation period was divided into three phases: (1) 24h at target temperature (32-34 °C); (2) 24h rewarming to 36.5 °C; and (3) 24h maintained at a core temperature below 37.5 °C.
  
  
  RESULTS
  During period 1, patients tolerated a median of 72% (interquartile range (IQR) 68.7%; range 31.3-100%) of administered feed. During period 2 (rewarming phase), a median of 95% (IQR 66.2%; range 33.77-100%) of administered feed was tolerated. During period 3 (normothermia) a median of 100% (IQR 4.75%; range 95.25-100%) of administered feed was tolerated. The highest incidence of vomiting or regurgitation of feed (19% of patients) occurred between 24 and 48 h of therapy.
  
  
  CONCLUSIONS
  Patients undergoing therapeutic hypothermia following cardiac arrest may be able to tolerate a substantial proportion of their daily nutritional requirements. It is possible that routine use of prokinetic drugs during this period may increase the success of feed delivery enterally and this could usefully be explored.
authors.affiliation: Intensive Therapy Unit, Royal United Hospital, Combe Park, Bath BA1 3NG, United Kingdom. Electronic address: 2ruffdogs@gmail.com.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Williams
authors.affiliation: Intensive Therapy Unit, Royal United Hospital, Combe Park, Bath BA1 3NG, United Kingdom.
authors.forename: Jerry P
authors.initials: JP
authors.lastname: Nolan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods; D004750:Enteral Nutrition / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006769:Hospitals, General; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods*; D007362:Intensive Care Units; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Enteral feeding; Gastric stasis; Ileus; Nutrition; Therapeutic hypothermia; Tolerance