title: Feeding the Postoperative Patient on Vasopressor Support: Feeding and Pressor Support.
abstract: Initiating enteral nutrition in the postoperative patient can be challenging. Postoperative ileus and bowel edema, bowel anastomosis, and intra-abdominal pathology contribute to the reluctance and inability to achieve adequate nutrition in this patient population. The addition of vasopressors confounds the difficulties. Clinical data are sparse but suggest that most postoperative patients requiring vasopressor therapy can be safely initiated and advanced on enteral nutrition. Consideration of the vasopressor agent being utilized and its dose is imperative, as are individual patient characteristics. Temporal changes in the dosage should be closely monitored, as increasing doses may reflect worsening clinical status that can be due to intestinal ischemia. Well-designed prospective trials are clearly necessary to address this controversial topic.
authors.affiliation: R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Brandon R
authors.initials: BR
authors.lastname: Bruns
authors.affiliation: R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland, USA rkozar@umm.edu.
authors.forename: Rosemary A
authors.initials: RA
authors.lastname: Kozar
mesh_terms: D000005:Abdomen / Q000473:pathology / Q000601:surgery; D003422:Critical Care / Q000379:methods*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007422:Intestines / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000188:drug therapy; D011184:Postoperative Period; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
chemical_list: D014662:Vasoconstrictor Agents
keywords: critical care; critical illness; enteral nutrition; intensive care units; nonocclusive bowel necrosis; postoperative care; vasoconstrictor agents; vasopressors