Clinical Impact of Enteral Nutrition for Severe Acute Decompensated Heart Failure Patients Who Required Mechanical Ventilation

Abstract

Introduction: While enteral nutrition is standard nutritional support for acutely ill patients, it is uncertain whether artificial nutritional support is necessary for acute decompensated heart failure (ADHF) patients who required mechanical ventilation. The purpose of this study is to observe nutritional support techniques in consecutive cardiac care unit (CCU) patients with ADHF who required mechanical ventilation. Methods and Results: We reviewed 96 consecutive patients who admitted in our CCU and were required noninvasive or invasive ventilation from January 2013 to December 2014. Of those, 5 patients in the noninvasive-ventilation group (NV-group, n = 81, average ventilation duration: 4.0 ± 0.5 days, enteral nutrition for 1 and parenteral nutrition for 4), and 13 patients in the invasive-ventilation group (IV-group, n = 13, average ventilation duration: 20.7 ± 6.3 days, enteral nutrition for 5 and parenteral nutrition for 6) were reviewed. Premature nutrition discontinuation (PND) occurred in 3 patients because of treated infectious complication (n = 2 in parenteral nutrition) and cholecystitis (n = 1 in parenteral nutrition) in NV-group, whereas PND occurred in 2 patients because of treated infectious complication (n = 1 in parenteral nutrition) and paralytic ileus (n = 1 in parenteral nutrition) in IV-group. No PND occurred in enteral feeding patients in either group. Conclusion: Considering the patient selection bias could not be fully avoided, the enteral nutrition as the default strategy for severe ADHF patients who required mechanical ventilation might be warranted.