Association between enteral nutrition initiation within 48 h of intubation and 90-day mortality in patients with severe acute heart failure requiring mechanical circulatory support: A retrospective cohort study

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-04-11 DOI:10.1002/jpen.2759

Takeshi Saijo RD, PhD, Koji Yasumoto MD, Kayoko Ryomoto MD, PhD, Chika Momoki RD, PhD, Daiki Habu MD, PhD

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引用次数: 0

Abstract

Background

We explored the association between the initiation of enteral nutrition within 48 h of intubation and 90-day mortality in patients with severe acute heart failure requiring mechanical circulatory support.

Methods

We retrospectively analyzed patients with acute heart failure who were admitted to the critical care unit and underwent endotracheal intubation and mechanical circulatory support. Multivariate Cox proportional hazard models were used to evaluate the association between early enteral nutrition and 90-day mortality. Multivariate logistic regression analyses were used to evaluate the association between early enteral nutrition and the incidence of infectious- and enteral nutrition-related complications. The following variables were used in the analysis: sequential organ failure assessment, lactate, length of mechanical circulatory support, early enteral nutrition, body mass index, chronic renal failure, serum albumin level, cardiopulmonary arrest, diabetes mellitus, intraaortic balloon pump, venoarterial extracorporeal membrane oxygenation, and IMPELLA. These variables were then examined in models with different combinations for outcomes.

Results

The analysis included 80 and 35 patients in the early and delayed enteral nutrition groups, respectively. Multivariate analysis indicated that early enteral nutrition was an independent factor for reduced 90-day mortality (model 1: hazard ratio = 0.39 [95% confidence interval = 0.19–0.77]; model 2: hazard ratio = 0.38 [95% confidence interval = 0.19–0.76]; model 3: hazard ratio = 0.41 [95% confidence interval = 0.20–0.81]; and model 4: hazard ratio = 0.38 [95% confidence interval = 0.19–0.76]). Furthermore, early enteral nutrition was an independent factor for infectious complications but not for enteral nutrition-related complications.

Conclusion

Early enteral nutrition can be initiated without increasing complications in patients with severe acute heart failure requiring mechanical circulatory support. This may have beneficial effect on improving prognosis.

Abstract Image

查看原文本刊更多论文

需要机械循环支持的严重急性心力衰竭患者插管后48小时内开始肠内营养与90天死亡率之间的关系：一项回顾性队列研究

背景：我们探讨了需要机械循环支持的严重急性心力衰竭患者在插管后48小时内开始肠内营养与90天死亡率之间的关系。方法：回顾性分析在重症监护病房接受气管插管和机械循环支持的急性心力衰竭患者。采用多变量Cox比例风险模型评估早期肠内营养与90天死亡率之间的关系。多因素logistic回归分析用于评估早期肠内营养与感染和肠内营养相关并发症发生率之间的关系。以下变量用于分析：序贯器官衰竭评估、乳酸、机械循环支持长度、早期肠内营养、体重指数、慢性肾功能衰竭、血清白蛋白水平、心肺骤停、糖尿病、主动脉内球囊泵、静脉动脉体外膜氧合和IMPELLA。然后在不同结果组合的模型中检查这些变量。结果：早期肠内营养组80例，延迟肠内营养组35例。多因素分析表明，早期肠内营养是降低90天死亡率的独立因素(模型1：风险比= 0.39[95%可信区间= 0.19-0.77]；模型2：风险比= 0.38[95%置信区间= 0.19-0.76]；模型3：风险比= 0.41[95%置信区间= 0.20-0.81]；模型4：风险比= 0.38[95%置信区间= 0.19-0.76])。此外，早期肠内营养是感染并发症的独立因素，而不是肠内营养相关并发症的独立因素。结论：对于需要机械循环支持的严重急性心力衰竭患者，早期肠内营养可以不增加并发症。这可能对改善预后有有益的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.