Enteral nutrition in septic shock: A pathophysiologic conundrum.
enteral nutrition
epithelial barrier function
gut dysfunction
sepsis
septic shock
shock
Journal
JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
revised:
02
08
2021
received:
01
04
2021
accepted:
02
08
2021
entrez:
13
12
2021
pubmed:
14
12
2021
medline:
1
4
2022
Statut:
ppublish
Résumé
Septic shock is a public health burden and defined as a subset of sepsis whereby abnormalities in microcirculatory and cellular metabolism manifest as acute circulatory failure. At the level of the gut, septic shock impairs epithelial barrier function (EBF), and the gut initiates proinflammatory responses contributing to multiple organ dysfunction syndrome. The timing and dose of enteral nutrition (EN) in septic shock remains a conundrum. On the one hand, early EN preserves EBF. On the other hand, serious gastrointestinal complications such as bowel necrosis may limit EN initiation in septic shock. We (1) describe the pathophysiologic conundrum septic shock poses for EN initiation, (2) outline guideline-based recommendations for EN in septic shock, (3) identify the role of parenteral nutrition in septic shock, and (4) identify and appraise postguideline literature on the timing, dose, and titration of EN in septic shock.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
74-78Informations de copyright
© 2021 American Society for Parenteral and Enteral Nutrition.
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