Clinical Nutrition Research

The Korean Society of Clinical Nutrition (한국임상영양학회)
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Enteral Nutrition in Critically Ill Patient With Septic Shock Requiring Vasopressor: Case Report

  • Hee Young Kim (Department of Nutrition, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Min Young Noh (Department of Nutrition, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Jisun Lee (Department of Nutrition, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • Received : 2023.12.28
  • Accepted : 2024.01.16
  • Published : 2024.01.31
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Abstract

Nutritional support in critically ill patients is an essential aspect of treatment. In particular, the benefits of enteral nutrition (EN) are well recognized, and various guidelines recommend early EN within 48 hours in critically ill patients. However, there is still controversy regarding EN in critically ill patients with septic shock requiring vasopressors. Therefore, this case report aims to provide basic data for the safe and effective nutritional support in septic shock patients who require vasopressors. A 62-year-old male patient was admitted to the intensive care unit with a deep neck infection and mediastinitis that progressed to a septic condition. Mechanical ventilation was initiated after intubation due to progression of respiratory acidosis and deterioration of mental status, and severe hypotension required the initiation of norepinephrine. Due to hemodynamic instability, the patient was kept nil per os. Subsequently, trophic feeding was initiated at the time of norepinephrine dose tapering and was gradually increased to achieve 75% of the energy requirement through EN by the 7th day of enteral feeding initiation. Although there were signs of feeding intolerance during the increasing phase of EN, adjusting the rate of EN resolved the issue. This case report demonstrates the gradual progression and adherence to EN in septic shock patient requiring vasopressors, and the progression observed was relatively consistent with existing studies and guidelines. In the future, further case reports and continuous research will be deemed necessary for safe and effective nutritional support in critically ill patients with septic shock requiring vasopressors.

Keywords

References

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