Should critically ill patients in shock and/or receiving vasopressors receive Enteral Nutrition (EN)?

Ischemic bowel is a very rare complication of EN but has been reported in critically ill patients and can be fatal. Therefore the general recommendation is that EN be avoided in patients who are in shock and in those patients in whom resuscitation is active, vasopressors are being initiated, or vasopressor doses are increasing.

Once patients are resuscitated and hemodynamically stable, EN may be initiated, even if they are receiving stable lower doses of vasopressors.

However, special attention should be paid to signs of enteral feeding intolerance such as abdominal distention or increasing gastric residual volumes.