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Nutrition in Clinical Practice
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Invited Reviews

The Patient With Circulatory Shock: To Feed or Not to Feed?

Gail Cresci, MS, RD
Jorge Cúe, MD

From the Medical College of Georgia, Augusta, Georgia.

Correspondence: Address correspondence to: Gail Cresci, MS, RD, Medical College of Georgia, Department of Surgery, Room 4072, 1120 15th Street, Augusta, GA 30912; e-mail:gcresci{at}mcg.edu.

Controversy continues to surround the appropriate form and timing of nutrition support for the patient with circulatory shock. Clinical studies have demonstrated improvements in outcome with the administration of enteral nutrition to critically ill patients; however, the provision of enteral nutrition to critically ill patients with ongoing shock remains controversial. This article reviews gut perfusion during normal states and during circulatory shock as well as alterations in perfusion when enteral feeding is provided. Pharmaconutrients studied during ischemia and reperfusion are discussed.

Key Words: enteral nutrition • shock • antioxidants • glutamine

Nutrition in Clinical Practice, Vol. 23, No. 5, 501-509 (2008)
DOI: 10.1177/0884533608323431
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J. Omata, K. Fukatsu, S. Murakoshi, M. Noguchi, H. Miyazaki, T. Moriya, K. Okamoto, S. Fukazawa, T. Akase, D. Saitoh, et al.
Enteral Refeeding Rapidly Restores PN-Induced Reduction of Hepatic Mononuclear Cell Number Through Recovery of Small Intestine and Portal Vein Blood Flows
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