Nutritional support in patients with extracorporeal life support and ventricular assist devices

Current Opinion in Critical Care
Christian StoppeGunnar Elke

Abstract

Extracorporeal life support (ECLS) including venovenous and venoarterial extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VAD) provide mechanical pulmonary and circulatory support, respectively, in patients with acute pulmonary or cardiovascular failure. This review discusses recently published data regarding specific topics of nutritional support in patients with ECLS and VAD. ECLS may aggravate loss of endogenous and exogenous micronutrients and macronutrients. Observational studies have shown that enteral nutrition is feasible and most commonly used in patients with ECLS. Indirect calorimetry may be feasible for measuring energy expenditure during ECLS. Specific tools are available to assess malnutrition or nutrition risk in patients with VAD but require further validation in the perioperative setting. If parenteral nutrition is indicated, the use of intravenous lipid emulsions may be associated with membrane oxygenator dysfunction of the ECLS device or increased infectious risk in patients with VAD. Despite the exponential use of ECLS and VAD over the last decade, the role of nutrition on clinical outcome in this patient population remains an important but yet underinvestigated field.

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Citations

Jun 15, 2018·Current Opinion in Critical Care·Arthur R H van Zanten
Mar 27, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Akihito SaitoIssei Komuro
Mar 30, 2019·Nutrition and Metabolic Insights·Marko BobanAleksandar Vcev
Jan 14, 2021·Journal of Intensive Care·Hanneke Pierre Franciscus Xaverius MoonenArthur Raymond Hubert van Zanten
Feb 7, 2021·European Journal of Pediatrics·Ilaria AmodeoGiacomo Cavallaro
Jun 17, 2019·The Journal of Thoracic and Cardiovascular Surgery·Christian StoppeDaren K Heyland

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NCT02530788

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