Outcomes Associated With Delayed Enteral Feeding After Cardiac Arrest Treated with Veno-Arterial Extracorporeal Membrane Oxygena

This retrospective, single-center analysis reviewed 142 consecutive patients with cardiac arrest treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and targeted temperature management (TTM) to determine the impact of enteral feeding on clinical outcomes and survival. The authors propose that feeding may lead to redistribution of blood flow from the brain to the gut, thus decreasing brain perfusion at a vulnerable time. In contrast to other studies which demonstrate benefits with early feeding in critically ill patients, this study included a population that was presumably well nourished and ambulatory prior to admission. Additionally, TTM was used for all patients and may have contributed to reduced gut motility. Despite limitations that include a non-randomized, single-center design, this study provides important cautions about early enteral feeding in this “ultra-sick” population that warrant further study.