Nutrition During Targeted Temperature Management After Cardiac Arrest: Observational Study of Neurological Outcomes and Nutrition Tolerance

Background Whether providing nutrition support is beneficial or deleterious during targeted temperature management (TTM) after cardiac arrest is unclear. We therefore performed a retrospective observational study to determine whether early nutrition was beneficial or deleterious during TTM. Methods...

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Published in:JPEN. Journal of parenteral and enteral nutrition 2020-01, Vol.44 (1), p.138-145
Main Authors: Martin, Maelle, Reignier, Jean, Thuaut, Aurélie, Lacherade, Jean Claude, Martin‐Lefèvre, Laurent, Fiancette, Maud, Vinatier, Isabelle, Lebert, Christine, Bachoumas, Konstantinos, Yehia, Aihem, Henry Lagarrigue, Matthieu, Colin, Gwenhael, Lascarrou, Jean Baptiste
Format: Article
Language:English
Subjects:
Body Temperature
cardiac arrest
Food Intolerance
Humans
Hypothermia, Induced
induced hypothermia
Intensive Care Units
Nervous System Physiological Phenomena
nutrition
Nutritional Support
Out-of-Hospital Cardiac Arrest - therapy
pneumonia
Retrospective Studies
targeted temperature management
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Summary:Background Whether providing nutrition support is beneficial or deleterious during targeted temperature management (TTM) after cardiac arrest is unclear. We therefore performed a retrospective observational study to determine whether early nutrition was beneficial or deleterious during TTM. Methods We retrospectively studied patients admitted to our intensive care unit (ICU) between 2008 and 2014 after successfully resuscitated cardiac arrest. We compared the group given nutrition within 48 hours after ICU admission (E+ group) to the group given nutrition later on or not at all (E‐ group). Results Of the 203 included patients, 143 were in the E+ group and 60 in the E‐ group. The E+ group had a significantly higher proportion of patients with a good 3‐month neurological outcome (42.7% vs 16.7%, P < 0.001). The difference remained significant after adjustment on a propensity score (odds ratio, 3.47; 95% confidence interval, 1.48–8.14; P = 0.004). The cumulative energy deficit for an energy goal of 20 kcal/kg/d from admission to day 7 was significantly lower in the E+ group (3304 ± 2863 kcal vs 5017 ± 2655 kcal, P < 0.001). Within the E+ group, the subgroups with nutrition initiation when body temperature was 0.05). Conclusions Early nutrition after cardiac arrest during TTM appears safe and may be associated with better neurological outcomes. These findings warrant a randomized controlled trial to resolve the remaining issues.
ISSN:0148-6071
1941-2444
DOI:10.1002/jpen.1596