Nutrition During Targeted Temperature Management After Cardiac Arrest: Observational Study of Neurological Outcomes and Nutrition Tolerance
Abstract
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 0.05). 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.
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Early enteral nutrition may be associated with potential benefits in neurological outcomes and infectious complications after cardiac arrest.
“early EN may be associated with potential benefits in neurological outcomes and infectious complications after cardiac arrest,176,178”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [176]
Newer data demonstrated no difference in complications with early enteral nutrition (<48 hours) even during targeted temperature management.
“newer data demonstrated no difference in complications with early EN (<48 hours) even during targeted temperature management.19,174–177”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [176]
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Markers of intestinal injury are associated with endotoxemia in successfully resuscitated patients
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Nolan, J. P., Sandroni, C., Cariou, A., Cronberg, T., D’Arrigo, S., Haywood, K. L., Hoedemaekers, A. C. W. E., Lilja, G., Nikolaou, N. I., Olasveengen, T. M., et al. (2025) · Resuscitation · doi:10.1016/j.resuscitation.2025.110809 · Cited by 103 · see citing works
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“184,185 However, a large published study on early EN versus early parenteral nutrition in patients with shock 186 suggested a possible harmful effect of the enteral route, so EN regimens should be carefully evaluated in patients after CA who have hemodynamic impairment.”
BackgroundHirsch, K. G., Abella, B. S., Ghassemi, M. M., Bader, M., Barletta, J. F., Berg, K. M., Callaway, C., Friberg, H., Gilmore, E., Greer, D. M., et al. (2023) · Neurocritical Care · doi:10.1007/s12028-023-01871-6 · Cited by 50 · see citing works
“Moreover, in 2 other studies, early EN after CA during temperature control appeared safe and was even associated with better neurological outcomes [183, 184].”
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“Differences in case-mix and in care delivered during TTM [15, 27], together with residual confounding, complicate the interpretation of these results.”
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Post Cardiac Arrest Care in the Cardiac Intensive Care Unit
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“In the post-arrest population specifically, studies have shown conflicting results regarding the superiority of early (< 48 h after admission to the ICU) versus delayed (> 48 h after admission to the ICU) feeding in patients treated with TH [160, 161].”
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Reply to: immortal time bias in an observational study on enteral nutrition
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Perioperative Extracardiac Management in Low-flow States
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- Authors
- Martin, M., Reignier, J., Le Thuaut, A., Lacherade, J. C., Martin‐Lefèvre, L., Fiancette, M., Vinatier, I., Lebert, C., Bachoumas, K., Yehia, A., Henry Lagarrigue, M., Colin, G., & Lascarrou, J. B.
- Affiliations
- Médecine Intensive Réanimation University Hospital Centre Nantes France
- Centre Hospitalier Universitaire de Nantes (FR)
- Clinical Research Unit District Hospital Centre La Roche‐sur‐Yon France
- Medical‐Surgical Intensive Care Unit District Hospital Centre La Roche‐sur‐Yon France
- Centre Hospitalier Départemental Vendée (FR)
- Centre Hospitalier Universitaire de Clermont-Ferrand (FR)
- Corresponding author
- Lascarrou, Jean Baptiste
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2019-04-22
- Volume
- 44
- Issue
- 1
- Pages
- 138-145
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W2936189393
- Cited by
- 29
- References
- 0
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 13
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- targeted temperature management, cardiac arrest, early enteral nutrition, neurological outcome, negative energy balance, post-cardiac arrest syndrome, intensive care, ventilator-associated pneumonia, prokinetic drugs
- MeSH terms
- Food Intolerance, Body Temperature, Humans, Hypothermia, Induced, Intensive Care Units, Nervous System Physiological Phenomena, Retrospective Studies, Nutritional Support, Out-of-Hospital Cardiac Arrest
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