Is enteral feeding tolerated during therapeutic hypothermia?
Abstract
Objective To determine whether patients undergoing therapeutic hypothermia following cardiac arrest tolerate early enteral nutrition. Methods We undertook a single-centre longitudinal cohort analysis of the tolerance of enteral feeding by 55 patients treated with therapeutic hypothermia following resuscitation from cardiac arrest. The observation period was divided into three phases: (1) 24h at target temperature (32-34 °C); (2) 24h rewarming to 36.5 °C; and (3) 24h maintained at a core temperature below 37.5 °C. Results During period 1, patients tolerated a median of 72% (interquartile range (IQR) 68.7%; range 31.3-100%) of administered feed. During period 2 (rewarming phase), a median of 95% (IQR 66.2%; range 33.77-100%) of administered feed was tolerated. During period 3 (normothermia) a median of 100% (IQR 4.75%; range 95.25-100%) of administered feed was tolerated. The highest incidence of vomiting or regurgitation of feed (19% of patients) occurred between 24 and 48 h of therapy. Conclusions Patients undergoing therapeutic hypothermia following cardiac arrest may be able to tolerate a substantial proportion of their daily nutritional requirements. It is possible that routine use of prokinetic drugs during this period may increase the success of feed delivery enterally and this could usefully be explored.
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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 [177]
The Results (lines 18–30) show that patients received and tolerated some enteral feeding during the first 48 hours of therapeutic hypothermia. But the Strengths and limitations section (lines 207–215) describes a retrospective, descriptive study with no control of feeding practices; it cannot establish that complication rates were no different from a comparator. The Results also report vomiting or regurgitation in 19% of patients during hours 24–48. (LLM, conf=0.88)
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References 19 · Cited by 36
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- Authors
- Williams, M.-L., & Nolan, J. P.
- Affiliations
- Royal United Hospital (GB)
- ORCID
- Nolan, Jerry P.
- Venue
- Resuscitation
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 85
- Issue
- 11
- Pages
- 1469-1472
- ISSN
- 0300-9572 (ISSN-L)
- OpenAlex
- W2006397509
- Cited by
- 36
- References
- 19
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 2
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Resuscitation (publishedVersion)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- 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
- therapeutic hypothermia, enteral nutrition, cardiac arrest, post-resuscitation care, feed tolerance, rewarming, prokinetic drugs, nutritional support
- MeSH terms
- Adult, Age Factors, Aged, Aged, 80 and over, Critical Care, Enteral Nutrition, Female, Follow-Up Studies, United Kingdom, Heart Arrest, Hospitals, General, Humans, Hypothermia, Induced, Intensive Care Units, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Sex Factors, Time Factors, Cohort Studies, Cardiopulmonary Resuscitation, Treatment Outcome, Risk Assessment, Patient Safety
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