Nutrición enteral (temprana) y estado hemodinámico en el paciente críticamente enfermo: ¿Qué debe saber el clínico de soporte nutricional?

Carlos Alfredo Galindo Martín; Enrique Monares Zepeda; Orlando Rubén Pérez Nieto

doi:10.35454/rncm.v1n1.077

Autores

Carlos Alfredo Galindo Martín https://orcid.org/0000-0002-9739-1647
Enrique Monares Zepeda https://orcid.org/0000-0003-1407-1478
Orlando Rubén Pérez Nieto https://orcid.org/0000-0003-2840-8924

DOI:

https://doi.org/10.35454/rncm.v1n1.077

Palavras-chave:

nutricion enteral, estabilidad hemodinamica, isquemia mesenterica no oclusiva

Resumo

Múltiples guías recomiendan el uso de soporte nutricional enteral temprano en pacientes críticamente enfermos, a su vez contraindica dicho inicio en pacientes con inestabilidad hemodinámica. El principal riesgo adjudicado al soporte enteral en este tipo de pacientes es la isquemia mesentérica no oclusiva
la cual cuenta con una gran mortalidad. Debido a la falta de evidencia concreta en esta área el presente trabajo propone la evaluación del paciente en forma integral, considerando los antecedentes del paciente, aminas vasoactivas (tendencias y dosis), signos vitales, condición clínica y niveles de lactato, con el fin de iniciar aporte enteral principalmente temprano. Posteriormente el monitoreo estrecho de signos de intolerancia enteral y deterioro clínico pudiendo iniciar el proceso diagnóstico y abordaje inmediato en el caso de isquemia mesentérica. Se abordan temas como vía de acceso para alimentación enteral, modalidad de soporte, fórmula a utilizar y conceptos básicos de shock, su manejo y mecanismos fisiopatológicos propuestos a isquemia intestinal no oclusiva.

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