Effect of timing of enteral nutrition initiation on poor prognosis in patients after cardiopulmonary bypass: a prospective observational study
Abstract
Background
Current guidelines recommend enteral nutrition (EN) should be implemented as early as possible in patients after cardiopulmonary bypass (CPB), but the optimal time to initiate EN is still controversial. Therefore, the aim of this study was to investigate the effect of timing of EN initiation on poor prognosis in patients after CPB.
Methods
We conducted a prospective observational study. Patients who underwent CPB in a tertiary hospital from September 1, 2021 to January 31, 2022 were consecutively included. The patients were divided into three groups according to the timing of EN initiation: <24 hours, 24-48 hours, and >48 hours. Unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals to identify independent risk factors for poor prognosis.
Results
A total of 579 patients were included in this study. There were 255 (44.0%) patients with EN <24 hours, 226 (39.0%) patients with EN 24-48 hours, and 98 (17.0%) patients with EN >48 hours. With EN <24 hours as reference, multivariate logistic analysis showed that EN 24-48 hours (OR =1.940, P =0.011) and EN > 48 hours (OR =8.826, P <0.001) was an independent risk factor for poor prognosis after CPB. Age (OR =1.028, P =0.009), emergency surgery (OR =3.740, P =0.021), operation time (OR =1.006, P <0.001), sequential organ failure assessment score (OR =2.284, P =0.001), nasogastric EN (OR =4.937, P =0.001) also increased the risk of poor prognosis after CPB.
Conclusions
Compared with early EN <24 hours, EN 24-48 hours and EN >48 hours will increase the risk of poor prognosis in patients after CPB.