PMID- 30030574
OWN - NLM
STAT- MEDLINE
DCOM- 20190213
LR  - 20190308
IS  - 1432-1238 (Electronic)
IS  - 0342-4642 (Linking)
VI  - 44
IP  - 8
DP  - 2018 Aug
TI  - Early enteral nutrition for cardiogenic or obstructive shock requiring 
      venoarterial extracorporeal membrane oxygenation: a nationwide inpatient database 
      study.
PG  - 1258-1265
LID - 10.1007/s00134-018-5319-1 [doi]
AB  - PURPOSE: Despite extensive research on enteral nutrition (EN) for patients in 
      shock, it remains unclear whether this should be postponed in patients with 
      cardiogenic or obstructive shock requiring venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO). In this study, we aimed to compare outcomes of early and 
      delayed EN for patients with cardiogenic or obstructive shock requiring VA-ECMO. 
      METHODS: In this retrospective database study drawing on the Japanese Diagnosis 
      Procedure Combination inpatient database from July 2010 to March 2016, we 
      identified patients with cardiogenic or obstructive shock who had received 
      VA-ECMO for more than 2 days. We allocated the patients to two groups: those who 
      received EN within 2 days (early) or 3 days or more (delayed) after starting 
      VA-ECMO. We then used a marginal structural model to analyze associations between 
      early EN and various outcomes, including in-hospital mortality and 28-day 
      mortality. RESULTS: We identified 1769 eligible patients during the 69-month 
      study period, 220 of whom (12%) received early EN. After using a marginal 
      structural model to adjust for baseline and time-dependent confounders, we found 
      that the early EN group showed significantly lower in-hospital mortality [hazard 
      ratio 0.78, 95% confidence interval (95% CI) 0.62-0.98, P = 0.032] and lower 
      28-day mortality (hazard ratio 0.74, 95% CI 0.56-0.97, P = 0.031) than the 
      delayed EN group. CONCLUSIONS: According to this retrospective database study, 
      early EN is not associated with harm but rather with lower mortality in patients 
      with cardiogenic or obstructive shock requiring at least 2 days of VA-ECMO.
FAU - Ohbe, Hiroyuki
AU  - Ohbe H
AUID- ORCID: 0000-0001-8544-2569
AD  - Department of Clinical Epidemiology and Health Economics, School of Public 
      Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan. 
      hohbey@gmail.com.
FAU - Jo, Taisuke
AU  - Jo T
AD  - Department of Health Services Research, Graduate School of Medicine, The 
      University of Tokyo, Tokyo, Japan.
FAU - Yamana, Hayato
AU  - Yamana H
AD  - Department of Health Services Research, Graduate School of Medicine, The 
      University of Tokyo, Tokyo, Japan.
FAU - Matsui, Hiroki
AU  - Matsui H
AD  - Department of Clinical Epidemiology and Health Economics, School of Public 
      Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan.
FAU - Fushimi, Kiyohide
AU  - Fushimi K
AD  - Department of Health Policy and Informatics, Tokyo Medical and Dental University 
      Graduate School of Medicine, Tokyo, Japan.
FAU - Yasunaga, Hideo
AU  - Yasunaga H
AD  - Department of Clinical Epidemiology and Health Economics, School of Public 
      Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan.
LA  - eng
GR  - H29-Policy-Designated-009/Ministry of Health, Labour and Welfare of 
      Japan/International
GR  - H29-ICT-Genral-004/Ministry of Health, Labour and Welfare of Japan/International
GR  - 17H04141/Ministry of Education, Culture, Sports, Science and Technology of 
      Japan/International
PT  - Journal Article
DEP - 20180720
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
SB  - IM
CIN - Intensive Care Med. 2018 Sep;44(9):1558-1560. PMID: 30054689
MH  - Aged
MH  - *Enteral Nutrition
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - Humans
MH  - Inpatients
MH  - Japan
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - *Shock, Cardiogenic/therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Bowel ischemia
OT  - Enteral nutrition
OT  - Extracorporeal membrane oxygenation
OT  - Marginal structural model
OT  - Venoarterial
EDAT- 2018/07/22 06:00
MHDA- 2019/02/14 06:00
CRDT- 2018/07/22 06:00
PHST- 2018/02/23 00:00 [received]
PHST- 2018/07/12 00:00 [accepted]
PHST- 2018/07/22 06:00 [pubmed]
PHST- 2019/02/14 06:00 [medline]
PHST- 2018/07/22 06:00 [entrez]
AID - 10.1007/s00134-018-5319-1 [pii]
AID - 10.1007/s00134-018-5319-1 [doi]
PST - ppublish
SO  - Intensive Care Med. 2018 Aug;44(8):1258-1265. doi: 10.1007/s00134-018-5319-1. 
      Epub 2018 Jul 20.