Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec;38(6):1236-1246.
doi: 10.1002/ncp.11045. Epub 2023 Jul 20.

Enteral feeding tolerance during pharmacologic neuromuscular blockade

Roland N Dickerson  1 , Julie E Farrar  1 , Saskya Byerly  2 , Dina M Filiberto  2
Affiliations
Review

Enteral feeding tolerance during pharmacologic neuromuscular blockade

Roland N Dickerson et al. Nutr Clin Pract. 2023 Dec.

Abstract

A common misperception is that critically ill patients who receive paralytic therapy will not tolerate enteral nutrition. As a result, some clinicians empirically withhold enteral feedings for critically ill patients who receive neuromuscular blocker pharmacotherapy (NMB). The intent of this review is to examine the evidence regarding enteral feeding tolerance for critically ill patients given NMB. Studies evaluating enteral feeding during paralytic therapy are provided and critiqued. Evidence examining enteral feeding tolerance during NMB is limited. Enteral feeding intolerance is more likely attributable to the underlying illnesses and concurrent opioid analgesia, sedation, and vasopressor therapies. Most critically ill patients can be successfully fed during NMB. Prokinetic pharmacotherapy may be warranted in some patients.

Keywords: critical illness; enteral nutrition; feeding tolerance; neuromuscular blockade.

PubMed Disclaimer

References

REFERENCES

    1. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79. doi:10.1016/j.clnu.2018.08.037
    1. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition Support therapy in the adult critically ill patient: society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159-211. doi:10.1177/0148607115621863
    1. da Silva JSV, Seres DS, Sabino K, et al. ASPEN consensus recommendations for refeeding syndrome. Nutr Clin Pract. 2020;35(2):178-195. doi:10.1002/ncp.10474
    1. Dickerson RN, Mitchell JN, Morgan LM, et al. Disparate response to metoclopramide therapy for gastric feeding intolerance in trauma patients with and without traumatic brain injury. JPEN J Parenter Enteral Nutr. 2009;33(6):646-655. doi:10.1177/0148607109335307
    1. Morgan LM, Dickerson RN, Alexander KH, Brown RO, Minard G. Factors causing interrupted delivery of enteral nutrition in trauma intensive care unit patients. Nutr Clin Pract. 2004;19(5):511-517. doi:10.1177/0115426504019005511

MeSH terms

LinkOut - more resources