CC BY-NC-ND 4.0 · Journal of Cardiac Critical Care TSS 2022; 06(01): 001-004
DOI: 10.1055/s-0042-1750425

Nutrition Aggrandizement while on ECMO

Poonam Malhotra Kapoor
1   Department of Cardiac Anaesthesia and Critical Care, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations

Nutrition accrual on extracorporeal membrane oxygenation (ECMO) is the need of the hour. The crescendo interest in nutrition optimization on ECMO comes in the wake of the recent American Society for Parenteral and Enternal Nutrition (ASPEN) guidelines on pediatric patients.[1] Due to the technical hazards of ECMO, the presence of a multitude of inotropes, hemodynamic perturbations, and the risk of ischemic bowel, the association with nutrition therapy on ECMO is controversial.[2] The crescendo waxing and waning of feeding on ECMO are to be avoided. A recent review round-up of the literature assures that beginning enteral nutrition (EN) early in ECMO is secure and circumspect.[3]

Most of these indisposed ill ECMO patients have limited nutrients as endogenous stores; thus, it is important to administer nutritional support as early as possible in these moribund patients. So, relatively high nutritional requirements, with early institution of nutritional support, is important.[4] [5] This, however, is delayed in most intensive care unit (ICU) settings. So, EN is ideal as it stimulates the secretion of intestinal hormones.[6] As ECMO patients have limited nutritional reserves and high nutritional requirements are essential in these sick patients, early feeding on ECMO is essentially needed.[7] As EN is begun, multifold benefits appear, some of which are enlisted in [Table 1].

Table 1

Benefits of enteral nutrition

• Prevents sepsis

• Stimulates structural and functional changes in the gut through the release of intestinal hormones in the gut

• Is well-tolerated and safe

• High vasopressor support can be started

• Post cardiopulmonary bypass (CPB), an ECMO on high vasopressors, enteral nutrition (EN) is successful

Publication History

Article published online:
01 June 2022

© 2022. Official Publication of The Simulation Society (TSS), accredited by International Society of Cardiovascular Ultrasound (ISCU). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India