Nutrient stimulation of mesenteric blood flow - implications for older critically ill patients.
AuthorNguyen, TA; Abdelhamid, YA; Phillips, LK; Chapple, LS; Horowitz, M; Jones, KL; Deane, AM
Source TitleWorld Journal of Critical Care Medicine
PublisherBaishideng Publishing Group Inc.
Document TypeJournal Article
CitationsNguyen, T. A., Abdelhamid, Y. A., Phillips, L. K., Chapple, L. S., Horowitz, M., Jones, K. L. & Deane, A. M. (2017). Nutrient stimulation of mesenteric blood flow - implications for older critically ill patients.. World J Crit Care Med, 6 (1), pp.28-36. https://doi.org/10.5492/wjccm.v6.i1.28.
Access StatusOpen Access
Open Access at PMChttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295167
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death. In older critically ill patients, the administration of enteral nutrition acutely increases mesenteric blood flow, but whether this pathophysiological response is protective, or precipitates mesenteric ischaemia, is unknown. There are an increasing number of older patients surviving admission to intensive care units, who are likely to be at increased risk of postprandial hypotension, both during, and after, their stay in hospital. In this review, we describe the prevalence, impact and mechanisms of postprandial hypotension in older people and provide an overview of the impact of postprandial hypotension on feeding prescriptions in older critically ill patients. Finally, we provide evidence that postprandial hypotension is likely to be an unrecognised problem in older survivors of critical illness and discuss potential options for management.
- Click on "Export Reference in RIS Format" and choose "open with... Endnote".
- Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References