Gut Luminal and Clinical Benefits of Early Enteral Nutrition in Shock

Purpose of Review Circulatory shock and subsequent gut hypoperfusion turn on the 'gut motor,' which impairs gut barrier function, promotes dysbiosis, and generates immune dysfunction to perpetuate inflammation. Clinicians may be reluctant to commence enteral nutrition in circulatory shock out of concern for bowel ischemia and splanchnic steal syndrome. Here, we identify contemporary studies which have evaluated the impact of enteral nutrition during circulatory shock on gut lumen functions and clinical outcomes. Recent Findings Recent studies show enteral nutrition has luminal benefits and is safe. Observational and pilot randomized controlled trial data evaluating early enteral nutrition in circulatory shock suggest an association between early enteral nutrition and improved clinical outcomes. Contemporary literature suggests enteral nutrition continues to have gut lumen benefits and is associated with improved clinical outcomes. Future trials are needed to evaluate optimal dose, timing, and composition of enteral nutrition in circulatory shock.