Most all recent studies show Enteral Nutrition (EN) can be delivered safely to patients on vasopressors. In fact, many studies show an outcome benefit of early EN (EEN) in ICU patients who are receiving vasopressors.

It appears that there are doses of norepinephrine (or equivalent) that are safer, and perhaps beneficial, in which to provide EN.

Based on existing data, a suggested this cutoff appears to lay between 0.14 and 0.3 μg/kg/d norepinephrine or equivalent.

It is also essential to realize that slow advance of trophic feeds, perhaps with maintenance of trophic feeding with supplemental PN until full stability is achieved.

Without doubt, patients exhibiting signs of feeding intolerance and patients who are not resuscitated should not receive EN until patient is stabilized further.

Future meaningful randomized controlled data are needed in this field as most all existing studies are retrospective observational studies or large health outcome databases trials.

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