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Nutrition du patient post arrêt cardio-respiratoire

Year: 2026
Type: dissertation
Study design: Observational Study
Abstract: Cardiorespiratory arrest (CRA) is a severe condition associated with a poor prognosis, with survival rates below 10%. Although early nutrition is recommended in the intensive care setting, data specific to post-CRA patients remain limited, and optimal strategies are not clearly defined. In this context, we conducted a multicenter observational study aimed at describing nutritional practices in the ICU among patients admitted after CRA and evaluating their association with 90-day mortality. Among the 1,691 patients included, 1,313 (78%) had an indication for nutritional support, of whom 953 (73%) received nutrition. Nutrition was initiated at a median of day 2 [2–3], predominantly via the enteral route (92%). Caloric intake was 11 kcal/kg/day on day 1 and averaged 17.2 kcal/kg/day over the first week. Nutrition was associated with a reduction in 90-day mortality (61% vs. 70%, p = 0.002), confirmed after adjustment (HR = 0.56 [0.47–0.67], p < 0.001). Caloric intake between 0 and 6 kcal/kg/day was associated with increased mortality compared to 6–10 kcal/kg/day, with no significant difference beyond 10 kcal/kg/day. Patients who received nutrition had a higher incidence of mesenteric ischemia (1.2% vs. 0%, p = 0.042), but without a significant increase in gastrointestinal bleeding or the need for renal replacement therapy. Duration of mechanical ventilation and length of stay were longer in nourished patients, likely reflecting survival bias. In conclusion, early nutrition after CRA appears feasible and is associated with improved survival, without a demonstrated impact on neurological outcomes. However, nutrition is associated with an increased incidence of mesenteric ischemia, suggesting the need for particular caution, especially in patients with shock. These findings highlight the need for randomized controlled trials to determine the optimal nutritional management in this population.
Source: HAL
Language: French
Field: Nursing
Open Access status: green
OpenAlex ID: W7221264813
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