Enteral Nutrition During Extracorporeal Membrane Oxygenation in the Neonatal and Pediatric Populations: A Literature Review

Abstract

Objectives: The number of infants and children requiring extracorporeal membrane oxygenation (ECMO) is rising. While critically ill, providers may believe that enteral nutrition puts the patient at risk for severe complications such as necrotizing enterocolitis. However, enteral nutrition is associated with the potential to improve the gut barrier and reduce the risk of morbidity and mortality. The purpose of this article is to review the existing evidence about providing exclusive enteral and parenteral nutrition and its association with rates of complications and mortality in critically ill neonatal and pediatric populations on ECMO.

Data sources: Literature addressing enteral nutrition while on ECMO for neonatal and pediatric populations was searched using PubMed, CINAHL, and Scopus.

Study selection: Studies ranged from 1998 to 2022 and were conducted mostly in the PICU and neonatal ICU settings.

Data extraction: Fourteen articles were reviewed after inclusion and exclusion criteria were applied.

Data synthesis: Characteristics included an even number of males and females in samples from mostly PICUs. The predominant underlying illnesses were neonatal pulmonary disease and cardiac disease. Upon reviewing the literature, three major themes were revealed: no significant complications with enteral feeding, underutilization of enteral feeding, and reduced mortality with enteral feeding.

Conclusion: The use of enteral nutrition in the neonatal and pediatric population while on ECMO has the potential to improve survival rates and reduce complications. Further studies are needed to investigate how to optimize this population's nutrition and develop feeding protocols and pathways.