Why is feeding a patient before hemodynamic stability has been achieved not recommended?

• A. It may cause fluid overload
• B. It may increase the risk of intestinal ischemia
• C. It may cause hyperglycemia
• D. It may increase infection risk

Answer: (B)

In unstable patients, the gut is vulnerable because blood flow to the intestines is already compromised. Enteral feeding raises the gut’s metabolic demand, and when hemodynamics are not stable (often with shock or on vasopressors), splanchnic perfusion is reduced to other organs. This mismatch between increased nutritional delivery and limited intestinal blood flow can lead to intestinal ischemia or mesenteric damage. So delaying feeding until stability is restored helps protect the gut from hypoperfusion injury. Once stabilized, cautious initiation of enteral nutrition can proceed. While other issues like fluid balance or blood sugar can also be concerns, the acute risk driving the recommendation is intestinal ischemia due to inadequate gut perfusion.