Enteral Nutrition in Patients Receiving Mechanical Ventilation in a Prone Position.

Autor: Saez de la Fuente I; Department of Intensive Care Medicine, Hospital Universitario, Madrid, Spain isaezdelafuente@gmail.com., Saez de la Fuente J; Department of Pharmacy, Hospital Universitario Infanta Leonor, Madrid, Spain., Quintana Estelles MD; Department of Intensive Care Medicine, Hospital Universitario, Madrid, Spain., Garcia Gigorro R; Department of Intensive Care Medicine, Hospital Universitario, Madrid, Spain., Terceros Almanza LJ; Department of Intensive Care Medicine, Hospital Universitario, Madrid, Spain., Sanchez Izquierdo JA; Department of Intensive Care Medicine, Hospital Universitario, Madrid, Spain., Montejo Gonzalez JC; Department of Intensive Care Medicine, Hospital Universitario, Madrid, Spain.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2016 Feb; Vol. 40 (2), pp. 250-5. Date of Electronic Publication: 2014 Oct 01.
DOI: 10.1177/0148607114553232
Abstrakt: Background: Patients treated with mechanical ventilation in the prone position (PP) could have an increased risk for feeding intolerance. However, the available evidence supporting this hypothesis is limited and contradictory.
Objective: To examine the feasibility and efficacy of enteral nutrition (EN) support and its associated complications in patients receiving mechanical ventilation in PP.
Methods: Prospective observational study including 34 mechanically ventilated intensive care patients who were turned to the prone position over a 3-year period. End points related to efficacy and safety of EN support were studied.
Results: In total, more than 1200 patients were admitted to the intensive care unit over a period of 3 years. Of these, 34 received mechanical ventilation in PP. The mean days under EN were 24.7 ± 12.3. Mean days under EN in the supine position were significantly higher than in PP (21.1 vs 3.6; P < .001), but there were no significant differences in gastric residual volume adjusted per day of EN (126.6 vs 189.2; P = .054) as well as diet volume ratio (94.1% vs 92.8%; P = .21). No significant differences in high gastric residual events per day of EN (0.06 vs 0.09; P = .39), vomiting per day of EN (0.016 vs 0.03; P = .53), or diet regurgitation per day of EN (0 vs 0.04; P = .051) were found.
Conclusions: EN in critically ill patients with severe hypoxemia receiving mechanical ventilation in PP is feasible, safe, and not associated with an increased risk of gastrointestinal complications. Larger studies are needed to confirm these findings.
(© 2014 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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