Format

Send to

Choose Destination
Clin Nutr. 2010 Apr;29(2):210-6. doi: 10.1016/j.clnu.2009.08.004. Epub 2009 Aug 26.

Before-after study of a standardized ICU protocol for early enteral feeding in patients turned in the prone position.

Author information

1
Medical-Surgical Intensive Care Unit, District Hospital Center, La Roche-sur-Yon, France; Clinical Research Unit, District Hospital Center, La Roche-sur-Yon, France. jean.reignier@chd-vendee.fr

Abstract

BACKGROUNDS & AIMS:

To evaluate an intervention for improving the delivery of early enteral nutrition (EN) in patients receiving mechanical ventilation with prone positioning (PP).

METHODS:

Eligible patients receiving EN and mechanical ventilation in PP were included within 48h after intubation in a before-after study. Patients were semi-recumbent when supine. Intolerance to EN was defined as residual gastric volume greater than 250ml/6h or vomiting. In the before group (n=34), the EN rate was increased by 500ml every 24h up to 2000ml/24h; patients were flat when prone and received erythromycin (250mgIV/6h) to treat intolerance. In the intervention group (n=38), the EN rate was increased by 25ml/h every 6h to 85ml/h, 25 degrees head elevation was used in PP, and prophylactic erythromycin was started at the first turn.

RESULTS:

Compared to the before group, larger feeding volumes were delivered in the intervention group (median volume per day with PP, 774ml [IQR 513-925] vs. 1170ml [IQR 736-1417]; P<0.001) without increases in residual gastric volume, vomiting, or ventilator-associated pneumonia.

CONCLUSION:

An intervention including PP with 25 degrees elevation, an increased acceleration to target rate of EN, and erythromycin improved EN delivery.

PMID:
19709786
DOI:
10.1016/j.clnu.2009.08.004
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center