feeding in prone position

Q: Patients should not be fed in prone positioning, and tube feeding should be stopped.

A) True

B) False

Answer: B

Conventionally, it was thought that in the prone position, the chances of aspiration or emesis go high, but tube feeding in the prone position is safe, particularly if placed post-pyloric. The only precaution needed is to keep the patient's head in a slightly elevated position (about 25 degrees). 

Said that high residual volumes should be monitored. Adjuvant use of Prokinetic agents (like erythromycin) is helpful.

#nutrition

#pulmonary

References:

1. Reignier J, Thenoz-Jost N, Fiancette M, et al. Early enteral nutrition in mechanically ventilated patients in the prone position. Crit Care Med 2004; 32:94.

2. Saez de la Fuente I, Saez de la Fuente J, Quintana Estelles MD, et al. Enteral Nutrition in Patients Receiving Mechanical Ventilation in a Prone Position. JPEN J Parenter Enteral Nutr 2016; 40:250.

3. Reignier J, Dimet J, Martin-Lefevre L, et al. Before-after study of a standardized ICU protocol for early enteral feeding in patients turned in the prone position. Clin Nutr 2010; 29:210.

4. Linn DD, Beckett RD, Foellinger K. Administration of enteral nutrition to adult patients in the prone position. Intensive Crit Care Nurs 2015; 31:38.