Lucchini Alberto, Bonetti Ilaria, Borrelli Gloria, Calabrese Nicola, Volpe Sara, Gariboldi Roberto, Minotti Dario, Cannizzo Luigi, Elli Stefano, Fumagalli Roberto, Bambi Stefano
Assist Inferm Ric. 2017 Apr-Jun;36(2):76-83. doi: 10.1702/2721.27752.
. Enteral nutrition during prone positioning in mechanically ventilated patients.
The Enteral Nutrition (EN) tends to be stopped during prone positioning to prevent the risk of acid reflux and vomiting.
To compare the gastric residual volume during continuous enteral nutrition in patients in prone and supine position.
Observational restrospective study on Acute Respiratory Distress Syndrome patients, mechanically ventilated, with continuous enteral nutrition implemented according to the same protocol, in prone and supine position.
The 25 patients included had a mean age of 51.13±15.93 (range: 16-80) years. Gastic residual volume was checked on 656 occasions (408 in supine and 248 in prone position). Mean infusion rate was 63.3±18.5 ml/h: 62.1±18.9 ml/h in supine and 66.2±16.5 ml/h in prone position. The mean overall gastric residual volume was 24.4±54.2 ml: 20.6±18.9 ml in supime and 23.6±50.0 ml in prone posizion. In 4 occasions (2 in prone and 2 in supine position9, the gastric residual volume was > 300ml; EN was interrupted on 1 occasion with a gastric residual volume >500ml.
No clinically relevant differences of gastric residual volume were observed in prone and supine position. A protocol for the management of gastric residual volume allows a safe and effective administration of EN also in patients positioned for several hours in prone position.
机械通气患者俯卧位时的肠内营养。
在俯卧位期间往往会停止肠内营养,以防止胃酸反流和呕吐的风险。
比较俯卧位和仰卧位患者持续肠内营养期间的胃残余量。
对急性呼吸窘迫综合征患者进行观察性回顾性研究,这些患者接受机械通气,并按照相同方案在俯卧位和仰卧位实施持续肠内营养。
纳入的25例患者平均年龄为51.13±15.93岁(范围:16 - 80岁)。共检查了656次胃残余量(仰卧位408次,俯卧位248次)。平均输注速率为63.3±18.5毫升/小时:仰卧位为62.1±18.9毫升/小时,俯卧位为66.2±16.5毫升/小时。平均总体胃残余量为24.4±54.2毫升:仰卧位为20.6±18.9毫升,俯卧位为23.6±50.0毫升。有4次(俯卧位2次,仰卧位2次)胃残余量>300毫升;有1次胃残余量>500毫升时中断了肠内营养。
俯卧位和仰卧位的胃残余量在临床上无显著差异。胃残余量管理方案可使肠内营养在俯卧位数小时的患者中也能安全有效地进行。