Administration of enteral nutrition to adult patients in the prone position.

OBJECTIVE: To examine the safety and efficacy of administering enteral nutrition (EN) to patients in the prone position.

STUDY SELECTION AND DATA EXTRACTION: All English-language articles describing human studies identified from data sources were reviewed for inclusion. Included studies had to have at least two groups for comparison, one or all of which had to contain adult patients managed in the prone position.

DATA SYNTHESIS: Four studies were identified that met our inclusion criteria. Only two of the included studies were specifically designed to compare outcomes associated with EN in the prone versus supine position. The remaining two studies did not specifically compare EN in the prone versus supine position, but did provide some insight on the tolerability of EN in the prone position. Overall, administration of EN to patients in the prone position results in gastric residual volumes similar to those seen in the supine position and does not appear to increase the risk of vomiting or ventilator associated pneumonia.

CONCLUSIONS: There is limited evidence proving the safety and tolerability of EN administered to patients in the prone position; however, it does not substantially increase the rate of complications when compared to EN administered in the supine positioning.