Saez de la Fuente et al.(9)9 Saez de la Fuente I, Saez de la Fuente J, Quintana Estelles MD, Garcia Gigorro R, Terceros Almanza LJ, Sanchez Izquierdo JA, et al. Enteral nutrition in patients receiving mechanical ventilation in a prone position. JPEN J Parenter Enteral Nutr. 2016;40(2):250-5.
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GRV/day (p = 0.054): Control: 126.6 ± 132.1 mL Intervention: 189.2 ± 203.2 mL Frequency of elevated GRV/day (p = 0.39): Control: 0.06 ± 0.01 Intervention: 0.09 ± 0.17 Frequency of vomiting/day (p = 0.53): Control: 0.016 ± 0.03 Intervention: 0.03 ± 0.09 Regurgitation/day (p =0.051): Control: 0 Intervention: 0.04 ± 0.13 |
Not evaluated |
Not evaluated |
ENT in critically ill patients with severe hypoxemia in prone position is viable and safe and is not associated with an increase in gastrointestinal complications |
Weaknesses: Duration of ENT during supine position significantly longer than the prone position Sample size not calculated Enteral nutrition volume administered differed during prone and supine position. Strengths: Crossover design |
Reignier et al.(19)19 Reignier J, Thenoz-Jost N, Fiancette M, Legendre E, Lebert C, Bontemps F, et al. Early enteral nutrition in mechanically ventilated patients in the prone position. Crit Care Med. 2004;32(1):94-9.
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GRV (mean of 5 days): Control: 10.6 (0 - 58.6)mL Intervention: 27.6 (3.8 - 119.4)mL Significant difference at days 1, 2 and 4 (p <0.01) Interruption of EN (p < 0.01): Control: 49% Intervention: 82% Vomiting (p < 0.001): Control: 26 episodes Intervention: 30 episodes RR = 2.5 (1.5 - 4.0) |
Associated with VM (NS): Control: 24% Intervention: 35% |
Infused volume (mean of 5 days): Control: 1095 (876 - 1336) mL Intervention: 754 (552 - 929) mL Significant difference in the five days (p <0.05). Mortality (NS): Control: 24% Intervention: 35% |
In severely hypoxemic patients on invasive MV, the administration of EN in the prone position is associated with a higher frequency of vomiting |
Weaknesses: Allocation of the subjects to the groups according to the need for pronation Regular measurement of gastric residual volume and vomiting may underestimate changes in gastric emptying and esophageal reflux No sample size calculation was presented. Strengths: Similar groups regarding age, gender and SAPS (minimizes confounding bias) |
Chen et al.(20)20 Chen SS, Tzeng YL, Gau BS, Kuo PC, Chen JY. Effects of prone and supine positioning on gastric residuals in preterm infants: a time series with crossover study. Int J Nurs Stud. 2013;50(11):1459-67.
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Redução % do VRG: 1º estágio - 50mL/kg/dia (p < 0,01): Controle: 23,26% Intervenção: 43,95% 2º estágio - 100mL/kg/dia (p < 0,01): Controle: 28,46% Intervenção: 48,07% |
Not evaluated |
Not evaluated |
Preterm infants have lower GRV in the prone position compared to the supine position, when 50 mL/kg/day and 100 mL/kg/day are offered |
Weaknesses: Short-term GRV assessment Breast milk may limit the generalization of results Fixed volumes of breast milk administered Strengths: Sample size calculated Random allocation Allocation Blinding |
Van der Voort et al.(21)21 van der Voort PH, Zandstra DF. Enteral feeding in the critically ill: comparison between the supine and prone positions: a prospective crossover study in mechanically ventilated patients. Crit Care. 2001;5(4):216-20.
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VRG em 3 horas (p = 0,69): Controle: 59,5 (0 - 180) mL Intervenção: 59,7 (0 - 200) mL VRG em 6 horas (p = 0,85): Controle: 110 (0 - 325) mL Intervenção: 95 (10 - 340) mL |
Not evaluated |
Not evaluated |
GRV did not differ significantly after 3 and 6 hours of enteral nutrition in the prone or supine position |
Weaknesses: Sample size not calculated Order of interventions was not randomized Does not inform method of administration of the ENT and initial volume Short duration of interventions Strengths: Constant EN volume Crossover design |
Lucchini et al.(22)22 Lucchini A, Bonetti I, Borrelli G, Calabrese N, Volpe S, Gariboldi R, et al. [Enteral nutrition during prone positioning in mechanically ventilated patients]. Assist Inferm Ric. 2017;36(2):76-83. Italian.
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VRG (p = 0,73): Controle: 20,62 ± 18,92mL I: 23,62 ± 50,02mL VRG > 300 ml (p = 0,65): Controle: 2 (0,4%) I: 2 (0,8%) |
Not evaluated |
Not evaluated |
The administration of ENT in the prone position did not promote a significant increase in GRV compared to the supine position |
Weaknesses: Sample size Criteria for pronation not described Strengths: Infused volume did not differ between groups |