Nutrition entérale et ventilation mécanique en décubitus ventral

Early enteral nutrition (EN) is a key component of the care of critically ill patients treated with invasive mechanical ventilation. However, early EN in the critically ill is often poorly tolerated with subsequent risks of vomiting, aspiration and ventilator-associated pneumonia. Patients turned in the prone position are at increased risk for intolerance to early EN. They often exhibit a number of factors associated with impaired gastric motility. An original approach for EN in patients turned in the prone position including 25°-head elevation in the prone position, increased acceleration to target rate of EN and prophylactic erythromycin allowed the delivery of larger EN volumes without increasing vomiting or ventilator-associated pneumonia.