Application Of Early Post-pyloric Non-deceleration Feeding Strategy In Patients With Prone Ventilation

Research Purpose:1.Formulate the strategy of early post-pyloric feeding without slowing down for patients with prone ventilation.2.Observe the clinical effect of early pyloric undecelerated feeding strategy for patients with prone ventilation,so as to provide reference for patients with prone ventilation to achieve higher nutritional goals.Research Methods:1.By referring to relevant domestic and foreign guidelines and literature,the first draft of the non-decelerating feeding strategy behind the pyloric in the early stage of prone ventilation was developed.After two rounds of expert meetings,the draft was revised and improved to determine the final strategy.2.This study is a different period controlled study,with 84 effective samples collected.The convenience sampling method was used to select patients with prone ventilation who received early post-pyloric feeding in ICU,EICU and GICU in grade III,A hospital in Hangzhou City,Zhejiang Province from January 2019 to February 2021.Patients admitted from January 2019 to December 2019 were included in the control group(the deceleration strategy feeding group),and patients admitted from January 2020 to January 2021 were included in the study group(no deceleration strategy feeding group).Patients in both groups were treated with conventional procedures,and early post-pyloric feeding in prone position was carried out within 24～48hours after admission,and gastrointestinal tolerance was assessed every 4 hours in both groups.The control group was fed with deceleration,while the study group was fed without deceleration on the basis of evaluating gastrointestinal tolerance and monitoring intra-abdominal pressure.The nutrition intake,the rate of reaching the nutrition target,the incidence of aspiration,vomiting,diarrhea and respiratory associated pneumonia were compared between the two groups for 5 days.Research Results:The nutritional intake and the nutritional compliance rate of the patients in the study group were significantly higher than those in the control group(p<0.001).There were no significant differences in the incidence of aspiration,vomiting,diarrhea and respiratory associated pneumonia between the study group and the control group(p>0.05).The albumin and pre-albumin levels in the study group were higher than those in the control group(p<0.05).The difference of albumin and pre-albumin before and after treatment in the study group was higher than that in the control group(p<0.05).There were no significant differences in ICU hospitalization days and total hospitalization days between the two groups(p>0.05).Research Conclusion:Under the premise of dynamic monitoring of intra-abdominal pressure and assessment of gastrointestinal tolerance,the adoption of the pyloric undecelerated feeding strategy for patients with prone ventilation can significantly improve the daily nutrition compliance rate of patients and do not increase the incidence of aspiration,vomiting and respiratory associated pneumonia.