Would prone position be recommended in a patient with elevated GRVs?

Would prone position be recommended in a patient with elevated GRVs?

• A. No, may increase the risk of aspiration.
• B. Yes, prone positioning is recommended for elevated GRV.
• C. Only during feeding.
• D. Only if connected to continuous feeding.

Answer: (A)

Elevated gastric residual volumes indicate delayed gastric emptying and a higher risk that gastric contents can reflux and be aspirated into the lungs during feeding. Prone positioning can compromise airway protection and alter gastric dynamics in ways that may increase the chance of aspiration, especially when the stomach isn’t emptying well. For this reason, prone positioning is not recommended in a patient with elevated GRVs. Instead, keep the patient in a semi-upright position (head of bed about 30-45 degrees) to reduce aspiration risk, and consider managing feeding with slower/paused feeds and prokinetics as appropriate. Prone has other indications, such as certain cases of severe respiratory failure, but not to mitigate elevated GRV-related aspiration risk.

Elevated gastric residual volumes indicate delayed gastric emptying and a higher risk that gastric contents can reflux and be aspirated into the lungs during feeding. Prone positioning can compromise airway protection and alter gastric dynamics in ways that may increase the chance of aspiration, especially when the stomach isn’t emptying well. For this reason, prone positioning is not recommended in a patient with elevated GRVs. Instead, keep the patient in a semi-upright position (head of bed about 30-45 degrees) to reduce aspiration risk, and consider managing feeding with slower/paused feeds and prokinetics as appropriate. Prone has other indications, such as certain cases of severe respiratory failure, but not to mitigate elevated GRV-related aspiration risk.