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Updated: Sep 6, 2025

An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Challenges to Provision of Adequate Medical Nutrition Therapy in a Critically Ill COVID-19 Patient Fed in the Prone
Terry Brown1, Riva Touger-Decker1, Susan Roberts1
1Department of Clinical and Preventive Nutrition Sciences, Rutgers School of Health Professions, Newark, New Jersey (Ms Brown and Dr Touger-Decker); HealthTrust Supply Chain, Food and Nutrition Services, Coppell, Texas (Mr Brown); Keiser University, Melbourne, Florida (Dr Roberts); Medical City Dallas Hospital, Food and Nutrition Services, Dallas, Texas (Ms Reed); Department of Internal Medicine, East Carolina University, Greenville, North Carolina (Dr Matarese); and Rutgers University, Newark, New Jersey (Dr Matarese).
Abstract:
Adults with acute respiratory distress syndrome (ARDS) may experience enteral nutrition (EN) intolerance. They often require mechanical ventilation and other specialized management including prone positioning. There is a controversy as to whether patients fed in prone position experience more EN intolerance than when they are in supine position. This narrative review synthesizes the literature published between 2001 and 2021 in adults with ARDS who are fed EN while in the prone position to determine safety and tolerance. A case of an adult patient with Down syndrome who developed ARDS due to COVID-19 and required EN while in prone position is presented.
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