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Clinical Outcomes of Nutritional Supply in Critically Ill Patients in the Prone Position
복와위 상태 중환자에서의 영양공급에 따른 임상적 예후 분석
J Clin Nutr 2018;10:2-8
Published online June 30, 2018
© 2018 Korean Society for Parenteral and Enteral Nutrition.

Yeonju Lee1, Hyung-Sook Kim1, Hyungwook Namgung1, Eun Sook Lee1, Euni Lee2, Young-Jae Cho3, Yeon Joo Lee3
이연주1, 김형숙1, 남궁형욱1, 이은숙1, 김은경2, 조영재3, 이연주3

1Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, 2College of Pharmacy, Seoul National University, Seoul, 3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
1분당서울대학교병원 약제부, 2서울대학교 약학대학, 3분당서울대학교병원 호흡기내과
Yeon joo Lee
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea
Tel: +82-31-787-7082, Fax: +82-31-787-4052, E-mail:
Received April 4, 2018; Revised June 22, 2018; Accepted June 23, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Enteral nutrition is recommended in critically ill patients. On the other hand, the recommendation of nutritional support is limited and often controversial in critically ill patients in the prone position. Therefore, this study evaluated the clinical outcomes of nutritional support in critically ill patients in the prone position.
Methods: A retrospective evaluation of the electronic medical records was conducted, including adult patients who were in the medical intensive care unit (ICU) in the prone position in Seoul National University Bundang Hospital from May 1, 2015 to June 30, 2017. The patients’ characteristics, nutritional support status while they were in the prone position, mortality in ICU and during hospitalization, ICU length of stay, mechanical ventilation days, and complications, such as ventilator associated pneumonia (VAP) and vomiting were collected.
Results: In total, 100 patients were included. Of these, 12 received enteral nutrition and parenteral nutrition and 88 received only parenteral nutrition. The groups were similar in terms of age, sex, number of comorbidity, weight, PaO2/FiO2, hours of prone position, Simplified Acute Physiology Score II (SAPS II), Acute Physiologic and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score. No differences were observed in ICU mortality (75.0% vs.46.6%; P=0.065), hospital mortality (83.3% vs. 58.0%; P=0.081), ICU length of stay (22.2±14.6 vs. 18.2±21.2; P=0.128) and mechanical ventilation days (19.3±14.8 vs. 14.5±19.1; P=0.098). In addition, there were no differences in the possible complications of the prone position, such as VAP (8.3% vs. 4.5%; P=0.480) and vomiting (8.3% vs. 1.1%; P=0.227).
Conclusion: No significant differences in the clinical outcomes were observed. Further studies will be needed to confirm the way of nutrition support while in the prone position.
Keywords : Prone position, Enteral nutrition, Parenteral nutrition, Critical illness


June 2018, 10 (1)