Post-pyloric Feeding and Feeding Intolerance in ARDS Patients Receiving Prone Position Ventilation

Post-pyloric Feeding and Feeding Intolerance in ARDS Patients Undergoing Prone Position Ventilation: a Single-center, Retrospective Study

Evidence remains limited regarding the optimal enteral nutrition (EN) route for acute respiratory distress syndrome (ARDS) patients undergoing prone positioning. This study aimed to explore the association of post-pyloric feeding with feeding intolerance (FI), specifically in that population.

Study Overview

• Status: Completed
• Conditions: Clinical Outcomes

Detailed Description

This single-center retrospective study included adult patients with ARDS who received prone position ventilation at Zhongda Hospital, Southeast University, between July 30, 2016, and April 30, 2024. The primary outcome was the incidence of FI, defined as the failure to achieve an enteral energy intake of 17.5 kcal/kg/day within 72 hours of initiating EN. The statistical approaches utilized included multivariate regression, inverse probability weighting model, and marginal structural cox model to ensure the robustness of our findings. Subgroup analyses were also performed.

• Study Type: Observational
• Enrollment (Actual): 319

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

intensive care unit

Description

Inclusion Criteria:

1. age ≥ 18 years old
2. ARDS, defined by the Berlin standard
3. patients receiving prone position ventilation treatment

Exclusion Criteria:

1. No enteral nutrition within 4 days after initiation of invasive mechanical ventilation
2. Duration of invasive mechanical ventilation <72 hours after initiation of enteral nutrition
3. Prone positioning initiated >3 days after EN
4. Duration of each prone session <12 hours
5. Severe acute pancreatitis
6. Contraindications to early enteral nutrition

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
gastric feeding; Patients receiving gastric feeding
post-pyloric feeding; Patients receiving post-pyloric feeding

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of FI	Incidence of feeding intolerance during enteral nutrition within 72 hours of initiating EN	at day 3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
28-day mortality	mortality in Day 28	at day 28
Incidence of enteral nutrition-related complications	Incidence of feeding-related complications during enteral nutrition	up to 3 days
ICU mortality	the survival rate(survival/total) during ICU stay	up to 24 months
VFDs at day 28	defined as the number of days between successful weaning from MV and day 28 after study enrollment	28 days
Length of ICU stay	the number of days from ICU admission to ICU discharge or death	up to 24 months

Collaborators and Investigators

• Sponsor: Southeast University, China
• Investigators: Study Director: ling liu, phD, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University

Study record dates

Study Major Dates

• Study Start (Actual): July 30, 2016
• Primary Completion (Actual): April 30, 2024
• Study Completion (Actual): December 30, 2024

Study Registration Dates

• First Submitted: February 12, 2026
• First Submitted That Met QC Criteria: February 12, 2026
• First Posted (Actual): February 19, 2026

Study Record Updates

• Last Update Posted (Actual): March 30, 2026
• Last Update Submitted That Met QC Criteria: March 24, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: prone nutrition

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No