Patient selection: ICU patient receiving enteral nutrition
Major risk factors:
(1
) history of aspiration (documented previous episode)
(2) decreased level of consciousness (sedation, increased intracranial pressure, coma)
(3) neuromuscular disease
(4) structural abnormalities of the aerodigestive tract
(5) endotracheal intubation
(6) vomiting
(7) persistently high gastric residual volumes
(8) prolonged supine position
Additional risk factors:
(1) presence of a nasoenteric tube
(2) intermittent or noncontinuous feeding
(3) thoracoabdominal trauma or surgery
(4) delayed gastric emptying
(5) poor oral care
(6) older age
(7) inadequate nursing staff
(8) large size or large diameter of the feeding tube
(9) malpositioned feeding tube
(10) being transported