How can the risk of aspiration associated with enteral nutrition be decreased?

Elevating the head of the bed (HOB) to 30 degrees during enteral feeding is an important strategy to reduce the risk of aspiration. This positioning helps to utilize gravity to prevent the content of the stomach from backing up into the esophagus, which can lead to aspiration into the lungs. Aspiration can cause serious complications, including aspiration pneumonia, so maintaining an elevated position during and for a period after feeding is critical for patient safety.

Monitoring gastric residual volumes (GRV) is also part of this approach, as it helps to assess whether the stomach is emptying adequately. High residuals can indicate delayed gastric emptying, which increases the risk of aspiration; therefore, monitoring GRV helps inform decisions about adjusting the feeding regimen or further interventions.

While the use of sedatives could sometimes be necessary for patient comfort or compliance, they can alter a patient's ability to protect their airway. Larger bore feeding tubes may facilitate the passage of enteral nutrition but do not directly address the risk of aspiration. Increasing the volume of feedings could lead to gastric distension and delayed emptying, which would further increase the aspiration risk rather than decrease it. Thus, the practice of head elevation combined with monitoring GRV serves as an effective method to manage and minimize