Response to enteral nutrition can be measured by assessing the amount of enteral nutrition received compared to a prescribed target, gastric residual volumes or a variety of gastrointestinal symptoms (abdominal distension, pain, bowel output). Enteral feeding tolerance is not well defined and several definitions exist in clinical practice and the literature.
Feasibility/Equipment: Assessed daily in clinical practice with no specific equipment needed.
Scoring information: No established scoring system exists to measure response to enteral nutrition. Tolerance is assessed often by subjective measures and is not standardised.
Cost: No additional costs involved.
Evidence: A systematic review of enteral feeding intolerance found a variety of different definitions exist and there is no standardised approach to classifying or scoring the response to enteral nutrition. Response to enteral nutrition may be measured by volume of feed received but this is dependent on other factors such as feed interuptions for procedures. Response may also be measured by monitoring of gastrointestinal symptoms but no agreement has been reached on thresholds that indicate an intolerance to enteral nutrition.
Accuracy / measurement properties: Response is generally assessed at the bedside by ICU healthcare professionals and as such the assessment is highly subjective.
References:
Jenkins B, Calder PC, Marino LV. A systematic review of the definitions and prevalence of feeding intolerance in critically ill adults. Clin Nutr ESPEN. 2022 Jun;49:92-102.
Blaser AR, Starkopf J, Kirsimägi Ü, Deane AM. Definition, prevalence, and outcome of feeding intolerance in intensive care: a systematic review and meta-analysis. Acta Anaesthesiol Scand. 2014 Sep;58(8):914-22.
Reintam Blaser A, Deane AM, Preiser JC, Arabi YM, Jakob SM. Enteral Feeding Intolerance: Updates in Definitions and Pathophysiology. Nutr Clin Pract. 2021 Feb;36(1):40-49.