Description: Enteral nutrition is usually provided using a whole protein formula. Peptide based formulas contain proteins that have been enzymatically hydrolysed to dipeptides and tripeptides. These hydrolysed proteins are often combined with a higher medium-chain triglyceride content to produce a formula which may be easier to absorb and utilise (Elfadil et al. 2023).  

Feasibility/Equipment: No specialist equipment is required to monitor use of peptide based formulas and recording of feed type provided is part of routine care on the ICU. Peptide based enteral nutrition formulas are widely available for use.  

Scoring information: No specific scoring scale is required. Type of enteral formula provided is documented in critical care notes and fluid charts.  

Cost: Cost are low, and no specific training is necessary.

Evidence: Use of peptide based formulas significantly reduced the duration of enteral feeding intolerance compared with standard whole protein enteral formulas in a prospective randomised study in medical and surgical critical care units (Seres and Ippolito, 2017). Liu et al. (2016) Demonstrated a lower mean maximum gastric residual volume in patients receiving peptide based formulas compared to standard enteral nutrition in the ICU setting post abdominal surgery. Wang et al. (2022) noted an increase in calories and protein delivered in patients in the ICU with acute gastrointestinal injury who were provided with peptide based enteral feed compared to standard feed.


Mohamed Elfadil O, Shah RN, Hurt RT, Mundi MS. Peptide-based formula: Clinical applications and benefits. Nutr Clin Pract. 2023 Apr;38(2):318-328. doi: 10.1002/ncp.10961

Seres DS, Ippolito PR. Pilot study evaluating the efficacy, tolerance and safety of a peptide‐based enteral formula versus a high protein enteral formula in multiple ICU settings (medical, surgical, cardiothoracic). Clin Nutr. 2017;36(3): 706‐709. doi:10.1016/j.clnu.2016.04.016

Liu MY, Tang HC, Hu SH, Chang SJ. Peptide‐based enteral formula improves tolerance and clinical outcomes in abdominal surgery patients relative to a whole protein enteral formula. World J Gastrointest Surg. 2016;8(10):700‐705. doi:10.4240/wjgs.v8.i10.700

Wang YQ, Li YH, Li YT, Li HX, Zhang D. Comparisons between short‐peptide formula and intact‐protein formula for early enteral nutrition initiation in patients with acute gastrointestinal injury: a single‐center retrospective cohort study. Ann Transl Med. 2022; 10(10):573. doi:10.21037/atm-22-1837

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