Enteral Feeding Intolerance: Updates in Definitions and Pathophysiology

Area of Science:

• Critical Care Medicine
• Gastroenterology
• Clinical Nutrition

Background:

• Enteral feeding intolerance (EFI) is prevalent in critically ill patients.
• Existing definitions of EFI are inconsistent, complicating research and clinical application.
• EFI is often linked to delayed gastric emptying but may involve diverse pathophysiological mechanisms.

Purpose of the Study:

• To review current definitions and pathophysiological mechanisms of EFI.
• To explore the clinical relevance and impact of EFI on patient outcomes.
• To propose a conceptual framework for a standardized EFI definition.

Main Methods:

• Literature review of existing definitions of EFI.
• Analysis of pathophysiological mechanisms contributing to EFI.
• Synthesis of evidence on clinical relevance and patient outcomes associated with EFI.

Main Results:

• Significant heterogeneity exists in current EFI definitions.
• Multiple underlying mechanisms contribute to EFI, leading to varied clinical presentations.
• A pragmatic clinical definition and a research-oriented definition are both necessary.

Conclusions:

• A consensus on a standardized definition for enteral feeding intolerance is crucial.
• A proposed conceptual framework can guide future research and clinical consensus.
• Standardizing EFI definitions will enhance understanding and improve interventions for critically ill patients.