Enteral Feeding Intolerance in Adult Patients Receiving Mechanical Ventilation: A Comprehensive Review

Area of Science:

• Critical care medicine
• Gastroenterology
• Nursing practice

Background:

• Enteral feeding intolerance is a frequent gastrointestinal dysfunction in adults on mechanical ventilation.
• Variability in definition and assessment complicates diagnosis and management.
• Untreated intolerance can lead to underfeeding and adverse patient outcomes.

Purpose of the Study:

• To review current knowledge on enteral feeding intolerance.
• To identify at-risk populations, clinical signs, diagnostic methods, and treatments.
• To discuss implications for nursing practice.

Main Methods:

• Literature review and synthesis of existing data on enteral feeding intolerance.
• Analysis of diagnostic criteria, symptoms, and management strategies.
• Examination of clinical implications for nursing.

Main Results:

• Enteral feeding intolerance is characterized by altered GI function, high gastric residual volume, or inadequate nutrition delivery.
• Diagnosis often combines GI symptoms (e.g., vomiting, distention, diarrhea) with high gastric residual volume.
• Promotility agents and reduced formula rates are common interventions.

Conclusions:

• Many current assessment findings are subjective; objective biomarkers are needed.
• Routine gastric residual volume measurement is not always indicated but useful for at-risk patients.
• Nurses require education on assessment, treatment, and differentiation from other GI complications.