FACTORS AFFECTİNG ENTERAL FEEDİNG INTOLERANCE İN INTENSİVE CARE UNİT PATİENTS (EFI-ICU)

August 20, 2026 updated by: Eda Cirit Bardakçi

FACTORS AFFECTİNG ENTERAL FEEDİNG INTOLERANCE İN INTENSİVE CARE UNİT PATİENTS: A PROSPECTİVE OBSERVATİONAL STUDY

Enteral nutrition is the first-line nutritional support method in critically ill patients because it helps preserve gastrointestinal system integrity, reduce the risk of infection, and meet metabolic requirements. However, gastrointestinal motility is frequently impaired in critically ill patients due to physiological stress, hemodynamic instability, sedative and vasopressor medications, mechanical ventilation, and underlying diseases. This may result in enteral feeding intolerance (EFI), which complicates nutritional management.

This prospective observational study aims to determine the demographic, clinical, laboratory, and treatment-related factors associated with enteral feeding intolerance in adult intensive care unit patients and to evaluate the association between enteral feeding intolerance and morbidity and mortality.

Adult patients who are started on enteral nutrition in the Anesthesiology and Reanimation Intensive Care Unit will be prospectively followed. No additional intervention will be performed. Patients will be monitored according to routine intensive care and enteral nutrition protocols. Enteral feeding intolerance and potentially associated factors will be recorded prospectively.

The study is planned to include 102 patients.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

Enteral nutrition is an important component of nutritional support in critically ill patients. However, enteral feeding intolerance is frequently observed in intensive care units and may result from impaired gastrointestinal motility associated with critical illness, hemodynamic instability, sedative and vasopressor use, mechanical ventilation, and underlying diseases.

In this study, demographic, clinical, laboratory, physiological, nutritional, and treatment-related variables that may affect the development of enteral feeding intolerance will be evaluated prospectively.

All adult patients admitted to the intensive care unit who are planned to receive enteral nutrition will be screened daily. Patients meeting the eligibility criteria will be enrolled after informed consent has been obtained from the patient or legally authorized representative.

Because this is an observational study, there will be no randomization and no investigator-assigned intervention. Patients will be classified according to their natural clinical course into an enteral feeding intolerance group and a non-enteral feeding intolerance group.

Demographic characteristics, admission diagnosis, APACHE II, SOFA, and Glasgow Coma Scale scores will be recorded. Daily clinical variables including bowel sounds, presence of stool, sedation, opioid use, vasopressor requirement, sepsis, and aspiration pneumonia will also be recorded.

Routine laboratory parameters including total protein, albumin, C-reactive protein, procalcitonin, lactate, hemoglobin, leukocyte count, and lymphocyte count will be obtained from the hospital electronic medical record twice weekly according to routine clinical practice.

The modified Nutrition Risk in Critically Ill (mNUTRIC) score and Prognostic Nutritional Index (PNI) will be calculated. Mechanical ventilation characteristics, enteral nutrition initiation time, formula type, daily energy and protein targets, delivered amounts, and interruptions of enteral nutrition will be recorded.

Enteral feeding intolerance will be assessed according to predefined criteria and international recommendations. The following findings will be considered enteral feeding intolerance: vomiting, a single gastric residual volume greater than 250 mL, a 24-hour gastric residual volume greater than 500 mL, abdominal distension, and suspected aspiration.

Gastric residual volume will be measured by intensive care nurses using a 50-mL syringe according to the standard intensive care unit protocol.

Intra-abdominal pressure will be measured twice weekly as part of routine intensive care practice using the Foley bladder pressure measurement technique.

All study data will be obtained from routine clinical records, laboratory results, enteral nutrition monitoring charts, ventilator records, and the hospital electronic medical record. No additional invasive procedure, imaging study, surgical procedure, or other intervention will be performed for research purposes.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
102

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Eda Cirit Bardakci, Medical Doctor
  • Phone Number: +90 541 308 9295
  • Email: edacrt@gmail.com

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

The study population will consist of adult patients aged 18 years or older who are admitted to the Anesthesiology and Reanimation Intensive Care Unit of Ankara Atatürk Sanatoryum Training and Research Hospital and who are started on enteral nutrition.

Patients will be prospectively screened and consecutively enrolled if they meet all inclusion criteria and none of the exclusion criteria.

Description

Inclusion Criteria:

  • Age ≥18 years
  • Admission to the Anesthesia Intensive Care Unit
  • Enteral nutrition planned or initiated during intensive care unit admission
  • Expected to require enteral nutrition during intensive care unit follow-up
  • Availability of sufficient clinical and nutritional data for study evaluation
  • Patient or legally authorized representative provides informed consent when required by the ethics protocol

Exclusion Criteria:

  • Age <18 years
  • Patients receiving only parenteral nutrition
  • Patients in whom enteral nutrition is contraindicated throughout the observation period
  • Patients with insufficient data for evaluation of enteral feeding tolerance
  • Patients transferred to another intensive care unit before adequate study assessment
  • Patients who decline participation or whose legally authorized representative declines participation when consent is required

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Occurrence of Enteral Feeding Intolerance
Time Frame: 7 days
Enteral feeding intolerance will be defined by the presence of at least one predefined clinical criterion: vomiting, a single gastric residual volume greater than 250 mL, 24-hour cumulative gastric residual volume greater than 500 mL, abdominal distension, or clinical suspicion of aspiration related to enteral feeding.
7 days

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Achievement of Energy Target
Time Frame: 3 days
The proportion of prescribed or calculated daily energy target actually delivered through enteral nutrition. Achievement of ≥70-80% of the calculated daily energy target will be considered adequate.
3 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Eda Cirit Bardakçi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 15, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 12, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 20, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 21, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 21, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 20, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2024-BCEK/483

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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