Enteral Nutrition Interruptions in the Intensive Care Unit: A Systematic Review of Frequency, Causes, and Nutritional Implications

Abstract

Enteral nutrition interruptions (ENIs) are a major cause of inadequate nutrition goals in critically ill patients. The aim of this systematic review was to provide an update on the various clinical and logistical reasons for ENIs and observe their nutritional implications. PubMed, MEDLINE, Embase, and The Cochrane Library were searched from the inception of each database until March 11, 2024. For data extraction, a structured checklist was used. The initial literature search yielded 522 results. In total, 26 studies were included, comprising 3067 participants. Among the included studies, there were 20 prospective studies, two before-and-after studies, one RCT, and three retrospective studies. The main reasons for ENI were high gastric residual volumes, nasogastric tube dysfunction, and diagnostic and surgical procedures. In conclusion, although the nutritional management of critically ill patients in the ICU has improved drastically, ENIs remain a major problem in clinical practice. Future research should consider different treatments and ICU protocols. Additionally, there is a need for standardized ENI definitions and standardized reporting of the evaluation of energy and/or protein requirements, objectively determining adequate intake, and reporting the causes, frequency, and duration of ENIs.

Keywords: critical care; enteral nutrition; enteral nutrition interruption; intensive care; malnutrition; underfeeding; undernutrition.

Figure 1. PRISMA flowchart of the included studies

PRISMA: Preferred Reporting Items for Systematic Reviews