When the subjects are admitted to the department, the researchers will monitor potential biomarkers of gastrointestinal injury before administering enteral nutrition (a small amount of blood is drawn, serum is separated by centrifugation, and the serum sample is frozen for final centralized biomarker detection), and measure the antral movement index under ultrasound (300ml of warm water is injected into the stomach before measurement, and then the antral movement is observed for 6 minutes) Then, monitor whether the patient has developed feeding intolerance within 7 days of the ICU
Study Type
OBSERVATIONAL
Enrollment
160
This is a prospective observational study and does not involve any intervention measures
The First Hospital of Jilin University
Changchun, China
The subject developed feeding intolerance within 7 days of the ICU
The subject developed feeding intolerance (FI) within 7 days of the ICU FI is defined as either: * intolerance to EN due to any clinical reason (e.g., vomiting (any visible regurgitation of gastric content irrespective of the amount), high gastric residual volume (a single volume exceeds 200 ml), diarrhea (having three or more loose or liquid stools per day with a stool weight greater than 200-250 g/day (or greater than 250 ml/day)), gastrointestinal GI bleeding (any bleeding into the GI tract lumen, confirmed by macroscopic presence of blood in vomited fluids, gastric aspirate or stool), etc.), or * FI should be considered present if at least 20 kcal/kg BW/day via enteral route cannot be reached within 72 h of feeding attempt or if enteral feeding has to be stopped for whatever clinical reason.
Time frame: The first to seventh days in the ICU
Pragmatic Definition of Enteral Feeding Intolerance (EFI) - Sensitivity Analysis of the Primary Outcome
This outcome represents a sensitivity analysis for the primary outcome of feeding intolerance. EFI is pragmatically defined as a clinician's decision to reduce the prescribed amount of enteral nutrition (EN) specifically because features of gastrointestinal dysfunction appeared during feeding. Results from this pragmatic definition will be analyzed to test the robustness of the primary outcome and will be interpreted only as supportive evidence, not as separate primary or secondary outcomes.
Time frame: From enrollment (ICU admission) through day 7 of enteral nutrition
28-day mortality
Whether the patient died on the 28th day after being admitted to the ICU
Time frame: From the 1st to the 28th day after admission to the ICU
Nutritional adequacy rate on the 7th day
The probability of achieving 80% of the calorie target (25 kcal/kg/day) in enteral nutrition on the 7th day in the ICU
Time frame: On the seventh day of admission to the ICU
Length of stay in the ICU
The duration (in days) of the subjects' hospital stay in the ICU
Time frame: From enrollment to the patient's departure from the ICU (up to 90 days)
28-day ventilator-free days
The number of days within the first 28 days after enrollment during which the patient was alive and free from invasive mechanical ventilation.
Time frame: From enrollment (ICU admission) through day 28
Incidence of Gastric Retention
The occurrence of gastric retention during the first 7 days of enteral nutrition. Gastric retention is defined as a single gastric residual volume \>200 mL measured by syringe aspiration method. The outcome will be recorded as a binary variable (presence or absence).
Time frame: From enrollment (ICU admission) through day 7 of enteral nutrition
Incidence of Diarrhea
having three or more loose or liquid stools per day with a stool weight greater than 200-250 g/day (or greater than 250 ml/day
Time frame: From enrollment (ICU admission) through day 7 of enteral nutrition
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