Publication date: Aug 12, 2026
BackgroundAdequate enteral nutrition is essential in critical illness, yet optimal delivery strategies remain debated. Rate-based and volume-based are commonly used, with prior studies suggesting improved caloric delivery with volume-based. However, real-world clinical outcomes, particularly with mixed protocols and in COVID-19 patients, are unclear. We hypothesized that volume-based would improve caloric delivery versus rate-based or mixed, and that critically ill COVID-19 patients would achieve a lower goal intake. MethodsThis single-center retrospective cohort study included ICU patients (2020-2023) receiving ≥48 h of enteral nutrition via rate-based, volume-based, or mixed strategies. The primary outcome was the percentage of prescribed intake achieved. Secondary outcomes included hospital and ICU length of stay, ventilator days, hospital-acquired pressure injuries and infections. Baseline illness severity was assessed using standard comorbidity and organ failure scores. ResultsAmong 324 patients, 24% achieved ≥80% of caloric goal, with no difference across feeding strategies (P = . 30). Mixed feeding was associated with longer hospital and ICU stays, more ventilator days, and longer enteral nutrition duration (all P
| Concepts | Keywords |
|---|---|
| adverse events | |
| critical illness | |
| enteral nutrition | |
| intensive care unit | |
| length of stay | |
| rate-based feeding | |
| volume-based feeding |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Critically Ill |
| disease | MESH | COVID-19 |
| disease | MESH | included |
| disease | MESH | pressure injuries |
| disease | MESH | infections |