Other Titles

Volume-Based Feeding Protocol Implementation in Metropolitan Medical ICU [Poster Title]

Abstract

Optimal nutritional support is a fundamental aspect of the recovery process for critically ill patients (Compher et al., 2022). It plays a crucial role in mitigating the catabolic effects of severe illness and trauma (Bharal et al., 2019). In the intensive care unit (ICU), enteral feeding (EF) is the preferred nutrition delivery method (Holyk et al., 2020). However, traditional EF protocols such as Rate-Based Feeding (RBF) fail to meet patients’ nutritional requirements. RBF protocol provides only 60% of the prescribed daily caloric intake (Wang et al., 2023). An evaluation of our Medical ICU (MICU) has revealed that the EF was held for 3 to 3.5 hours per day, depriving a caloric intake of 15%, which accounts for 12,150kcal of missed nutrition to the patients. The inadequacy exposes critically ill patients to an increased risk of iatrogenic malnutrition, prolonging ICU length of stay, increasing the risk of infection, extending the duration of mechanical ventilation, and contributing to higher mortality rates (Smith et al., 2024).

Volume-based Feeding (VBF) is designed to mitigate the problem of underfeeding by providing an average of 90% of the recommended nutrition. This project describes a clinical practice improvement and advancement by implementing a VBF protocol that will improve nutrition practice in the ICU.

Notes

References:

Bharal, M., Morgan, S., Husain, T., Hilari, K., Morawiec, C., Harrison, K., Bassett, P., & Culkin, A. (2019). Volume based feeding versus rate based feeding in the critically ill: A UK study. Journal of the Intensive Care Society, 20(4), 299–308. https://doi.org/10.1177/1751143719847321

Compher, C., Bingham, A. L., McCall, M., Patel, J., Rice, T. W., Braunschweig, C., & McKeever, L. (2022). Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. JPEN. Journal of parenteral and enteral nutrition, 46(1), 12–41. https://doi.org/10.1002/jpen.2267

Holyk, A., Belden, V., Sirimaturos, M., Chiles, K., Fontenot, N., Lista, A., Broadway, M. K., & Leon, R. S. (2020). Volume-Based Feeding Enhances Enteral Delivery by Maximizing the Optimal Rate of Enteral Feeding (FEED MORE). JPEN. Journal of parenteral and enteral nutrition, 44(6), 1038–1046. https://doi.org/10.1002/jpen.1727

Smith, L. D., Jr, Hoy, H., & Whitmore, S. (2024). Increasing the Volume of Delivered Enteral Feeds Using a Volume-Based Feeding Protocol in a Neuroscience Intensive Care Unit. Critical care nurse, 44(3), 54–64. https://doi.org/10.4037/ccn2024622

Wang, L., Wang, Y., Li, H. X., Zhang, R. P., Chang, L., Zeng, J., & Jiang, H. (2023). Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review. Critical care (London, England), 27(1), 173. https://doi.org/10.1186/s13054-023-04439-0

Description

Enteral feeding is a crucial method for providing adequate nutrition to critically ill patients in the intensive care unit (ICU). Despite its importance, the traditional method only provides 60% of the daily recommended intake, which can lead to serious complications. This study will offer insights on how Volume-Based Feeding is a superior and effective delivery method and how it integrates into the ICU.

Author Details

Abraham J. Wang, BSN, RN, CCRN

Sigma Membership

Iota Kappa

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Quantitative Research

Keywords:

Acute Care, Enteral Feeding, Volume-based Feeding, Critically Ill Patients, Malnutrition Mitigation, Interprofessional Initiatives

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-11-17

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Volume-Based Feeding Protocol in Metropolitan Medical ICU

Indianapolis, Indiana, USA

Optimal nutritional support is a fundamental aspect of the recovery process for critically ill patients (Compher et al., 2022). It plays a crucial role in mitigating the catabolic effects of severe illness and trauma (Bharal et al., 2019). In the intensive care unit (ICU), enteral feeding (EF) is the preferred nutrition delivery method (Holyk et al., 2020). However, traditional EF protocols such as Rate-Based Feeding (RBF) fail to meet patients’ nutritional requirements. RBF protocol provides only 60% of the prescribed daily caloric intake (Wang et al., 2023). An evaluation of our Medical ICU (MICU) has revealed that the EF was held for 3 to 3.5 hours per day, depriving a caloric intake of 15%, which accounts for 12,150kcal of missed nutrition to the patients. The inadequacy exposes critically ill patients to an increased risk of iatrogenic malnutrition, prolonging ICU length of stay, increasing the risk of infection, extending the duration of mechanical ventilation, and contributing to higher mortality rates (Smith et al., 2024).

Volume-based Feeding (VBF) is designed to mitigate the problem of underfeeding by providing an average of 90% of the recommended nutrition. This project describes a clinical practice improvement and advancement by implementing a VBF protocol that will improve nutrition practice in the ICU.