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
Sigma Membership
Iota Kappa
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Acute Care, Interprofessional Initiatives, Transition to Practice or Onboarding, Volume-based Feeding
Recommended Citation
Wang, Abraham J., "Volume-Based Feeding Protocol in Metropolitan Medical ICU" (2025). International Nursing Research Congress (INRC). 73.
https://www.sigmarepository.org/inrc/2025/presentations_2025/73
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, 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.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Volume-Based Feeding Protocol in Metropolitan Medical ICU
Seattle, Washington, 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.
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.