Surreal illustration of a patient in a hospital bed with a half-empty IV drip, symbolizing insufficient enteral nutrition.

Are You Getting Enough? The Truth About Enteral Nutrition in Hospitals

Theo Raines in Health & Wellness December 2025 • 4 min read.

"A new study reveals that many patients in intensive care units aren't receiving the full benefits of their prescribed enteral nutrition, hindering their recovery."

For patients unable to eat on their own, enteral nutrition (ENT) – a method of delivering nutrients directly to the digestive system – is a lifeline. It's designed to maintain or restore nutritional status, support recovery, and preserve immunity. Early ENT intervention can significantly impact health outcomes and reduce stress on the body.

However, simply prescribing the right amount of enteral nutrition isn't enough. Ensuring that patients actually receive the prescribed diet is equally crucial. A concerning trend is emerging: many patients, particularly those in intensive care units (ICUs), are not getting the full amount of nutrition they need.

A recent study investigated the discrepancy between prescribed and administered enteral nutrition in adult ICU patients. The findings reveal a significant gap, highlighting the challenges in delivering adequate nutrition to vulnerable patients. This article breaks down the study's results, explores the reasons behind this shortfall, and discusses the implications for patient care.

The ICU Nutrition Gap: Why Patients Aren't Receiving Enough

Surreal illustration of a patient in a hospital bed with a half-empty IV drip, symbolizing insufficient enteral nutrition.

The 2009 study, conducted in a high-complexity Brazilian hospital, followed 85 adult patients receiving exclusive enteral nutrition in the ICU. Researchers tracked the prescribed and actual amounts of enteral nutrition given to patients over a 30-day period, from the start of ENT to its discontinuation or discharge from the ICU.

The results revealed a concerning trend: on average, patients received significantly less volume, energy, and protein than prescribed. Specifically, patients received an average of 428±243 ml/day less volume, 665±412 Kcal/day less energy, and 30±19 g/day less protein than what was prescribed. Individual evaluations showed that approximately 40% of the prescribed volume was not administered.

Gastrointestinal Issues: Nausea, vomiting, abdominal distension, and constipation were major factors, accounting for 52% of interruptions.
Diagnostic Procedures: Medical tests and procedures requiring patients to fast contributed to 41.6% of interruptions.
Transition to Oral Feeding: As patients transitioned to oral diets, ENT was sometimes reduced or discontinued, accounting for 5.6% of interruptions.

These findings underscore the challenges of consistently delivering adequate enteral nutrition in the ICU setting. Various factors, often related to the patient's clinical condition and necessary medical interventions, can disrupt the delivery of prescribed nutrition.

Closing the Nutrition Gap: Improving Patient Outcomes

The study's conclusion is clear: critically ill adults in the ICU often receive less enteral nutrition than prescribed. This shortfall, driven by routine care interruptions and gastrointestinal complications, can hinder their recovery.

Addressing this nutrition gap requires a multi-faceted approach. Healthcare teams need to be vigilant in monitoring patients' tolerance to enteral nutrition, proactively managing gastrointestinal symptoms, and coordinating nutrition delivery with diagnostic and therapeutic procedures. It may involve adjusting feeding protocols, exploring alternative delivery methods, or considering supplemental parenteral nutrition when ENT alone is insufficient.

By recognizing the challenges and implementing strategies to improve enteral nutrition delivery, healthcare professionals can ensure that critically ill patients receive the vital nutrients they need to support healing and improve their overall outcomes. Further research is needed to determine optimal strategies for bridging this gap and personalizing nutrition therapy in the ICU.

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Everything You Need To Know

What is enteral nutrition and why is it important?

Enteral nutrition (ENT) is a method of delivering nutrients directly to the digestive system for patients who cannot eat on their own. Its importance lies in its ability to maintain or restore nutritional status, support recovery, and preserve immunity. Early intervention with ENT can significantly improve health outcomes and reduce stress on the body. The study highlights the critical need for patients in the ICU to receive the full benefits of their prescribed ENT, which supports their recovery.

What did the study find regarding enteral nutrition in the ICU?

The study reveals that patients in the intensive care unit (ICU) often do not receive the full amount of enteral nutrition (ENT) they are prescribed. Specifically, the study, conducted in a high-complexity Brazilian hospital, found that patients received less volume, energy, and protein than prescribed. Patients received an average of 428±243 ml/day less volume, 665±412 Kcal/day less energy, and 30±19 g/day less protein than what was prescribed. This discrepancy underscores a significant gap in nutritional care for critically ill patients.

What are the main reasons patients in the ICU don't get enough nutrition?

Several factors contribute to the shortfall in enteral nutrition (ENT) delivery in the intensive care unit (ICU). The study identifies three main contributors: Gastrointestinal issues like nausea, vomiting, abdominal distension, and constipation were a major factor, accounting for 52% of interruptions. Diagnostic procedures that require patients to fast contributed to 41.6% of interruptions. Lastly, the transition to oral feeding, where ENT was reduced or discontinued, accounted for 5.6% of interruptions. These interruptions and complications highlight the challenges in consistently delivering adequate nutrition in the ICU setting.

What are the implications of not getting enough nutrition for ICU patients?

The implications of not receiving the full amount of prescribed enteral nutrition (ENT) are significant for patients in the intensive care unit (ICU). The shortfall in nutrients can hinder recovery, as ENT is designed to maintain or restore nutritional status, support recovery, and preserve immunity. When patients do not receive enough nutrients, their bodies may struggle to heal, fight off infections, and regain strength. This can lead to longer hospital stays, increased complications, and potentially worse health outcomes. Ensuring patients get the full benefits of their prescribed ENT is crucial for their health.

How can nutritional care be improved for patients in the ICU?

The study's findings emphasize the need to improve the delivery of enteral nutrition (ENT) in the intensive care unit (ICU) to bridge the nutrition gap and improve patient outcomes. Addressing the root causes, such as gastrointestinal issues and interruptions for medical procedures, is crucial. Strategies might include better management of gastrointestinal symptoms, optimizing feeding schedules, and ensuring ENT is prioritized during medical interventions. Improving nutritional care is crucial to supporting the recovery and overall health of critically ill patients.