Early Enteral Feeding and Clinical Outcomes in ICU Patients (EEFP)

Loai Muawiah Zabin

Status: Completed

Conditions: Feeding Protocol; Enteral Nutrition; Critical Illness; Nutritional Support; Intensive Care Unit ICU

Treatments: Other: Standard Nutritional Care; Other: Early Enteral Feeding Protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT07131098

AAUP-EEFP-ICU-2024

Details and patient eligibility

About

This study evaluated the effectiveness of an early enteral feeding protocol in critically ill adult patients admitted to an Intensive Care Unit (ICU). The intervention involved initiating enteral nutrition within 24-48 hours of ICU admission. Clinical outcomes such as ICU length of stay, ventilator dependency, and selected laboratory values were compared between patients who received early enteral feeding and those who received standard nutritional care. The study was conducted at Jenin Governmental Hospital in Palestine between January and April 2024, with 80 adult participants.

Full description

This is a retrospectively registered, quasi-experimental study that investigated the clinical impact of implementing an early enteral feeding protocol in a critical care setting. Conducted in Jenin Governmental Hospital, Palestine, the research explored how protocolized early nutritional support affects physiological recovery and ICU-related outcomes in critically ill adult patients.

The study was motivated by the well-established role of early enteral nutrition in maintaining gut integrity, supporting immune function, and reducing complications in ICU patients. Despite international guidelines recommending its use within 24-48 hours of ICU admission, early enteral feeding remains underutilized in many low-resource healthcare settings. Factors contributing to this gap include variability in clinical practice, limited institutional protocols, and staff training constraints.

This investigation was carried out between January and April 2024 and followed rigorous ethical standards, with Institutional Review Board approval from Arab American University (Reference: R-2024/B/85/N). Patients were grouped based on the time period of admission into either a protocol-based early feeding group or a standard care group. Intervention fidelity was maintained through a pre-defined feeding protocol implemented by ICU staff after appropriate orientation and monitoring.

The study contributes to the growing body of evidence supporting structured nutritional protocols in ICUs and highlights the feasibility and benefits of such interventions in middle-income and resource-constrained settings. The data gathered and analyzed provide a foundation for future policy development aimed at standardizing nutritional support for critically ill patients.

Enrollment: 80 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults aged 18 years and older
• Admitted to the ICU and eligible for enteral feeding
• Expected to stay in the ICU for more than 48 hours
• Able to initiate enteral feeding within 24-48 hours of ICU admission
• Informed consent obtained from the patient or legal guardian

Exclusion criteria

• Pregnant or lactating women
• Patients with gastrointestinal bleeding or obstruction
• Patients undergoing gastrointestinal surgery or with short bowel syndrome
• Diagnosed with COVID-19 during admission
• End-of-life care patients or those with do-not-resuscitate (DNR) orders
• Refusal to participate or withdrawal of consent

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 2 patient groups

Early Enteral Feeding Protocol

Experimental group

Description:

Participants in this group received early enteral nutrition initiated within 24-48 hours of ICU admission, based on a structured feeding protocol. The protocol followed international guidelines (ASPEN/ESPEN) and was implemented by ICU staff with training and monitoring support.

Treatment:

Other: Early Enteral Feeding Protocol

Standard Nutritional Care

Other group

Description:

Participants in this group received standard ICU nutritional care without the implementation of the early enteral feeding protocol. Feeding initiation and type were left to physician discretion based on clinical judgment and routine hospital practices.

Treatment:

Other: Standard Nutritional Care