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General Critical Care

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Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review


Interruptions in EN therapy contribute to underfeeding in these patients. The volume-based feeding (VBF) protocol has gained attention as a solution to address under-delivery caused by interruptions.


This study provides an updated assessment of the efficacy of implementing the volume-based feeding (VBF) protocol for optimized enteral nutrition (EN) delivery in critically ill patients. Sixteen studies involving 2,896 critically ill patients were included in the meta-analysis. The VBF protocol significantly improved energy and protein delivery compared to the rate-based feeding (RBF) protocol. Patients in the VBF group had a shorter ICU stay. The VBF protocol did not increase the risk of death or prolong mechanical ventilation duration. Additionally, it did not have a significant impact on EN complications such as diarrhea, emesis, feeding intolerance, and gastric retention. The study concludes that the VBF protocol improves calorie and protein delivery in critically ill patients without additional risks.


What is the delivery method for enteral nutrition in your ICU?

  • 0%Rate-based feeding

  • 0%Volume-based feeding

  • 0%We do not have a specific method!


Conclusion: The study demonstrates that implementing the VBF protocol for optimized EN delivery is effective and safe for critically ill patients. It supports the use of the VBF protocol in clinical practice to improve nutritional outcomes in this patient population.



Wang L, Wang Y, Li HX, Zhang RP, Chang L, Zeng J, Jiang H. Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review. Crit Care. 2023 May 5;27(1):173. doi: 10.1186/s13054-023-04439-0. PMID: 37147701; PMCID: PMC10161662. Link

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Mazen Kherallah
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