Enteral Feeding Intolerance Diagnostic Criteria And Current Approaches; Classic Review

Objective: Enteral feeding intolerance (EFI) is a common complication in the nutritional management of critically ill patients in intensive care units and directly affects clinical outcomes. This review aims to examine the incidence, assessment criteria, and current clinical practices related to EFI and provide an evidence-based perspective.Method: Recent literature was reviewed regarding the definition, incidence, diagnostic criteria, and clinical management of EFI. Particularly, the use of gastric residual volume (GRV) and its place within clinical guidelines were compared using multidimensional assessment approaches.Findings: Literature indicates that EFI incidence ranges between 20% and 30%; however, varying diagnostic criteria result in significant differences across studies. GRV has traditionally been a primary indicator of intolerance, yet recent evidence shows that it is not reliable when used alone. GRV values above 500 mL are considered clinically meaningful only when accompanied by other gastrointestinal symptoms such as abdominal distension, vomiting, or diarrhea. Current evidence emphasizes that EFI should be evaluated holistically rather than through a single parameter, highlighting the importance of combining objective measurements with patient-specific clinical findings.Conclusion: EFI is a multifactorial condition that influences nutritional adequacy and patient safety in critical care. Therefore, nurses and other healthcare professionals should rely on multidimensional clinical evaluations and current evidence-based guidelines when managing EFI. A holistic approach that considers multiple symptoms provides more accurate and effective outcomes than single-parameter assessments.