Interruptions in administration of enteral feeding and automatic compensation: A post hoc analysis of the smART+ study
Open accessAbstract
Rationale Multiple obstacles exist to achieve enteral feeding targets defined as patient-related (PR) or diagnostic/therapeutic related (DTR) interruptions. A new technology was developed to adapt and compensate enteral feeding according to gastric tolerance as well as DTR interruptions (1). In this post hoc analysis we evaluated PR or DTR interruptions as well as the compensation achieved by the platform. Methods The compensation related to PR or DTR was analyzed in 50 patients from the study group (1). A computerized analysis detected all the PR and DTR interruptions. Analysis used only those days with at least 12 hours of active system. Compensation was programmed to provide 100 % of the missing nutrition related to DTR interruptions and 50 % of the measured gastric active residual release (ARR). Results 280 days were obtained with at least 12 hours of recording from the 313 hospitalization days. Interruptions occurred during 4.5 hours in mean. A total median of 75 min (19.5 % of the interruption time) was related to PR and a total median of 196 min (80.5 %) to DTR interruptions. However, the feeding efficacy remained very high (89,3 %) during the study period. Nutritional therapy close to 100 % of the target was obtained in 176 days out of the 280 investigated days. Conclusion Interruptions of enteral feeding were mainly related to DTR interventions, but the platform was able to fully compensate for them. The PR interruptions were only partially compensated. The smart + platform provides an effective tool to recognize feeding interruptions and to compensate them.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with elevated C-reactive protein did not seem to profit from the nutritional intervention including macro- and micronutrients.
“However, patients with elevated CRP did not seem to profit from this intervention [86].”
From Gastrointestinal function and nutritional interventions in septic shock (2025) · cites this paper as [86]
Cites
ESPEN guideline on clinical nutrition in the intensive care unit.
Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.037 · Cited by 2,904 · see citing works
Self-citationNutritionDay ICU: a 7 year worldwide prevalence study of nutrition practice in intensive care
Bendavid, I., Singer, P., Theilla, M., Themessl-Huber, M., Sulz, I., Mouhieddine, M., Schuh, C., Mora, B., & Hiesmayr, M. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2016.07.012 · Cited by 175 · see citing works
Self-citationA guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice
Preiser, J.-C., Arabi, Y. M., Berger, M. M., Casaer, M., McClave, S., Montejo-González, J. C., Peake, S., Reintam Blaser, A., Van den Berghe, G., van Zanten, A., et al. (2021) · Critical Care · doi:10.1186/s13054-021-03847-4 · Cited by 166 · see citing works
Reid, C. L. (2006) · Journal of Human Nutrition and Dietetics · doi:10.1111/j.1365-277x.2006.00661.x · Cited by 145 · see citing works
Causes and Consequences of Interrupted Enteral Nutrition
Peev, M. P., Yeh, D. D., Quraishi, S. A., Osler, P. M., Chang, Y., Gillis, E., Albano, C. E., Darak, S., & Velmahos, G. C. (2014) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607114526887 · Cited by 127 · see citing works
Impact of enteral nutrition interruptions on underfeeding in intensive care unit
Šalčiūtė-Šimėnė, E., Stasiūnaitis, R., Ambrasas, E., Tutkus, J., Milkevicius, I., Šostakaitė, G., Klimašauskas, A., & Kėkštas, G. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.08.014 · Cited by 81 · see citing works
Jenkins, B., Calder, P. C., & Marino, L. V. (2022) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2022.04.014 · Cited by 71 · see citing works
Monitoring of gastric residual volume during enteral nutrition
Yasuda, H., Kondo, N., Yamamoto, R., Asami, S., Abe, T., Tsujimoto, H., Tsujimoto, Y., & Kataoka, Y. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013335.pub2 · Cited by 57 · see citing works
Stewart, M. L. (2014) · Critical Care Nurse · doi:10.4037/ccn2014243 · Cited by 56 · see citing works
To return or to discard? Randomised trial on gastric residual volume management
Juvé‐Udina, M., Valls-Miró, C., Granero, A. C., Estalella, G. M., Prat, D. M., Domingo-Felici, C.-M., Llusa-Finestres, J., & Asensio-Malo, G. (2009) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2009.06.004 · Cited by 48 · see citing works
Kagan, I., Hellerman-Itzhaki, M., Bendavid, I., Statlender, L., Fishman, G., Wischmeyer, P. E., Waele, E. D., & Singer, P. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.018 · Cited by 32 · see citing works
Self-citationThong, D., Halim, Z., Chia, J., Chua, F., & Wong, A. (2021) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2324 · Cited by 28 · see citing works
The Value of Audit and Feedback Reports in Improving Nutrition Therapy in the Intensive Care Unit
Sinuff, T., Cahill, N. E., Dhaliwal, R., Wang, M., Day, A. G., & Heyland, D. K. (2010) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607110373484 · Cited by 27 · see citing works
Enteral nutrition interruptions in the intensive care unit: A prospective study
van Nieuwkoop, M. M., Ramnarain, D., & Pouwels, S. (2021) · Nutrition · doi:10.1016/j.nut.2021.111580 · Cited by 27 · see citing works
Kasti, A. N., Θεοδωρακοπούλου, Μ., Katsas, K., Synodinou, K. D., Nikolaki, M. D., Zouridaki, A., Fotiou, S., Kapetani, A., & Armaganidis, A. (2023) · Nutrients · doi:10.3390/nu15040917 · Cited by 24 · see citing works
Nutritional adequacy in critically ill patients: Result of PNSI study
Javid, Z., Shadnoush, M., Khadem‐Rezaiyan, M., Honarvar, N. M., Sedaghat, A., Hashemian, S. M., Ardehali, S. H., Nematy, M., Pournik, O., Beigmohammadi, M. T., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.05.047 · Cited by 22 · see citing works
Danielis, M., Mattiussi, E., Piani, T., Iacobucci, A., Tullio, A., Molfino, A., Vetrugno, L., Deana, C., Capolicchio, L., Castriotta, L., et al. (2023) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2023.07.007 · Cited by 16 · see citing works
Periprocedural nutrition in the intensive care unit: a pilot study
Yeh, D. D., Cropano, C. M., Quraishi, S. A., Fuentes, E., Kaafarani, H. M. A., Lee, J., & Velmahos, G. C. (2015) · Journal of Surgical Research · doi:10.1016/j.jss.2015.06.039 · Cited by 14 · see citing works
Gastric residual volume monitoring practices in UK intensive care units: A web-based survey
Jenkins, B., Calder, P. C., & Marino, L. V. (2023) · Journal of the Intensive Care Society · doi:10.1177/17511437231210483 · Cited by 10 · see citing works
Barrick, C., Stewart, M. W., & Palokas, M. J. (2020) · JBI Evidence Synthesis · doi:10.11124/jbisrir-d-19-00123 · Cited by 6 · see citing works
Association Between Nil Per Os Status and Intubated Patients Undergoing Surgery
Siu, M., Coulter, A. M. P., Grant, H. M., Alouidor, R., & Tirabassi, M. V. (2023) · Journal of Surgical Research · doi:10.1016/j.jss.2023.10.015 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Gastrointestinal function and nutritional interventions in septic shock
Bachmann, K. F., Cotoia, A., & Reintam Blaser, A. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001302 · Cited by 13 · see citing works
- Authors
- Kagan, I., Robinson, E., Itshaki, M. H., & Singer, P.
- Affiliations
- Rabin Medical Center (IL)
- Reichman University (IL)
- Corresponding author
- Singer, P.
- Venue
- Clinical Nutrition Open Science
- Publisher
- Elsevier BV
- Published
- 2025-06
- Volume
- 61
- Pages
- 62-69
- ISSN
- 2667-2685 (ISSN-L)
- OpenAlex
- W4408564231
- Cited by
- 1
- References
- 22
- Citations by year
- 2025: 1
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Nutrition Open Science (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- enteral nutrition, feeding interruptions, automatic compensation, gastric residual volume, gastric tolerance, intelligent platform, nutritional therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review