Optimizing Enteral Nutrition Regimen for Critically Ill Patients

Clinical Trial The goal of this clinical trial is to learn whether different enteral feeding cycles (18-hour, 20-hour, or standard 24-hour continuous feeding) improve outcomes for critically ill ICU patients who need tube feeding. It will also look at tolerance, nutrition delivery, and safety. The main questions it aims to answer are: Do shorter feeding cycles (with fasting windows) reduce ICU length of stay? Do they lower the risk of infections like ventilator-associated pneumonia? How do they affect calorie delivery, blood sugar control, and gastrointestinal tolerance? Researchers will compare: Continuous 24-hour feeding (standard care) 20-hour feeding with a 4-hour fasting window 18-hour feeding with a 6-hour fasting window Participants will: Be critically ill adults in the ICU who require at least 7 days of enteral feeding Be randomized to one of the three feeding schedules Receive daily monitoring of calories, protein, blood sugar, and GI tolerance Have outcomes measured, including ICU length of stay, infections, metabolic control, and feeding tolerance