Date of Award

Fall 12-14-2018

Degree Type


Degree Name

Master of Science (MS)



First Advisor

Dr. Anita Nucci

Second Advisor

Kate Wiley

Third Advisor

Kathy Taylor


Background: Patients determined to be at high nutrition risk are most likely to benefit from early enteral nutrition (EN) therapy. The use of enteral feeding protocols has been associated with significant improvements in nutrition practice and overall nutrition adequacy. The effect of a combined-approach volume-based enteral feeding protocol on the percent of calories received by patients is unknown.

Objective: The aim of this study was to determine if a newly implemented combined-approach volume-based enteral feeding (VBF) protocol is more effective in the delivery of EN volume and calories in intensive care unit (ICU) patients compared with the previous rate-based protocol where 88% of patients achieved 85% of their caloric requirements.

Participants/setting: Eighteen critically ill adults hospitalized in either the burn or neurological ICU at a large urban hospital.

Main outcome measure: The percentage of calories delivered for each patient after a minimum of 7 days of protocol compliance.

Results: Ten patients (50% male, 70% Caucasian) received VBF in compliance with protocol for a median of 5.5 days (Interquartile Range; 4.8, 14.0). The percent of goal volume delivered for those who received at least 7 days of treatment (n = 4) was 104.2 ± 7.9.

Conclusions: The delivery of goal EN volume using VBF exceeded the average volume provided by the previous rate-based approach in a small sample of critically ill adults. This study supports the use of feeding protocols in order to increase overall percentage of volume delivered. Additional research in a larger patient population is needed to determine the impact of this increase in volume delivery on patient outcomes.