Fig. 1
From: How to improve worldwide early enteral nutrition performance in intensive care units?
Strategies to improve early enteral feeding performance. *When oral feeding is impossible or supposed not to achieve the targets. Delay enteral nutrition only in patients with uncontrolled shock (when hemodynamic and tissue perfusion goals are not met despite fluids and vasopressors), in uncontrolled hypoxemia and acidosis, uncontrolled GI bleeding, overt bowel ischemia (occlusive or non-occlusive), bowel obstruction (mechanical ileus), abdominal compartment syndrome, gastric aspirate volume (GRV) > 500 ml/6 h or high-output fistula if reliable distal feeding access is not achievable. **Modified cut-off for GRV for the Chinese population: 400 ml/6 h. Abbreviations: GRV gastric aspiration volume, EN enteral nutrition, GI gastrointestinal, SPN supplemental parenteral nutrition