Comparison of Different Types of Nutritional Support in Mechanically Ventilated Critically Ill Patients

Background: Critically ill patients are exposed to severe physiological stress, which triggers multiple metabolic responses, including muscle wasting and stress-induced hyperglycemia. Adequate nutritional support is crucial in managing such patients. This study aimed to assess and compare the nutritional status and clinical outcomes of mechanically ventilated critically ill patients receiving different forms of nutritional support.Methods: This prospective observational study was conducted on 200 critically ill patients admitted to the Critical Care Medicine Department at Benha University Hospital during the study period. Patients were randomly assigned to two main groups based on the route and type of nutritional support. Group A (100 patients) was subdivided into: A1 – 50 patients receiving conventional enteral nutrition (EN), and A2 – 50 patients receiving modified EN. Group B (100 patients) was subdivided into: B1 – 50 patients receiving conventional total parenteral nutrition (TPN), and B2 – 50 patients receiving modified TPN.Results: The proportion of patients achieving their feeding goal differed significantly between the groups (P=0.012), with higher rates in the modified EN group (A2), followed by conventional EN (A1), compared to both TPN groups (B1 and B2).Conclusion: Modified EN was associated with more favorable clinical outcomes in mechanically ventilated critically ill patients compared to parenteral nutrition. Patients receiving EN had lower follow-up APACHE II scores, shorter stays in both the ICU and hospital, and fewer complications, including infections and sepsis. Overall, EN, particularly the modified form, proved to be a more effective, safer, and preferable nutritional strategy in this patient population.