Machine Learning–Driven Prediction of Early Enteral Nutrition Intolerance in ICU Patients Using Intra-Abdominal Pressure and Selected Gut Microbial Taxa
By: Kaihui Zheng, Xuena Zhang, Lishi Qu and Renshu Wang
References
- Bejarano N, Navarro S, Rebasa P, García-Esquirol O, Hermoso J. 2013. Intra-abdominal pressure as a prognostic factor for tolerance of enteral nutrition in critical patients. JPEN J Parenter Enteral Nutr. 37(3):352–360. https://doi.org/10.1177/0148607112447814
- Bordejé ML, Montejo JC, Mateu ML, Solera M, Acosta JA, Juan M, García-Córdoba F, García-Martínez MA, Gastaldo R, PIANE Study Group Spain. 2019. Intra-abdominal pressure as a marker of enteral nutrition intolerance in critically ill patients: the PIANE study. Nutrients. 11(11):2616. https://doi.org/10.3390/nu11112616
- Cao X, Wang H, Song Y, Yan X, Wu W, Li W, Chen L. 2025. Development and evaluation of a risk prediction model for enteral nutrition feeding intolerance in intensive care units. Front Nutr. 12:1667046. https://doi.org/10.3389/fnut.2025.1667046
- Chen H, Han J, Li J, Xiong J, Wang D, Han M, Shen Y, Lu W. 2025. Risk prediction models for feeding intolerance in patients with enteral nutrition: a systematic review and meta-analysis. Front Nutr. 11:1522911. https://doi.org/10.3389/fnut.2024.1522911
- Cheng J, Wei Z, Liu X, Li X, Yuan Z, Zheng J, Chen X, Xiao G, Li X. 2013. The role of intestinal mucosa injury induced by intra-abdominal hypertension in the development of abdominal compartment syndrome and multiple organ dysfunction syndrome. Crit Care. 17(6):R283. https://doi.org/10.1186/cc13146
- Clemmensen C, Müller TD, Woods SC, Berthoud HR, Seeley RJ, Tschöp MH. 2017. Gut-brain cross-talk in metabolic control. Cell. 168(5):758–774. https://doi.org/10.1016/j.cell.2017.01.025
- Falony G, Vieira-Silva S, Raes J. 2018. Richness and ecosystem development across faecal snapshots of the gut microbiota. Nat Microbiol. 3(5):526–528. https://doi.org/10.1038/s41564-018-0143-5
- Hu X, Chang Y, Wang Z, Bao W, Li Z. 2021. Altered gut microbiota is associated with feeding intolerance in preterm infants. Turk J Pediatr. 63(2):206–217. https://doi.org/10.24953/turkjped.2021.02.004
- Lu XM, Jia DS, Wang R, Yang Q, Jin SS, Chen L. 2022. Development of a prediction model for enteral feeding intolerance in intensive care unit patients: a prospective cohort study. World J Gastrointest Surg. 14(12):1363–1374. https://doi.org/10.4240/wjgs.v14.i12.1363
- Maddison L, Starkopf J, Reintam Blaser A. 2016. Mild to moderate intra-abdominal hypertension: does it matter? World J Crit Care Med. 5(1):96–102. https://doi.org/10.5492/wjccm.v5.i1.96
- Mesotten D, Preiser JC, Kosiborod M. 2015. Glucose management in critically ill adults and children. Lancet Diabetes Endocrinol. 3(9):723–733. https://doi.org/10.1016/S2213-8587(15)00223-5
- Mohammadi P, Varpaei HA, Khafaee Pour Khamseh A, Mohammadi M, Rahimi M, Orandi A. 2022. Evaluation of the relationship between nutritional status of COVID-19 patients admitted to the ICU and patients’ prognosis: a cohort study. J Nutr Metab. 2022:5016649. https://doi.org/10.1155/2022/5016649
- Murcia-Sáez IM, Sobrino-Hernández ML, García-López F, Córcoles-González V, Cortés-Monedero JL, Tendero-Egea A, Martínez-García A, Salinas-Sánchez AS. 2010. Usefulness of intra-abdominal pressure in a predominantly medical intensive care unit. J Crit Care. 25(1):175.e1–175.e6. https://doi.org/10.1016/j.jcrc.2009.05.017
- Ojima M, Motooka D, Shimizu K, Gotoh K, Shintani A, Yoshiya K, Nakamura S, Ogura H, Iida T, Shimazu T. 2016. Metagenomic analysis reveals dynamic changes of whole gut microbiota in the acute phase of intensive care unit patients. Dig Dis Sci. 61(6):1628–1634. https://doi.org/10.1007/s10620-015-4011-3
- Reintam Blaser A, Malbrain MLNG, Starkopf J, Fruhwald S, Jakob SM, De Waele J, Braun JP, Poeze M, Spies C. 2012. Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems. Intensive Care Med. 38(3):384–394. https://doi.org/10.1007/s00134-011-2459-y
- Salciute-Simene E, Stasiunaitis R, Ambrasas E, Tutkus J, Milkevicius I, Sostakaite G, Klimasauskas A, Kekstas G. 2021. Impact of enteral nutrition interruptions on underfeeding in intensive care unit. Clin Nutr. 40(3):1310–1317. https://doi.org/10.1016/j.clnu.2020.08.014
- Shi J, Wei L, Huang R, Liao L. 2018. Effect of combined parenteral and enteral nutrition versus enteral nutrition alone for critically ill patients: a systematic review and meta-analysis. Medicine (Baltimore). 97(41):e11874. https://doi.org/10.1097/MD.0000000000011874
- Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, Hiesmayr M, Mayer K, Montejo JC, Pichard C. 2019. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 38(1):48–79. https://doi.org/10.1016/j.clnu.2018.08.037
- Taylor BE, McClave SA, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA. 2016. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med. 44(2):390–438. https://doi.org/10.1097/CCM.0000000000001525
- Wang Y, Li Y, Wang H, Li H, Li Y, Zhang L, Zhang C, Gao M, Zhang N, Zhang D. 2023. Development and validation of a nomogram for predicting enteral feeding intolerance in critically ill patients (NOFI): mixed retrospective and prospective cohort study. Clin Nutr. 42(12):2293–2301. https://doi.org/10.1016/j.clnu.2023.10.003
- Xiao Y, Xu L. 2023. Prevalence and risk factors of enteral feeding intolerance in critically ill patients and the effectiveness of preventive treatments: a prospective study. Saudi J Med Med Sci. 11(2):135–142. https://doi.org/10.4103/sjmms.sjmms_384_22
- Xu J, Shi W, Xie L, Xu J, Bian L. 2024. Feeding intolerance in critically ill patients with enteral nutrition: a meta-analysis and systematic review. J Crit Care Med (Targu Mures). 10(1):7–15. https://doi.org/10.2478/jccm-2024-0007
- Xu W, Zhong M, Pan T, Qu H, Chen E. 2022. Gut microbiota and enteral nutrition tolerance in non-abdominal infection septic ICU patients: an observational study. Nutrients. 14(24):5342. https://doi.org/10.3390/nu14245342
- Yuan R, Liu L, Mi J, Li X, Yang F, Mao S. 2024. Development and validation of a risk prediction model for feeding intolerance in neurocritical patients with enteral nutrition. Front Nutr. 11:1481279. https://doi.org/10.3389/fnut.2024.1481279
- Yuan Z, Yan J, Wen H, Deng X, Li X, Su S. 2019. Feeding intolerance alters the gut microbiota of preterm infants. PLoS One. 14(1):e0210609. https://doi.org/10.1371/journal.pone.0210609
- Zhang Y, Ma D, Lang B, Zang C, Sun Z, Ren S, Chen H. 2023. Effect of opioid-free anesthesia on the incidence of postoperative nausea and vomiting: a meta-analysis of randomized controlled studies. Medicine (Baltimore). 102(38):e35126. https://doi.org/10.1097/MD.0000000000035126
Language: English
Page range: 243 - 257
Submitted on: Nov 22, 2025
Accepted on: Mar 10, 2026
Published on: Jun 30, 2026
Published by: Polish Society of Microbiologists
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
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© 2026 Kaihui Zheng, Xuena Zhang, Lishi Qu, Renshu Wang, published by Polish Society of Microbiologists
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.