Which parameters are commonly monitored to assess tolerance of enteral nutrition in the ICU?

• A. Gas-related symptoms, gastric residuals, and signs of intolerance.
• B. Blood glucose level only.
• C. Cardiac output and blood pressure exclusively.
• D. Wound healing rate.

Answer: (D)

Tolerance of enteral nutrition in the ICU is assessed by how the gut handles the feeds in real time. The most practical and commonly used indicators are gas-related symptoms and signs of intolerance, such as abdominal bloating or distension, nausea, vomiting, and abdominal discomfort. Gastric residual volumes are checked to gauge delayed gastric emptying and potential intolerance to the feeding; persistently high residuals or repeated interruptions may prompt adjustments to the rate, formula, or route. Diarrhea, abdominal pain, or other signs of GI distress also inform tolerance.

Other options look at aspects not directly about gut tolerance. Blood glucose levels matter for metabolic control but don’t measure tolerance to enteral feeds. Cardiac output and blood pressure reflect circulatory status, not how well the GI tract is tolerating feeding. Wound healing rate is influenced by overall nutrition but is a broader, longer-term outcome rather than a day-to-day measure of tolerance to the feeding itself.

So the side that aligns with monitoring tolerance is the set of GI symptoms and gastric residuals.