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Research Snapshot Theater: GI - Nutrition, Adult I

The Effect of Enteral Nutrition Strategy on Diarrhea: Preliminary Results From the ENND Goals Study

Sunday, March 22, 2026
9:45 AM - 10:45 AM Central Time
Location: Connections Central - RST 04

  • Justin B. Senecal, BMSc, MD (he/him/his)

    Ontario, Canada

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • TL

    Taiya Lakhanpal, BSc

    Research Assistant, McMaster University
    Department of Medicine, McMaster University, Hamilton, Canada

    Disclosure information not submitted.

  • AK

    Azin Khosravirad, MSc

    Health Research Methodology MSc Candidate, McMaster University
    Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada

    Disclosure information not submitted.

  • LM

    Lawrence Mbuagbaw, MD, MPH, PhD

    Professor, Health Research Methods, Evidence, and Impact
    Department of Medicine/Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada

    Disclosure information not submitted.

  • TG

    Tatianna Giannidis, N/A

    MSc Candidate
    Department of Medicine, McMaster University, Hamilton, Canada

    Disclosure information not submitted.

  • PK

    Parsa Khazaneh, MD

    PGY3 - Internal Medicine
    Department of Medicine, McMaster University, Hamilton, Canada

    Disclosure information not submitted.

  • Bram Rochwerg, MD, MSc(Epi), FRCPC (he/him/his)

    McMaster University, Ontario, CAN

    Disclosure information not submitted.

  • SO

    Simon Oczkowski, MD, MS

    Associate Professor, Medicine
    McMaster University

    Disclosure information not submitted.

  • DC

    Deborah Cook, MD

    Distinguished Professor of Medicine
    McMaster University

    Disclosure information not submitted.

  • MP

    Maria-Ines Pinto-Sanchez, MD

    Associate Professor, Medicine
    Department of Medicine, McMaster University, Hamilton, Canada

    Disclosure information not submitted.

  • JT

    Jennifer Tsang, MD

    Associate Professor, Medicine
    Niagara Health Knowledge Institute, Niagara Health, St. Catharines, Canada

    Disclosure information not submitted.

  • SS

    Sameer Sharif, MD, MSc

    Assistant Professor, Medicine
    McMaster University

    Disclosure information not submitted.

  • DA

    David Armstrong, MD

    Professor, Medicine
    Department of medicine, division of gastroenterology, McMaster University, Hamilton, Canada

    Disclosure information not submitted.

  • NO

    Natalia Ovtcharenko, MD

    Assistant Clinical Professor (Adjunct), Medicine
    Niagara Health Knowledge Institute, Niagara Health, St. Catharines, Canada

    Disclosure information not submitted.

  • NJ

    Nicole Janisse, RD

    Registered Dietician
    Critical Care, Hamilton Health Science, Hamilton, Canada

    Disclosure information not submitted.

  • TM

    Tina Millen, N/A

    Respiratory Therapist
    Critical Care, Hamilton Health Scientist, Hamilton, Canada

    Disclosure information not submitted.

  • Joanna Dionne, MD, MS, BN (she/her/hers)

    McMaster University, Ontario, CAN

    Disclosure information not submitted.

Introduction: Early enteral nutrition (EN) has become standard of care for most ICU patients. Despite this, the effect of different EN modalities, including intermittent (IEN) vs. continuous EN (CEN), is under-investigated. We evaluated the effect of IEN vs CEN on diarrhea and other GI symptoms amongst critically ill patients.


Methods: The ENND Goals study is a multicentre retrospective cohort study in Hamilton, Canada. Patients greater than 18 years of age, admitted to the ICU and receiving EN for at least 48 hours were included. Differences between groups were determined by chi-square analysis and two-tailed Welch’s T-test. Predictors of EN strategy and diarrhea were determined via multivariable logistic regression.


Results: Overall, 236 patients (84 female [35.6 %], mean age 61.7 years [SD 16.6]) were admitted to Hamilton Health Sciences between Jan 1, 2023, and Dec 31, 2023. Of them, 41 (17%) received IEN (14 (5.9%) for most of their ICU admission and 27 (11%) for some of their admission), and 195 (83%) received only CEN. Trauma patients, younger patients and patients with lower BMI were significantly more likely to receive IEN during their admission (OR 4.42 [95%CI 1.27-15.3]; 0.97 [95%CI 0.95-0.99] and 0.92 [95%CI 0.87-0.98] respectively). Those who received IEN had a similar incidence of days with diarrhea (0.04 per person-day [95%CI 0.02-0.05]) compared to those who only received CEN (0.04 per person-day [95%CI 0.03-0.05], p=0.745). There was no significant difference in terms of ICU-acquired infections or emesis. In multivariable analysis, receipt of IEN for at least some of the ICU stay was associated with an increased risk of developing diarrhea (OR 3.76; 95% CI, 1.56–9.05; p = 0.003).


Conclusions: In one year of ICU admissions at Hamilton Health Sciences, only 17% of patients requiring EN for 48 hours received IEN. While patients who received at least some IEN were more likely to develop diarrhea in the ICU, there was no difference in the incidence of diarrhea, emesis, or hospital-acquired infections, when compared to those who received only CEN. Further study is needed to determine the optimal EN strategy amongst critically ill patients.