ArticleFrontiers in nutrition2026
GNRI-stratified enteral nutrition protocol for elderly mechanically ventilated ICU patients: development and preliminary application.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To develop a clinically feasible enteral nutrition protocol for elderly mechanically ventilated patients in the intensive care unit (ICU) based on the Geriatric Nutritional Risk Index (GNRI) stratification, and to preliminarily evaluate its effects on nutritional indicators, gastrointestinal complications, mechanical ventilation duration, and hospital length of stay. Methods: Based on systematic literature review and multidisciplinary discussion, a preliminary GNRI-stratified enteral nutrition protocol was formulated. Two rounds of Delphi consultation were conducted among 20 experts to revise and optimize the protocol. A single-center, non-concurrent controlled study was performed in 128 elderly mechanically ventilated patients (63 in the experimental group and 65 in the control group). The experimental group received the standardized GNRI-stratified enteral nutrition protocol, while the control group received conventional nutritional management. The primary outcomes included serum albumin and hemoglobin at 1 week [adjusted by analysis of covariance (ANCOVA) and multivariable linear regression]. Secondary outcomes included enteral nutrition-related complications (analyzed by multivariable logistic regression), mechanical ventilation duration, and hospital length of stay (analyzed by Mann-Whitney Results: The expert authority coefficients were 0.83 and 0.87 in the two rounds, and Kendall's Conclusion: The GNRI-stratified enteral nutrition protocol developed using the Delphi method is scientific and clinically applicable. In this single-center non-concurrent study, implementation of the protocol was associated with improved nutritional indicators, fewer gastrointestinal complications, shorter mechanical ventilation duration, and shorter hospital stay in elderly mechanically ventilated ICU patients.
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