{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:26:55Z","timestamp":1770748015821,"version":"3.49.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In critically ill patients with acute gastrointestinal injury (AGI), early administration of a peptide-based enteral formula (PBF) may be beneficial during the acute phase. Nevertheless, after gastrointestinal function improves, it remains unclear whether continuing a PBF or switching to a standard polymeric formula (SPF) is preferable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the efficacy and safety of continuing a PBF versus switching to an SPF from day 4 onward in critically ill patients with AGI whose gastrointestinal function has recovered or improved to AGI grade I by day 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single-center, parallel-group, randomized, controlled, trial with 1:1 allocation, intention-to-treat analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Three clinical units of the Department of Critical Care Medicine at the First Hospital of Jilin University (Changchun, China).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We will ultimately include 496 adult critically ill patients with AGI grade I\u2013II who meet the eligibility criteria in the final analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Continuous Peptide-Based Enteral Formula Group (PBF group): patients will receive continuous infusion of a PBF, initiated within 7\u202fdays of ICU admission. Sequential Standard Polymeric Enteral Formula Group (SPF group): patients will receive a PBF during the first 3\u202fdays in the ICU and will be transitioned to an SPF if the AGI grade is 0\u2013I on ICU day 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>The primary outcome is the mean daily energy intake on day 7 (kcal\/kg\/day). An intention-to-treat analysis will be used to assess this outcome to enhance the robustness of the results. Secondary outcomes and relevant process measures will be evaluated in accordance with the study protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/showproj.html?pid=139513<\/jats:ext-link>\n                      , Identifier ChiCTR2200056858.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1761334","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T06:51:35Z","timestamp":1770706295000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Continuous peptide-based versus sequential standard polymeric enteral nutrition formula in critically ill patients with acute gastrointestinal injury: study protocol for a single-center, parallel-group randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanhua","family":"Li","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youquan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1097\/ccm.0000000000003152","article-title":"Early enteral nutrition provided within 24 hours of ICU admission: a meta-analysis of randomized controlled trials","volume":"46","author":"Tian","year":"2018","journal-title":"Crit Care Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1177\/0884533609335176","article-title":"The physiologic response and associated clinical benefits from provision of early enteral nutrition","volume":"24","author":"Mcclave","year":"2009","journal-title":"Nutr Clin Pract"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1016\/j.clnu.2023.07.011","article-title":"ESPEN practical and partially revised guideline: clinical nutrition in the intensive care unit","volume":"42","author":"Singer","year":"2023","journal-title":"Clin Nutr"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s00134-016-4665-0","article-title":"Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines","volume":"43","author":"Reintam Blaser","year":"2017","journal-title":"Intensive Care Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1016\/j.clnu.2023.03.004","article-title":"Association between Gastrointestinal Dysfunction Score (GIDS) and disease severity and prognosis in critically ill patients: a prospective, observational study","volume":"42","author":"Liu","year":"2023","journal-title":"Clin Nutr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1007\/s00134-011-2459-y","article-title":"Gastrointestinal function in intensive care patients: terminology, definitions and management. 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