{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:57:56Z","timestamp":1775026676196,"version":"3.50.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"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. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Enteral nutrition (EN) intolerance is a prevalent challenge in neurocritical care. Traditional markers, such as gastric residual volume, remain controversial due to their low specificity. While visualized nasojejunal tubes (NJT) facilitate placement, their application as an indwelling monitoring tool for observing real-time mucosal dynamics remains unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case description<\/jats:title>\n                    <jats:p>We report a case of a 62-year-old male with cerebral hemorrhage who required post-pyloric feeding due to high aspiration risk and initial gastric feeding intolerance. An indwelling hydrophilic-coated visual NJT with a distal tip camera was deployed. Serial bedside monitoring was performed on Days 1, 7, 14, and 21 over a 22-day indwelling period. We established a novel \u201cBedside Visual Mucosal Scoring System\u201d to semi-quantitatively assess mucosal color, villi morphology, and luminal contents. Serial monitoring revealed a distinct transition from an initial edematous and hyper-secretory state to a healthy state with distinct villi architecture. Notably, the visual improvement of mucosal integrity coincided chronologically with the patient\u2019s clinical stabilization, including decreased inflammatory markers and successful weaning from mechanical ventilation. The patient achieved full caloric targets without catheter-related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case demonstrates the feasibility and safety of using hydrophilic-coated visual NJT for long-term, bedside dynamic monitoring of jejunal mucosa. This technique offers a promising alternative from indirect assessment to direct visualization, highlighting the potential for mucosa-directed precision nutrition strategies in critically ill patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1802293","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:02:14Z","timestamp":1775019734000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term bedside dynamic monitoring of jejunal mucosa via an indwelling visualized nasojejunal tube in a neurocritical patient: a case report and proposal for a novel scoring system"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoyun","family":"Li","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University","place":["Guangzhou, China"]},{"name":"Guangdong Clinical Research Center for Critical Care Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongtang","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University","place":["Guangzhou, China"]},{"name":"Guangdong Clinical Research Center for Critical Care Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongfu","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University","place":["Guangzhou, China"]},{"name":"Guangdong Clinical Research Center for Critical Care Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1007\/s00423-025-03699-4","article-title":"The effect of cluster nursing combined with early enteral nutrition intervention in postoperative severe craniocerebral injury","volume":"410","author":"Chen","year":"2025","journal-title":"Langenbeck's Arch Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"907","DOI":"10.5152\/tjg.2021.201033","article-title":"Effect of early enteral nutrition on serum inflammatory factors and intestinal mucosal permeability in patients with severe acute pancreatitis","volume":"32","author":"Li","year":"2021","journal-title":"Turk J Gastroenterol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1038\/s41387-024-00292-4","article-title":"Effect of a diabetes-specific formula in non-diabetic inpatients with stroke: a randomized controlled trial","volume":"14","author":"Lopez-Gomez","year":"2024","journal-title":"Nutr Diabetes"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1097\/mcc.0000000000000386","article-title":"New insights into the gut as the driver of critical illness and organ failure","volume":"23","author":"Meng","year":"2017","journal-title":"Curr Opin Crit Care"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"128","DOI":"10.3390\/nu16010128","article-title":"Prolonged fasting induces histological and ultrastructural changes in the intestinal mucosa that may reduce absorption and revert after enteral refeeding","volume":"16","author":"Nunes","year":"2023","journal-title":"Nutrients"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s40560-025-00786-y","article-title":"Gut integrity in intensive care: alterations in host permeability and the microbiome as potential therapeutic targets","volume":"13","author":"Oami","year":"2025","journal-title":"J Intensive Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.3390\/nu17081352","article-title":"Critical care nutrition from a metabolic point of view: a narrative review","volume":"17","author":"Oami","year":"2025","journal-title":"Nutrients"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s11894-024-00954-4","article-title":"The gut in critical illness","volume":"27","author":"Patel","year":"2025","journal-title":"Curr Gastroenterol Rep"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1038\/s41430-021-00877-7","article-title":"The effect of enteral stimulation on the immune response of the intestinal mucosa and its application in nutritional support","volume":"75","author":"Quiroz-Olguin","year":"2021","journal-title":"Eur J Clin Nutr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s13613-025-01509-0","article-title":"Expert consensus-based clinical practice guidelines for nutritional support in the intensive care unit: the French Intensive Care Society (SRLF) and the French-speaking Group of Pediatric Emergency Physicians and Intensivists (GFRUP)","volume":"15","author":"Reignier","year":"2025","journal-title":"Ann Intensive Care"},{"key":"ref11","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":"ref12","doi-asserted-by":"publisher","first-page":"2402","DOI":"10.1161\/STROKEAHA.124.047582","article-title":"Metoclopramide to prevent pneumonia in patients with stroke and a nasogastric tube: data from the PRECIOUS trial","volume":"55","author":"Sluis","year":"2024","journal-title":"Stroke"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/S1474-4422(22)00010-2","article-title":"Safety and efficacy of three enteral feeding strategies in patients with severe stroke in China (OPENS): a multicentre, prospective, randomised, open-label, blinded-endpoint trial","volume":"21","author":"Zhao","year":"2022","journal-title":"Lancet Neurol"}],"container-title":["Frontiers in 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