الفهرس 
acknowledgmentOnly 14 pages are availabe for public view
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Abstract
Critically ill patients are often unable to eat because of endotracheal intubation and the need for mechanical ventilation . A a consequence malnutrition is prevalent in mechanically ventilated patients. Enteral nutrition if provided early offers distinct benefits to the critically ill patients mainly maintaining the structural and functional integrity of gastric intestinal tract, improving systemic immunity and lowering infection risk. However, enteral feeding in critically ill patients is often decreased or stopped because of large gastric residual volumes.
Gastric residual volumes are widely used to evaluate feeding tolerance in clinical practice, but controversy exists about how it affects management . Conflicting data are available for the volume of residual that represents intolerance, but most clinicans use 150-200 ml to signify gastrointestinal motility dysfunction.