Enteral nutrition dose-dependently inhibits gastric motility via a feedback loop that can be assessed with a novel gastric monitoring system

Rationale: In critically ill patients it is difficult to determine the appropriate enteral nutrition (EN) infusion speed, balancing the risk of malnutrition versus intolerance. A neurohumoral feedback loop matches gastric emptying (GE) rate to the intestine’s processing capacity by altering gastric motility. We developed a technique for continuous measurement of gastric motility (VIPUN™ Gastric Monitoring System (GMS), KU Leuven, Belgium). The GMS comprises a double-lumen 12 French nasogastric balloon catheter. One lumen for enteral access, the second lumen connects the intragastric balloon to a control unit with a pressure sensor. Pressure fluctuations reflect phasic gastric motility. We aimed to demonstrate that gastric motility, as measured with the GMS, can serve as an indicator for the feedback loop. This feature is essential for the development of the GMS as tool to guide enteral nutrition.