Continuous Versus Intermittent Enteral Feeding and Gastric Residual Volume in Critically Ill Patients

Inclusion Criteria: * Age 18 to 80 years. * Currently treated in an intensive care unit and has a clinical indication for gastric enteral nutrition through a nasogastric or orogastric tube. * The gastrointestinal tract is considered usable for enteral nutrition according to the treating physician. * Expected to remain in the intensive care unit and to be available for study follow-up for 72 hours after randomization, unless a prespecified early stopping criterion occurs. * A gastric enteral nutrition plan is in place; the enteral formula and energy/protein targets are determined by the treating physician in consultation with the Department of Nutrition before randomization. * Written informed consent is provided by the participant or a legally authorized representative. Exclusion Criteria: * Previous gastrectomy, pyloric stenosis, or recent gastric or duodenal surgery that alters gastric anatomy or function and may affect ultrasound-based gastric volume estimation. * Contraindication to enteral nutrition, including bowel obstruction, severe ileus, gastrointestinal perforation, intestinal ischemia or necrosis, severe gastrointestinal bleeding, or another condition requiring complete cessation of enteral feeding. * Expected death, transfer out of the intensive care unit, or removal of the gastric tube in the near term such that 72-hour study follow-up is not feasible. * Receiving exclusive parenteral nutrition with no plan to initiate gastric enteral feeding. * Pregnancy. * Uncontrolled shock or hemodynamic instability at screening, defined as norepinephrine ≥0.3 micrograms/kg/min or an equivalent vasopressor requirement according to the treating physician. * Unable to tolerate brief right lateral positioning for gastric ultrasonography because of hemodynamic or respiratory instability, spinal injury or fixation, contraindication to turning, or another safety concern. * Gastric antrum cannot be adequately visualized at screening because of an inadequate acoustic window, surgical wound or dressing, subcutaneous emphysema, excessive gas, or another reason. * Participant or legally authorized representative declines participation. * Participant lacks capacity to provide consent and no legally authorized representative is available at enrollment.