In critically ill patients receiving enteral nutrition in the intensive care unit, the functional capacity of the gastrointestinal system can be significantly influenced by the mode of nutritional support. The temperature of enteral feeding may exert potential effects on gastric emptying, intestinal motility, and nutrient absorption. However, the existing literature on the impact of feeding temperature is limited, and randomized or cross-over controlled studies directly comparing warm and cold enteral feeding are scarce. This study aims to systematically evaluate the effects of enteral feeding temperature on feeding tolerance (vomiting and aspiration), gastric emptying rate (gastric residual volume), and the incidence of diarrhea, thereby providing evidence to inform clinical practice.

Inclusion Criteria:

• Patients aged 18 years or older
• Expected length of stay in the intensive care unit of at least 96 hours
• Patients receiving enteral nutrition via a nasogastric tube
• Absence of ileus or active gastrointestinal bleeding

Exclusion Criteria:

• Patients younger than 18 years of age
• Use of high-dose opioids known to affect gastrointestinal motility
• Patients receiving parenteral nutrition
• Known gastrointestinal diseases or a history of gastrointestinal surgery
• Patients with acute intracranial events will not be included in the study

Individual participant data will not be shared because of the limited sample size, potential risks to participant confidentiality, and institutional restrictions on data sharing.