Enteral nutrition of critically ill patients has become a standard of care in intensive care units (ICUs), and early initiation of enteral feeding is recommended in international guidelines.1–4 Practical nutrition management, however, is often difficult in ICU patients for a variety of reasons, including gastroparesis with regurgitation of undigested feedings.5,6 In patients intolerant of gastric feeding, use of a nasojejunal feeding tube is recommended and can improve nutrient delivery.1–4,7,8 The implementation of structured nutrition support protocols improves nutrition practices, and several protocols published to date include placement of a postpyloric feeding tube but do not specifically report use or influence of this measure on nutrition outcomes.