The first week on a ventilator is especially important for providing proper nutrition, since patients’ needs often shift quickly during this period, say the investigators. “Too many patients on ventilators in the intensive care unit (ICU) don’t get the nutrition they need during the critical first week,” says co-senior corresponding author Ankit Sakhuja, MBBS, MS, Associate Professor of Artificial Intelligence and Human Health, and Medicine (Data-Driven and Digital Medicine). “Their needs are changing rapidly, and it’s easy for them to fall behind. We wanted to explore a simple, timely way to identify who is most at risk of being underfed so that clinicians could intervene earlier, adjust care, and make sure each patient receives the right support when it matters most.”
The research team built an AI tool, called NutriSightT, which analyzed routine ICU data such as vital signs, lab results, medications, and feeding information to predict, hours in advance, which patients may be underfed on days 3–7 of ventilation. Using large deidentified ICU datasets from Europe and the United States, the model was trained and validated to update predictions every four hours as patient conditions change.
The study identified several key insights that could potentially help guide patient care:
Underfeeding is common early in ICU care. About 41 percent to 53 percent of patients were underfed by day three, and 25-35 percent remained underfed by day seven.
The model is dynamic and interpretable, showing which routine factors—such as blood pressure, sodium levels, or sedation—influence underfeeding risk.
The research could support personalized feeding plans, guide nutrition teams, and inform clinical trials to determine the most effective nutrition strategies for individual patients.
The investigators emphasize that NutriSighT would not be intended to replace clinicians. Instead, it could serve as an early-warning system to help guide timely nutrition interventions.
The research team’s next steps include prospective multi-site trials to test whether acting on these predictions improves patient outcomes, careful integration into electronic health records, and expansion to broader individualized nutrition targets.
“The significance of our study’s findings is that, for the first time, it may be possible to identify which patients are at risk of underfeeding early in their ICU stay and tailor care to their individual needs,” says co-senior author Girish N. Nadkarni, MD, MPH, Chair of the Windreich Department of Artificial Intelligence and Human Health, Director of the Hasso Plattner Institute for Digital Health, and Irene and Dr. Arthur M. Fishberg Professor of Medicine at the Icahn School of Medicine at Mount Sinai, and Chief AI Officer of the Mount Sinai Health System. “It represents an important step towards giving clinicians better information to make decisions about nutrition. Ultimately, the goal is to provide the right amount of nutrition to the right patient at the right time, which could help improve recovery and outcomes in critically ill patients and lay the groundwork for more personalized care strategies.”
The paper is titled “NutriSighT: Interpretable Transformer Model for Dynamic Prediction of Underfeeding Enteral Nutrition in Mechanically Ventilated Patients.”
The study’s authors, as listed in the journal, are Mateen Jangda, Jayshil Patel, Akhil Vaid, Jaskirat Gill, Paul McCarthy, Jacob Desman, Rohit Gupta, Dhruv Patel, Nidhi Kavi, Shruti Bakare, Eyal Klang, Robert Freeman, Anthony Manasia, John Oropello, Lili Chan, Mayte Suarez-Farinas, Alexander W. Charney, Roopa Kohli-Seth, Girish N. Nadkarni, and Ankit Sakhuja.
This study was supported by the National Institutes of Health (NIH) grant K08DK131286. See the journal paper for details on conflicts of interest: Nature Communications.
For more Mount Sinai artificial intelligence news, visit: https://icahn.mssm.edu/about/artificial-intelligence.
About Mount Sinai's Windreich Department of AI and Human Health
Led by Girish N. Nadkarni, MD, MPH—an international authority on the safe, effective, and ethical use of AI in health care—Mount Sinai’s Windreich Department of AI and Human Health is the first of its kind at a U.S. medical school, pioneering transformative advancements at the intersection of artificial intelligence and human health.
The Department is committed to leveraging AI in a responsible, effective, ethical, and safe manner to transform research, clinical care, education, and operations. By bringing together world-class AI expertise, cutting-edge infrastructure, and unparalleled computational power, the department is advancing breakthroughs in multi-scale, multimodal data integration while streamlining pathways for rapid testing and translation into practice.
The Department benefits from dynamic collaborations across Mount Sinai, including with the Hasso Plattner Institute for Digital Health at Mount Sinai—a partnership between the Hasso Plattner Institute for Digital Engineering in Potsdam, Germany, and the Mount Sinai Health System—which complements its mission by advancing data-driven approaches to improve patient care and health outcomes.
At the heart of this innovation is the renowned Icahn School of Medicine at Mount Sinai, which serves as a central hub for learning and collaboration. This unique integration enables dynamic partnerships across institutes, academic departments, hospitals, and outpatient centers, driving progress in disease prevention, improving treatments for complex illnesses, and elevating quality of life on a global scale.
In 2024, the Department's innovative NutriScan AI application, developed by the Mount Sinai Health System Clinical Data Science team in partnership with Department faculty, earned Mount Sinai Health System the prestigious Hearst Health Prize. NutriScan is designed to facilitate faster identification and treatment of malnutrition in hospitalized patients. This machine learning tool improves malnutrition diagnosis rates and resource utilization, demonstrating the impactful application of AI in health care.
For more information on Mount Sinai's Windreich Department of AI and Human Health, visit: ai.mssm.edu
About the Hasso Plattner Institute at Mount Sinai
At the Hasso Plattner Institute for Digital Health at Mount Sinai, the tools of data science, biomedical and digital engineering, and medical expertise are used to improve and extend lives. The Institute represents a collaboration between the Hasso Plattner Institute for Digital Engineering in Potsdam, Germany, and the Mount Sinai Health System.
Under the leadership of Girish Nadkarni, MD, MPH, who directs the Institute, and Professor Lothar Wieler, a globally recognized expert in public health and digital transformation, they jointly oversee the partnership, driving innovations that positively impact patient lives while transforming how people think about personal health and health systems.
The Hasso Plattner Institute for Digital Health at Mount Sinai receives generous support from the Hasso Plattner Foundation. Current research programs and machine learning efforts focus on improving the ability to diagnose and treat patients.
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the seven member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to New York City’s large and diverse patient population.
The Icahn School of Medicine at Mount Sinai offers highly competitive MD, PhD, MD-PhD, and master’s degree programs, with enrollment of more than 1,200 students. It has the largest graduate medical education program in the country, with more than 2,600 clinical residents and fellows training throughout the Health System. Its Graduate School of Biomedical Sciences offers 13 degree-granting programs, conducts innovative basic and translational research, and trains more than 560 postdoctoral research fellows.
Ranked 11th nationwide in National Institutes of Health (NIH) funding, the Icahn School of Medicine at Mount Sinai is among the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. More than 4,500 scientists, educators, and clinicians work within and across dozens of academic departments and multidisciplinary institutes with an emphasis on translational research and therapeutics. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai.
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* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai
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