The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
ACG Clinical Guideline: Nutrition Therapy in the Adult Hospitalized Patient
Abstract
The value of nutrition therapy for the adult hospitalized patient is derived from the outcome benefits achieved by the delivery of early enteral feeding. Nutritional assessment should identify those patients at high nutritional risk, determined by both disease severity and nutritional status. For such patients if they are unable to maintain volitional intake, enteral access should be attained and enteral nutrition (EN) initiated within 24-48 h of admission. Orogastric or nasogastric feeding is most appropriate when starting EN, switching to post-pyloric or deep jejunal feeding only in those patients who are intolerant of gastric feeds or at high risk for aspiration. Percutaneous access should be used for those patients anticipated to require EN for >4 weeks. Patients receiving EN should be monitored for risk of aspiration, tolerance, and adequacy of feeding (determined by percent of goal calories and protein delivered). Intentional permissive underfeeding (and even trophic feeding) is appropriate temporarily for certain subsets of hospitalized patients. Although a standard polymeric formula should be used routinely in most patients, an immune-modulating formula (with arginine and fish oil) should be reserved for patients who have had major surgery in a surgical ICU setting. Adequacy of nutrition therapy is enhanced by establishing nurse-driven enteral feeding protocols, increasing delivery by volume-based or top-down feeding strategies, minimizing interruptions, and eliminating the practice of gastric residual volumes. Parenteral nutrition should be used in patients at high nutritional risk when EN is not feasible or after the first week of hospitalization if EN is not sufficient. Because of their knowledge base and skill set, the gastroenterologist endoscopist is an asset to the Nutrition Support Team and should participate in providing optimal nutrition therapy to the hospitalized adult patient.
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Citations
Cites
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Cited by
EASL Clinical Practice Guidelines on nutrition in chronic liver disease
Merli, M., Berzigotti, A., Zelber-Sagi, S., Dasarathy, S., Montagnese, S., Genton, L., Plauth, M., & Parés, A. (2019) · Journal of Hepatology · doi:10.1016/j.jhep.2018.06.024 · Cited by 1,130
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ESPEN guideline on nutritional support for polymorbid medical inpatients
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“In line with this fi nding, the recommendations from guideline on nutritional therapy by the American College of Gastroenterology [56] and other expert groups [51,79,80] for older patients and general inpatients are advocating daily protein targets of at least 1.2 g/kg body weight and even higher…”
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Best practices for unclogging feeding tubes in adults
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Metadata
- Authors
- McClave, S. A., DiBaise, J. K., Mullin, G. E., & Martindale, R. G.
- Venue
- American Journal of Gastroenterology
- Published
- 2016-03
- Volume
- 111
- Issue
- 3
- Pages
- 315-334
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W2294103358
- Cited by
- 281
- References
- 23
- FWCI
- 16.96
- Type
- journal article
- Language
- en
- Open access
- closed
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