The American College of Gastroenterology (ACG) has issued new practice guideline recommendations on nutrition therapy for adult hospitalized patients. The committee compiled a list of questions and recommendations based on a literature search, and used GRADE methodology to determine the quality of available evidence.
They recommended that enteral nutrition be initiated promptly (within 24 to 48 hours of admission) in patients at high nutritional risk who are unable to maintain volitional oral intake, and enteral nutrition is preferred over parenteral nutrition in those without a contraindication to luminal nutrient delivery who need non-volitional specialized nutrition therapy. Parenteral nutrition “should be reserved for high-risk patients when [enteral nutrition] is not feasible or sufficient enough to meet energy or protein goals,” as the risk–benefit ratio of parenteral nutrition is “much narrower.”
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