ASPEN-FELANPE Clinical Guidelines

Area of Science:

• Clinical Nutrition
• Gastroenterology
• Surgical Patient Care

Background:

• Enterocutaneous fistula (ECF) management is complex, requiring an interdisciplinary approach.
• Current nutrition guidelines for ECF patients are often vague and lack robust clinical evidence.
• Specific nutrient needs, feeding routes, and adjunctive therapies for ECF are not well-defined.

Purpose of the Study:

• To develop evidence-based recommendations for the nutrition care of adult patients with ECF.
• To address critical questions regarding nutrition status assessment and therapeutic interventions for ECF.

Main Methods:

• A systematic review of the best available evidence was conducted.
• The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was utilized.
• An anonymous consensus process informed guideline development and approval.

Main Results:

• Key questions addressed include: nutrition status factors, preferred nutrition therapy route (oral, enteral, parenteral), optimal protein/energy intake, fistuloclysis efficacy, immune-enhancing formulas, somatostatin analogue use, and home parenteral nutrition indications.
• The guideline synthesizes current evidence to answer these critical clinical questions.

Conclusions:

• The guideline provides clear recommendations for nutrition management in adult ECF patients.
• It aims to standardize and improve the quality of nutrition care for this challenging patient population.
• Further research may be needed to refine specific aspects of ECF nutrition therapy.