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<meta name="robots" content="NOINDEX,NOFOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="author" content="National Collaborating Centre for Acute Care (UK)" /><meta name="citation_title" content="Nutrition Support for Adults" /><meta name="citation_publisher" content="National Collaborating Centre for Acute Care (UK)" /><meta name="citation_date" content="2006/02" /><meta name="citation_author" content="National Collaborating Centre for Acute Care (UK)" /><meta name="citation_pmid" content="21309138" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK49269/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Nutrition Support for Adults" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Collaborating Centre for Acute Care (UK)" /><meta name="DC.Contributor" content="National Collaborating Centre for Acute Care (UK)" /><meta name="DC.Date" content="2006/02" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK49269/" /><meta name="description" content="These guidelines cover most aspects of nutrition support in adult patients (>18 years) who are either malnourished or are at ‘risk’ of malnutrition. 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The guideline therefore includes: information on the prevalence of malnutrition and the benefits of good nutrition; guidance on the appropriate forums for the organisation of nutrition support in all settings; guidance on who should be screened for malnutrition and when, along with the criteria for consideration when assessing patients’ nutritional status; the general indications for nutrition support together with ethical and legal considerations that may arise; guidance on the process and special considerations required to prescribe nutrition support and details information on the important parameters to monitor for patients receiving nutrition support; detailed guidance on the administration of oral, enteral and parenteral nutrition including; the appropriate types of access for enteral and parenteral nutrition and the optimum mode of delivering these; specific guidance on the management of providing nutrition support to patients with dysphagia; issues to consider for patients receiving enteral and parenteral nutrition support in the community; issues arising for patients and their carers." /><meta name="og:title" content="Nutrition Support for Adults" /><meta name="og:type" content="book" /><meta name="og:description" content="These guidelines cover most aspects of nutrition support in adult patients (>18 years) who are either malnourished or are at ‘risk’ of malnutrition. In some cases specific guidance related to patients in specific care settings or with specific diseases has been provided but in general the guidance is applicable to patients whatever their setting (hospital or community) or disease. The guideline therefore includes: information on the prevalence of malnutrition and the benefits of good nutrition; guidance on the appropriate forums for the organisation of nutrition support in all settings; guidance on who should be screened for malnutrition and when, along with the criteria for consideration when assessing patients’ nutritional status; the general indications for nutrition support together with ethical and legal considerations that may arise; guidance on the process and special considerations required to prescribe nutrition support and details information on the important parameters to monitor for patients receiving nutrition support; detailed guidance on the administration of oral, enteral and parenteral nutrition including; the appropriate types of access for enteral and parenteral nutrition and the optimum mode of delivering these; specific guidance on the management of providing nutrition support to patients with dysphagia; issues to consider for patients receiving enteral and parenteral nutrition support in the community; issues arising for patients and their carers." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK49269/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg32-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="warning" content="July 2017: Links were updated in the footnotes to recommendations 1.3.4 and 1.8.15 by NICE. 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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div><div class="bk_msg_box bk_bttm_mrgn clearfix bk_noprnt"><div class="iconblock clearfix"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/nicecg32guid/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg32guid-lrg.png" alt="Cover" height="100px" width="80px" /></a><div class="icnblk_cntnt"><ul class="messages"><li class="info icon"><span class="icon"><a href="/books/n/nicecg32guid/">See 2017 Partial Update</a></span></li></ul></div></div></div><div class="messagearea bk_noprnt" style="margin-bottom:1.3846em "><ul class="messages"><li class="warn icon"><span class="icon">July 2017: Links were updated in the footnotes to recommendations 1.3.4 and 1.8.15 by NICE. Recommendation 1.7.17 was updated and links added to National Patient Safety Agency documents.</span></li></ul></div><div class="bk_prnt"><p style="color:red;"><strong>July 2017: Links were updated in the footnotes to recommendations 1.3.4 and 1.8.15 by NICE. Recommendation 1.7.17 was updated and links added to National Patient Safety Agency documents.</strong></p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://www.nice.org.uk/guidance/index.jsp?action=folder&r=true&o=30535" title="National Collaborating Centre for Acute Care (UK)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg32-lrg.png" alt="Cover of Nutrition Support for Adults" /></a><div class="icnblk_cntnt"><h1 id="_NBK49269_"><span itemprop="name">Nutrition Support for Adults</span></h1><div class="subtitle">Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition</div><p><i>NICE Clinical Guidelines, No. 32</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Collaborating Centre for Acute Care (UK)</span>.</p><div class="half_rhythm">London: <a href="http://www.nice.org.uk/guidance/index.jsp?action=folder&r=true&o=30535" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Collaborating Centre for Acute Care (UK)</span></a>; <span itemprop="datePublished">2006 Feb</span>.<div class="small">ISBN-10: <span itemprop="isbn">0-9549760-2-9</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © 2006, National Collaborating Centre for Acute Care.</div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Excerpt</h2><p>These guidelines cover most aspects of nutrition support in adult patients (>18 years) who are either malnourished or are at ‘risk’ of malnutrition. In some cases specific guidance related to patients in specific care settings or with specific diseases has been provided but in general the guidance is applicable to patients whatever their setting (hospital or community) or disease. The guideline therefore includes: information on the prevalence of malnutrition and the benefits of good nutrition; guidance on the appropriate forums for the organisation of nutrition support in all settings; guidance on who should be screened for malnutrition and when, along with the criteria for consideration when assessing patients’ nutritional status; the general indications for nutrition support together with ethical and legal considerations that may arise; guidance on the process and special considerations required to prescribe nutrition support and details information on the important parameters to monitor for patients receiving nutrition support; detailed guidance on the administration of oral, enteral and parenteral nutrition including; the appropriate types of access for enteral and parenteral nutrition and the optimum mode of delivering these; specific guidance on the management of providing nutrition support to patients with dysphagia; issues to consider for patients receiving enteral and parenteral nutrition support in the community; issues arising for patients and their carers.</p></div><div><h2>Contents</h2><ul id="toc_tllNBK49269_toc_nicecg32_foreword" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK49269_toc_nicecg32_foreword"><a class="toc-item" href="/books/n/nicecg32/nicecg32.foreword/">Foreword</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_nicecg32_guideline"><a class="toc-item" href="/books/n/nicecg32/nicecg32.guideline/">Guideline Development Group membership and acknowledgments</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_nicecg32_stakeholder"><a class="toc-item" href="/books/n/nicecg32/nicecg32.stakeholder/">Stakeholder Involvement</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_abbreviations"><a class="toc-item" href="/books/n/nicecg32/abbreviations/">Abbreviations</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_glossary"><a class="toc-item" href="/books/n/nicecg32/glossary/">Glossary of Terms</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1"><a class="toc-item" href="/books/n/nicecg32/ch1/">1. Introduction and methods</a><ul id="toc_lst_NBK49269_toc_ch1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s1"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s1">1.1. The need for guidelines in nutrition support</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s2"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s2">1.2. What is a guideline?</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s3"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s3">1.3. Remit of the guideline</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s4"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s4">1.4. What the guideline covers</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s5"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s5">1.5. What the guideline does not cover</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s6"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s6">1.6. Who the guideline is for</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s7"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s7">1.7. Who developed the guideline?</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s8"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s8">1.8. Methodology</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s20"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s20">1.9. Hierarchy of clinical evidence</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s21"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s21">1.10. Health economics methods</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s24"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s24">1.11. Forming and grading the recommendations</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s25"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s25">1.12. Specific problems with evidence relating to the development of nutrition support guidelines</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s26"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s26">1.13. Patient-centred care</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s27"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s27">1.14. Summary of the recommendations</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch1_s58"><a class="toc-item" href="/books/n/nicecg32/ch1/#ch1.s58">1.14.3. Research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch2"><a class="toc-item" href="/books/n/nicecg32/ch2/">2. Malnutrition and the principles of nutrition support</a><ul id="toc_lst_NBK49269_toc_ch2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch2_s1"><a class="toc-item" href="/books/n/nicecg32/ch2/#ch2.s1">2.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch2_s2"><a class="toc-item" href="/books/n/nicecg32/ch2/#ch2.s2">2.2. The causes of malnutrition</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch2_s3"><a class="toc-item" href="/books/n/nicecg32/ch2/#ch2.s3">2.3. The effects of malnutrition</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch2_s4"><a class="toc-item" href="/books/n/nicecg32/ch2/#ch2.s4">2.4. The prevalence of malnutrition</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch2_s5"><a class="toc-item" href="/books/n/nicecg32/ch2/#ch2.s5">2.5. Principles underlying intervention</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3"><a class="toc-item" href="/books/n/nicecg32/ch3/">3. Organisation of nutrition support in hospital and the community</a><ul id="toc_lst_NBK49269_toc_ch3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s1"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s1">3.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s2"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s2">3.2. Nutrition support in the community</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s3"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s3">3.3. Nutrition support in Hospital</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s9"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s9">3.4. Methods</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s11"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s11">3.5. Clinical evidence</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s19"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s19">3.6. Cost effectiveness evidence</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s20"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s20">3.7. Conclusion</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s21"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s21">3.8. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch3_s22"><a class="toc-item" href="/books/n/nicecg32/ch3/#ch3.s22">3.9. Research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4"><a class="toc-item" href="/books/n/nicecg32/ch4/">4. Screening for malnutrition and the risk of malnutrition in hospital and the community</a><ul id="toc_lst_NBK49269_toc_ch4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s1"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s1">4.1. Nutritional assessment</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s2"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s2">4.2. Why and how to screen</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s3"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s3">4.3. Methods</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s4"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s4">4.4. Studies considered for this review</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s5"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s5">4.5. Clinical evidence</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s6"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s6">4.6. Cost-effectiveness evidence</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s10"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s10">4.7. Consensus development methods</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s11"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s11">4.8. Impact of nutritional assessment on the patient</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s12"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s12">4.9. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch4_s13"><a class="toc-item" href="/books/n/nicecg32/ch4/#ch4.s13">4.10. Research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5"><a class="toc-item" href="/books/n/nicecg32/ch5/">5. Indications for nutrition support</a><ul id="toc_lst_NBK49269_toc_ch5" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5_s1"><a class="toc-item" href="/books/n/nicecg32/ch5/#ch5.s1">5.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5_s2"><a class="toc-item" href="/books/n/nicecg32/ch5/#ch5.s2">5.2. Methodology</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5_s3"><a class="toc-item" href="/books/n/nicecg32/ch5/#ch5.s3">5.3. Appropriate Nutrition Support and ethical/legal issues</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5_s4"><a class="toc-item" href="/books/n/nicecg32/ch5/#ch5.s4">5.4. Rationale for recommendations</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5_s7"><a class="toc-item" href="/books/n/nicecg32/ch5/#ch5.s7">5.5. Patient Pathway Algorithm</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5_s8"><a class="toc-item" href="/books/n/nicecg32/ch5/#ch5.s8">5.6. Oral Algorithm</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch5_s9"><a class="toc-item" href="/books/n/nicecg32/ch5/#ch5.s9">5.7. Enteral and Parenteral Algorithm</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6"><a class="toc-item" href="/books/n/nicecg32/ch6/">6. What to give in hospital and the community</a><ul id="toc_lst_NBK49269_toc_ch6" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6_s1"><a class="toc-item" href="/books/n/nicecg32/ch6/#ch6.s1">6.1. Background</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6_s2"><a class="toc-item" href="/books/n/nicecg32/ch6/#ch6.s2">6.2. General Principles</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6_s3"><a class="toc-item" href="/books/n/nicecg32/ch6/#ch6.s3">6.3. Calculating requirements</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6_s10"><a class="toc-item" href="/books/n/nicecg32/ch6/#ch6.s10">6.4. Concerns with prescribing levels</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6_s11"><a class="toc-item" href="/books/n/nicecg32/ch6/#ch6.s11">6.5. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6_s12"><a class="toc-item" href="/books/n/nicecg32/ch6/#ch6.s12">6.6. Re-feeding Problems</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch6_s22"><a class="toc-item" href="/books/n/nicecg32/ch6/#ch6.s22">6.7. Recommendations for research</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch7"><a class="toc-item" href="/books/n/nicecg32/ch7/">7. Monitoring of nutrition support in hospital and the community</a><ul id="toc_lst_NBK49269_toc_ch7" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch7_s1"><a class="toc-item" href="/books/n/nicecg32/ch7/#ch7.s1">7.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch7_s2"><a class="toc-item" href="/books/n/nicecg32/ch7/#ch7.s2">7.2. Methods</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch7_s3"><a class="toc-item" href="/books/n/nicecg32/ch7/#ch7.s3">7.3. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch7_s4"><a class="toc-item" href="/books/n/nicecg32/ch7/#ch7.s4">7.4. Research Recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8"><a class="toc-item" href="/books/n/nicecg32/ch8/">8. Oral nutrition support in hospital and the community</a><ul id="toc_lst_NBK49269_toc_ch8" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s1"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s1">8.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s2"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s2">8.2. Oral nutritional support versus standard care in malnourished patients</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s14"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s14">8.3. Dietary advice versus standard care</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s22"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s22">8.4. Oral nutritional supplements versus dietary advice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s27"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s27">8.5. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s29"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s29">8.6. Oral nutrition support in surgical patients</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s49"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s49">8.7. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s50"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s50">8.8. Oral nutrition support in pancreatitis patients</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s52"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s52">8.9. Oral multivitamin and mineral supplementation in malnourished patients</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s71"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s71">8.10. Nutrition support in patients with dysphagia</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s78"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s78">8.11. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch8_s80"><a class="toc-item" href="/books/n/nicecg32/ch8/#ch8.s80">8.12. Research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9"><a class="toc-item" href="/books/n/nicecg32/ch9/">9. Enteral tube feeding in hospital and the community</a><ul id="toc_lst_NBK49269_toc_ch9" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s1"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s1">9.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s2"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s2">9.2. General Indications for Enteral Tube Feeding in hospital and the community</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s5"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s5">9.3. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s7"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s7">9.4. Enteral tube feeding versus standard care</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s17"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s17">9.5. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s19"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s19">9.6. Enteral tube feeding routes of access</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s31"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s31">9.7. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s33"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s33">9.8. Percutaneous Endoscopic Gastrostomy (PEG) versus Nasogastric (NG) Feeding</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s39"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s39">9.9. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s42"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s42">9.10. Commencing enteral tube feeding after insertion of a percutaneous endoscopic gastrostomy</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s47"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s47">9.11. Recommendation for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s49"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s49">9.12. Types of enteral feeds</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s50"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s50">9.13. Mode of delivering Enteral Tube Feeding</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s58"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s58">9.14. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s60"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s60">9.15. Motility Agents</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s68"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s68">9.16. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s70"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s70">9.17. Complications of enteral tube feeding</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s72"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s72">9.18. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch9_s74"><a class="toc-item" href="/books/n/nicecg32/ch9/#ch9.s74">9.19. Research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10"><a class="toc-item" href="/books/n/nicecg32/ch10/">10. Parenteral nutrition in hospital and the community</a><ul id="toc_lst_NBK49269_toc_ch10" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s1"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s1">10.1. Introduction</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s2"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s2">10.2. PN versus no PN</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s5"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s5">10.2.3. Clinical evidence</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s10"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s10">10.3. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s13"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s13">10.4. Parenteral versus enteral tube feeding</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s25"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s25">10.5. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s27"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s27">10.6. Venous access for PN</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s39"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s39">10.7. Recommendation for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s41"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s41">10.8. Peripheral PN versus central PN</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s49"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s49">10.9. PN via a tunnelled catheter versus PN via a non-tunnelled catheter</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s58"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s58">10.10. Tailored PN preparations versus standard PN preparations</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s64"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s64">10.11. Recommendation for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s66"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s66">10.12. Delivery of PN cyclically versus continuously</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s71"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s71">10.13. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s73"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s73">10.14. Complications from PN</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s77"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s77">10.15. Recommendation for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch10_s79"><a class="toc-item" href="/books/n/nicecg32/ch10/#ch10.s79">10.16. Research recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11"><a class="toc-item" href="/books/n/nicecg32/ch11/">11. Supporting patients in the community</a><ul id="toc_lst_NBK49269_toc_ch11" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11_s1"><a class="toc-item" href="/books/n/nicecg32/ch11/#ch11.s1">11.1. Home enteral tube feeding</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11_s5"><a class="toc-item" href="/books/n/nicecg32/ch11/#ch11.s5">11.2. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11_s7"><a class="toc-item" href="/books/n/nicecg32/ch11/#ch11.s7">11.3. Home parenteral nutrition</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11_s11"><a class="toc-item" href="/books/n/nicecg32/ch11/#ch11.s11">11.4. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11_s13"><a class="toc-item" href="/books/n/nicecg32/ch11/#ch11.s13">11.5. Working in partnership with patients, families and carers</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11_s17"><a class="toc-item" href="/books/n/nicecg32/ch11/#ch11.s17">11.6. Recommendations for clinical practice</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch11_s18"><a class="toc-item" href="/books/n/nicecg32/ch11/#ch11.s18">11.7. Research Recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_ch12"><a class="toc-item" href="/books/n/nicecg32/ch12/">12. Audit criteria</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_references_rl1"><a class="toc-item" href="/books/n/nicecg32/references.rl1/">Bibliography</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_appgroup1"><a class="toc-item" href="/books/n/nicecg32/appendixes.appgroup1/">Appendices</a><ul id="toc_lst_NBK49269_toc_appendixes_appgroup1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app1"><a class="toc-item" href="/books/n/nicecg32/appendixes.app1/">Appendix One. Scope</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app2"><a class="toc-item" href="/books/n/nicecg32/appendixes.app2/">Appendix Two. The Clinical Questions</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app3"><a class="toc-item" href="/books/n/nicecg32/appendixes.app3/">Appendix Three. Literature Search Strategies</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app4"><a class="toc-item" href="/books/n/nicecg32/appendixes.app4/">Appendix Four. Evidence Tables</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app5"><a class="toc-item" href="/books/n/nicecg32/appendixes.app5/">Appendix Five. Cost-Effectiveness Analysis of Malnutrition Screening</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app6"><a class="toc-item" href="/books/n/nicecg32/appendixes.app6/">Appendix Six. Meta-Analyses Oral versus Standard Care</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app7"><a class="toc-item" href="/books/n/nicecg32/appendixes.app7/">Appendix Seven. Meta-Analyses Oral versus Nil Post Operative Nutrition Support</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app8"><a class="toc-item" href="/books/n/nicecg32/appendixes.app8/">Appendix Eight. Meta-Analyses Enteral versus Nil Post Operative Nutrition Support</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app9"><a class="toc-item" href="/books/n/nicecg32/appendixes.app9/">Appendix Nine. Peripheral PN. Intervention details: continuous vs cyclical PN</a></li><li class="half_rhythm" id="toc_itm_NBK49269_toc_appendixes_app10"><a class="toc-item" href="/books/n/nicecg32/appendixes.app10/">Appendix Ten. Monitoring Survey</a></li></ul></li></ul></div><div><p>Commissioned by the National Institute for Clinical Excellence</p></div><div><h4 class="inline">Suggested citation:</h4><p>National Collaborating Centre for Acute Care, February 2006. Nutrition support in adults Oral nutrition support, enteral tube feeding and parenteral nutrition. National Collaborating Centre for Acute Care, London. Available from <a href="http://www.rcseng.ac.uk" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.rcseng.ac.uk</a></p></div></div></div>
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