Clinical Guidelines

Clinical Guidelines are systematically developed, evidence-based/evidence-informed statements and recommendations that assist and guide practitioner and patient decisions about appropriate nutrition care for specific clinical circumstances, including but not limited to the role of specific diagnostic and treatment modalities in the management of patients. Clinical Guidelines are developed by multidisciplinary panels of experts based on evidence from a rigorous systematic review and evaluation of the published medical literature. Clinical Guidelines may include, but are not limited to, the following categories: screening, evaluation, assessment of therapeutic effectiveness, management, rehabilitation, risk assessment, technology assessment, or treatment relating either to a specific disease or condition or to a therapy. The Clinical Guidelines are updated in order to ensure up-to-date information for members and the healthcare community. ASPEN uses the GRADE system of guideline development and clearly delineates this methodology in each guideline.  

Guidelines Under Development or Update:

• ASPEN Nutrition Guidelines for Replacement of a Balloon Gastrostomy Tube in Infants and Pediatric Patients: Open for comments until June 7.
  • Guideline Protocol: ASPEN Nutrition Guidelines for Replacement of a Balloon Gastrostomy Tube in Infants and Pediatric Patients 
• ASPEN International Nutrition Guidelines for Adult Perioperative Cardiac Patients: Open for comments until May 31.
  • Guideline Protocol: ASPEN International Nutrition Guidelines for Adult Perioperative Cardiac Patients 
• Nutrition Support in Head and Neck Cancer: Comment period closed.
  • Guideline Protocol: Nutrition Support in Head and Neck Cancer
• Nutrition Support in Pediatric Critically Ill Patients: Comment period closed.
  • Guideline Protocol: Nutrition Support in Pediatric Critically Ill Patients 

Current^* Published Guidelines By Topic Area (Topics Presented Alphabetically)
^*Current is defined as published within the last 5 years.

Body Composition

• 2019 American Society for Parenteral and Enteral Nutrition Clinical Guidelines: The Validity of Body Composition Assessment in Clinical Populations
  

Central Venous Access Devices

• 2019 ASPEN Guidelines for the Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration JPEN 2019 Vol 43, Issue 1, pp. 15 - 31
  

Critical Care
Adult

• 2021 Guidelines for the Provision of Nutrition Support Therapy in the Adult Critically Ill Patient JPEN 2021
  *Note: For questions not addressed in this updated guideline, clinicians should refer to best practices set by the 2016 guideline (see below) as well as the updated adult critical care nutrition support literature, exercising clinical and professional judgement.
  • Summary of 2021 Adult Critical Care Guidelines
    

Pediatric

• 2017 Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient JPEN 2017 Vol 41, Issue 5, pp. 706 - 742 
  • Summary of 2017 Pediatric Critical Care Guidelines
    

Enterocutaneous Fistula

• 2017 ASPEN‐FELANPE Clinical Guidelines. Nutrition Support of Adult Patients With Enterocutaneous Fistula JPEN 2017 Jan;41(1):104-112

Neonatal/Pediatric

• 2023 Guidelines for Parenteral Nutrition in Preterm Infants: The American Society for Parenteral and Enteral Nutrition JPEN 2023
• 2017 Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient JPEN 2017 Vol 41, Issue 5, pp. 706 - 742 
  • Summary of 2017 Pediatric Critical Care Guidelines
    

Additional^† Published Guidelines By Topic Area (Topics Presented Alphabetically)
^†The ASPEN Clinical Guidelines listed below are greater than 5 years old and may not represent the most up to date literature and recommendations. Some of these documents may currently be undergoing updates.

Critical Care
Adult

• 2016 Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient JPEN 2016 Vol 40, Issue 2, pp. 159 - 211
  

Pediatric

• 2009 Nutrition Support of the Critically Ill Child JPEN 2009, Vol 33, Issue 3, pp. 260 - 276  

Extracorporeal Membrane Oxygenation

• 2010 Nutrition Support of Neonates Supported with Extracorporeal Membrane Oxygenation JPEN 2010, Vol 34, Issue 3, pp. 247 - 253
  

Human Immunodeficiency Virus

• 2009 Nutrition Support of Children with Human Immunodeficiency Virus Infection JPEN 2009, Vol 33, Issue 6, pp. 588-606
  

Hyperglycemia
Adult

• 2013 ASPEN Clinical Guidelines: Nutrition Support of Adult Patients With Hyperglycemia JPEN 2013, Vol 37, Issue 1,  pp. 23 – 36

Pediatric

• 2012 ASPEN Clinical Guidelines: Hyperglycemia and Hypoglycemia in the Neonate Receiving Parenteral Nutrition JPEN 2012, Vol 36, Issue 1, pp. 81 - 95
  

Neonatal/Pediatric

• 2014 ASPEN Clinical Guidelines: Support of Pediatric Patients with Intestinal Failure at Risk of Parenteral Nutrition - Associated Liver Disease JPEN 2014 Vol. 38, Issue 5, pp. 538–557
• 2013 ASPEN Clinical Guidelines: Nutrition Support of Neonatal Patients at Risk for Metabolic Bone Disease JPEN 2013, Vol 37, Issue 5, pp. 570–598
• 2012 ASPEN Clinical Guidelines: Nutrition Support of Neonatal Patients at Risk for Necrotizing Enterocolitis JPEN 2012, Vol 36, Issue 5, pp. 506 - 523 
• 2012 ASPEN Clinical Guidelines: Hyperglycemia and Hypoglycemia in the Neonate Receiving Parenteral Nutrition JPEN 2012, Vol 36, Issue 1, pp. 81 - 95 
• 2010 Nutrition Support of Hospitalized Pediatric Patients with Obesity JPEN 2010, Vol 34, Issue 1, pp. 13 - 20
• 2009 Nutrition Support of the Critically Ill Child JPEN 2009, Vol 33, Issue 3, pp. 260 - 276
  

Nutrition Screening

• 2011 Nutrition Screening, Assessment, and Intervention in Adults JPEN 2011, Vol 35, Issue 1, pp. 16 – 24

Obesity
Adult

• 2013 ASPEN Clinical Guidelines: Nutrition Support of Hospitalized Adult Patients With Obesity JPEN 2013, Vol 37, Issue 6, pp. 714 - 744
  

Pediatric

• 2010 Nutrition Support of Hospitalized Pediatric Patients with Obesity JPEN 2010, Vol 34, Issue 1, pp. 13 - 20
  

Oncology

• 2009 Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation JPEN 2009, Vol 33, Issue 5, pp. 472 - 500
  

Parenteral Nutrition

• 2014 ASPEN Clinical Guidelines: Parenteral Nutrition Ordering, Order Review, Compounding, Labeling, and Dispensing JPEN 2014, Vol 38, Issue 3, pp. 334–377
• 2009 Clinical Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients JPEN 2009, Vol 33, Issue 3, pp. 255 – 259
• 2004 Safe Practices for Parenteral Nutrition - [Endorsed by the American Society of Health-System Pharmacists (ASHP)] JPEN 2004, Vol 28, Issue 6, pp. S39-S70 
  • Errata 2006, Vol 30, Issue 2, pp. 177-177
    

Renal Disease

• 2010 Nutrition Support in Adult Acute and Chronic Renal Failure JPEN 2010, Vol 34, Issue 4, pp. 366 - 377
  

Other Guideline Associated Publications

• New Implementations for the ASPEN Clinical Guidelines and a Call for Protocol Review on the Nutrition Guidelines for Adult Head and Neck Cancer JPEN 2021, Vol 45, Issue 7, pp. 1397-1399.
• 2012 Clinical Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients: Applying the GRADE System to Development of ASPEN Clinical Guidelines JPEN 2012, Vol 36, Issue 1, pp. 77-80
  
  

Submit Topics for ASPEN Guideline Development
The ASPEN Guidelines Program welcomes your submission of topics for consideration for guideline development. Topics will be evaluated by the Director of the ASPEN Guidelines Program. While it is not guaranteed that your suggestion will become a priority for guideline development, we welcome and appreciate your suggestions for consideration. ASPEN is not able to personally communicate updates around decisions made regarding these submissions. You can submit your suggestions using this online form.

Submit New Evidence for Consideration
For currently published guidelines, we welcome your submission of new evidence that you wish to be considered by the ASPEN Guidelines Program. All evidence will be reviewed internally by ASPEN and by members of the guideline clinical panel. Submissions are evaluated carefully and may be considered as a prompt for a guideline update. While it is not guaranteed that all suggestions will become a priority, all submissions are greatly appreciated. ASPEN is not able to personally communicate updates around decisions made regarding these submissions. You can submit your suggestions using this online form.