American Society of Anesthesiologists Guidance on Periprocedural Fasting in Patients Receiving Tube Feeding
Year: 2026
Type: article
Abstract: In the absence of guidelines from professional societies, periprocedural fasting practices in enteral nutrition vary widely and often lead to preventable, clinically significant nutritional deficits. To address the heterogeneity of current clinical practice, the authors aimed to develop expert consensus on best practices for the periprocedural management of tube feeding using a modified Delphi consensus process. Draft recommendations were iteratively modified during a four-round Delphi process by a multidisciplinary international panel of experts. After iterative consolidation and modification, a total of 20 recommendations were produced by round 4, and all recommendations achieved stability. Final recommendations advocate for the protocolization of institutional perioperative fasting approaches and establish best practices for perioperative management of tube feeding in patients with and without a secure airway (cuffed endotracheal or cuffed tracheostomy tube) across a range of common clinical scenarios. The recommendations are intended to harmonize local practices internationally and safely minimize unnecessary periprocedural nutritional loss.
Source: Anesthesiology Open
Authors: Jamie L. Sparling, Thomas Edmiston, Prashant Nasa, Ravindra A. Gupta, Kunal Karamchandani, Ashish K. Khanna, Jarva Chow, Federico Bilotta, Alisha Sachdev, Roshni Sreedharan, Shahla Siddiqui, Paul E. Wischmeyer, Christian Stoppe, Jeffrey I. Mechanick, D. Dante Yeh, Ronald G. Pearl, Todd W. Rice, Hassan S. Dashti, Michael DeWane, Martin Rosenthal, Richard P. Dutton, Alexander Nagrebetsky
Institutions: Harvard University, Mass General Brigham, University of California, San Francisco, Plymouth Hospital, University Hospitals Plymouth NHS Trust, University College London, Northwestern University, Northwestern Medicine, The University of Texas Southwestern Medical Center, Atrium Health Wake Forest Baptist, Wake Forest University Health Sciences, Wake Forest University, University of Chicago, University of Rome Tor Vergata, Rush University, Cleveland Clinic, Beth Israel Deaconess Medical Center, Duke University, University of Würzburg, Deutsches Herzzentrum der Charité, Universitätsklinikum Würzburg, The University of Texas Health Science Center at Houston, Icahn School of Medicine at Mount Sinai, Denver Health Medical Center, University of Colorado Anschutz, Stanford Medicine, Stanford University, Vanderbilt University Medical Center, University of Florida Health, University of Florida
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: U.S. Department of Defense, Eli Lilly and Company, AstraZeneca, Patient-Centered Outcomes Research Institute, Bayer Corporation, Danone, University of Texas Health Science Center at Houston, Novo Nordisk, European Society of Intensive Care Medicine, National Institutes of Health, Philips Research Americas, Science and Engineering Research Board, National Heart, Lung, and Blood Institute, National Center for Advancing Translational Sciences
OpenAlex ID: W7224117280