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- Editorial Bridging evidence and clinical practice: a practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition
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Suk-Kyung Hong
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Annals of Clinical Nutrition and Metabolism 2025;17(1):1-2.
DOI: https://doi.org/10.15747/ACNM.25.0008
Published online: April 1, 2025
Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Corresponding author: Suk-Kyung Hong email: skhong94@amc.seoul.kr
• Received: March 1, 2025 • Revised: March 17, 2025 • Accepted: March 31, 2025
© 2025 Korean Society of Surgical Metabolism and Nutrition · Korean Society for Parenteral and Enteral Nutrition · Asian Society of Surgical Metabolism and Nutrition · Japanese Society for Surgical Metabolism and Nutrition
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Enteral nutrition plays a crucial role in treating critically ill patients. However, administering enteral nutrition while assessing tolerance is especially challenging in patients with impaired consciousness and gastrointestinal dysfunction, including those with multi-organ failure. Consequently, this intervention must be approached with utmost caution.
International guidelines have recently been updated by the American Society for Parenteral and Enteral Nutrition/Society of Critical Care Medicine [1] and the European Society for Clinical Nutrition and Metabolism [2], each supported by varying levels of evidence. However, these guidelines primarily address contentious issues affecting clinical outcomes while often overlooking safety and feasibility in real-world settings. In clinical practice, many aspects of enteral nutrition continue to require multidisciplinary consensus to ensure effective communication and implementation. Relying solely on evidence-based approaches can be challenging because they tend to focus on highly specific details without considering broader practical concerns.
In this issue of Annals of Clinical Nutrition and Metabolism, an article by Chang et al. [3] introduces the Korean Enteral Nutrition Practical Guide developed by the Korean Society for Parenteral and Enteral Nutrition (KSPEN) [3]. In clinical practice, challenges related to safety incidents are encountered more frequently than improvements in clinical outcomes solely attributable to enteral nutrition [4]. Therefore, it is essential for multidisciplinary teams within each institution or country to establish a systematic, updated approach through structured enteral nutrition protocols based on mutual consensus. This strategy will promote safe and effective administration in intensive care units and ultimately improve patient care and outcomes.
Studies have demonstrated that implementing enteral feeding protocols is associated with improved energy intake and a reduced incidence of enteral nutrition-related adverse events in critically ill patients [5,6]. The publication of the Korean Enteral Nutrition Practical Guide by KSPEN represents a significant advancement as an updated clinical guideline reflecting expert consensus. It is tailored to the Korean healthcare environment and is grounded in the expertise and experience of healthcare professionals in the field. This guideline marks an important step toward standardizing enteral nutrition practices in Korea, ensuring both efficacy and safety in clinical application.
Authors’ contribution
All work was done by Suk-Kyung Hong.
Conflict of interest
Suk-Kyung Hong has served as the editor of the Annals of Clinical Nutrition and Metabolism since 2021. However, she was not involved in the peer review process or decision-making regarding publication. Otherwise, no potential conflict of interest relevant to this article was reported.
Funding
None.
Data availability
Not applicable.
Acknowledgments
None.
Supplementary materials
None.
- 1. Compher C, Bingham AL, McCall M, Patel J, Rice TW, Braunschweig C, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: the American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr 2022;46:12-41. ArticlePubMedPDF
- 2. Singer P, Blaser AR, Berger MM, Calder PC, Casaer M, Hiesmayr M, et al. ESPEN practical and partially revised guideline: clinical nutrition in the intensive care unit. Clin Nutr 2023;42:1671-89. ArticlePubMed
- 3. Chang YR, Kim BE, Lee IS, Cho YS, Han SS, Kim E, et al. A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part I. prescribing enteral nutrition orders. Ann Clin Nutr Metab 2025;17:3-8. Article
- 4. Preiser JC, Arabi YM, Berger MM, Casaer M, McClave S, Montejo-Gonzalez JC, et al. A guide to enteral nutrition in intensive care units: 10 expert tips for the daily practice. Crit Care 2021;25:424.ArticlePubMedPMCPDF
- 5. Padar M, Uusvel G, Starkopf L, Starkopf J, Reintam Blaser A. Implementation of enteral feeding protocol in an intensive care unit: before-and-after study. World J Crit Care Med 2017;6:56-64. ArticlePubMedPMC
- 6. Jiang L, Huang X, Wu C, Tang J, Li Q, Feng X, et al. The effects of an enteral nutrition feeding protocol on critically ill patients: a prospective multi-center, before-after study. J Crit Care 2020;56:249-56. ArticlePubMed
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