{ "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.", "abstract_shown": true, "affiliations": [ "Jamie L. Sparling, M.D., Hassan S. Dashti, Ph.D., R.D., and Alexander Nagrebetsky, M.D.: Department of Anesthesiology, Mass General Brigham, Boston, Massachusetts; Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts.", "Thomas Edmiston, M.B., B.Chir.: University of California San Francisco, Department of Anesthesia and Perioperative Care, San Francisco, California.", "Prashant Nasa, M.D.: Department of Anaesthesia and Critical Care Medicine, University Hospital Plymouth NHS Trust, Plymouth, United Kingdom; Department of Targeted Intervention, University College London, London, United Kingdom.", "Ravindra A. Gupta, M.D.: Division of Critical Care, Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.", "Kunal Karamchandani, M.D.: Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.", "Ashish K. Khanna, M.D., M.S.: Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina; Outcomes Research Consortium, Houston, Texas.", "Jarva Chow, M.D., M.S., M.P.H.: Department of Anesthesia & Critical Care, University of Chicago, Chicago, Illinois.", "Federico Bilotta, M.D., Ph.D.: Department of Anesthesiology, University of Rome \"Tor Vergata\", Rome, Italy.", "Alisha Sachdev, M.D.: Department of Anesthesiology, Rush University, Chicago, Illinois.", "Roshni Sreedharan, M.D.: Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio.", "Shahla Siddiqui, M.B.B.S., M.Sc.: Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts; Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.", "Paul E. Wischmeyer, M.D., E.D.I.C.: Departments of Anesthesiology and Surgery, Duke University School of Medicine, Raleigh-Durham, North Carolina.", "Jeffrey I. Mechanick, M.D.: Kravis Center for Cardiovascular Health, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York.", "D. Dante Yeh, M.D., M.H.P.E.: Division of Emergency General Surgery, Denver Health Medical Center, Denver, Colorado; Department of Surgery, University of Colorado School of Medicine, Denver, Colorado.", "Ronald G. Pearl, M.D., Ph.D.: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.", "Todd W. Rice, M.D., M.Sc.: Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.", "Michael DeWane, M.D.: Department of Surgery, Mass General Brigham, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts.", "Martin Rosenthal, M.D.: Division of Acute Care Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.", "Richard P. Dutton, M.D., M.B.A.: US Anesthesia Partners, Fulton, Maryland." ], "article_type": "research article", "arxiv": null, "author_total": 24, "authors": [ { "affs": [ 0 ], "name": "Jamie L Sparling", "orcid": "0000-0002-7132-6898" }, { "affs": [ 1 ], "name": "Thomas Edmiston" }, { "affs": [ 2 ], "name": "Prashant Nasa" }, { "affs": [ 3 ], "name": "Ravindra A Gupta" }, { "affs": [ 4 ], "name": "Kunal Karamchandani" }, { "affs": [ 5 ], "name": "Ashish K Khanna" }, { "affs": [ 6 ], "name": "Jarva Chow" }, { "affs": [ 7 ], "name": "Federico Bilotta" }, { "affs": [ 8 ], "name": "Alisha Sachdev" }, { "affs": [ 9 ], "name": "Roshni Sreedharan" }, { "affs": [ 10 ], "name": "Shahla Siddiqui" }, { "affs": [ 11 ], "name": "Paul E Wischmeyer" }, { "name": "Christian Stoppe" }, { "affs": [ 12 ], "name": "Jeffrey I Mechanick" }, { "affs": [ 13 ], "name": "D Dante Yeh" }, { "affs": [ 14 ], "name": "Ronald G Pearl" }, { "affs": [ 15 ], "name": "Todd W Rice" }, { "affs": [ 0 ], "name": "Hassan S Dashti" }, { "affs": [ 16 ], "name": "Michael DeWane" }, { "affs": [ 17 ], "name": "Martin Rosenthal" }, { "affs": [ 18 ], "name": "Richard P Dutton" }, { "affs": [ 0 ], "name": "Alexander Nagrebetsky", "orcid": "0000-0002-9866-8417" }, { "name": "ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding" }, { "name": "ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding" } ], "bibtex": "https://research.draconitic.com/paper/1tdg4zm5r71xs.bib", "cited_by": 0, "doi": "10.1097/ao9.0000000000000037", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13718895/?tool=EBI", "id": "1tdg4zm5r71xs", "issns": [ "3068-4129" ], "landing_url": "https://europepmc.org/article/PMC/PMC13718895", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Special Article" ], [ "openalex", "2746|Enhanced Recovery After Surgery" ] ], "openalex": "W7224117280", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13718895/pdf/?tool=EBI", "pmcid": "PMC13718895", "pmid": "42960004", "published": "2026-10-01", "publisher": null, "ris": "https://research.draconitic.com/paper/1tdg4zm5r71xs.ris", "sources": [ { "first_seen": "2026-10-31T00:20:39Z", "native_id": "PMC:PMC13718895", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13718895" }, { "first_seen": "2026-11-01T00:20:50Z", "native_id": "MED:42960004", "source": "europepmc", "url": "https://europepmc.org/article/MED/42960004" }, { "first_seen": "2026-11-02T12:22:50Z", "native_id": "PMC13718895", "source": "pmc", "url": "https://doi.org/10.1097/ao9.0000000000000037" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2746|Enhanced Recovery After Surgery", "subfield": "surgery" } ], "title": "American Society of Anesthesiologists Guidance on Periprocedural Fasting in Patients Receiving Tube Feeding", "title_text": "American Society of Anesthesiologists Guidance on Periprocedural Fasting in Patients Receiving Tube Feeding", "type": "peer-reviewed", "updated_at": "2026-11-02T12:22:50Z", "url": "https://research.draconitic.com/paper/1tdg4zm5r71xs", "venue": "Anesthesiology open", "versions": [] }