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Peer-reviewedCC BYAnesthesiology open

American Society of Anesthesiologists Guidance on Periprocedural Fasting in Patients Receiving Tube Feeding

  • Jamie L Sparling1
  • Thomas Edmiston2
  • Prashant Nasa3
  • Ravindra A Gupta4
  • Kunal Karamchandani5
  • Ashish K Khanna6
  • Jarva Chow7
  • Federico Bilotta8
  • Alisha Sachdev9
  • Roshni Sreedharan10
  • Shahla Siddiqui11
  • Paul E Wischmeyer12
12 more authors
  • Christian Stoppe
  • Jeffrey I Mechanick13
  • D Dante Yeh14
  • Ronald G Pearl15
  • Todd W Rice16
  • Hassan S Dashti1
  • Michael DeWane17
  • Martin Rosenthal18
  • Richard P Dutton19
  • Alexander Nagrebetsky1
  • ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding
  • ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding
19 affiliations
  1. 1Jamie 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.
  2. 2Thomas Edmiston, M.B., B.Chir.: University of California San Francisco, Department of Anesthesia and Perioperative Care, San Francisco, California.
  3. 3Prashant 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.
  4. 4Ravindra A. Gupta, M.D.: Division of Critical Care, Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
  5. 5Kunal Karamchandani, M.D.: Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.
  6. 6Ashish 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.
  7. 7Jarva Chow, M.D., M.S., M.P.H.: Department of Anesthesia & Critical Care, University of Chicago, Chicago, Illinois.
  8. 8Federico Bilotta, M.D., Ph.D.: Department of Anesthesiology, University of Rome "Tor Vergata", Rome, Italy.
  9. 9Alisha Sachdev, M.D.: Department of Anesthesiology, Rush University, Chicago, Illinois.
  10. 10Roshni Sreedharan, M.D.: Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio.
  11. 11Shahla 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.
  12. 12Paul E. Wischmeyer, M.D., E.D.I.C.: Departments of Anesthesiology and Surgery, Duke University School of Medicine, Raleigh-Durham, North Carolina.
  13. 13Jeffrey 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.
  14. 14D. 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.
  15. 15Ronald G. Pearl, M.D., Ph.D.: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.
  16. 16Todd W. Rice, M.D., M.Sc.: Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
  17. 17Michael DeWane, M.D.: Department of Surgery, Mass General Brigham, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts.
  18. 18Martin Rosenthal, M.D.: Division of Acute Care Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
  19. 19Richard P. Dutton, M.D., M.B.A.: US Anesthesia Partners, Fulton, Maryland.
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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.

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Cite

BibTeXRIS
BibTeX
@article{sparling2026american,
  title = {{American Society of Anesthesiologists Guidance on Periprocedural Fasting in Patients Receiving Tube Feeding}},
  author = {Jamie L Sparling and Thomas Edmiston and Prashant Nasa and Ravindra A Gupta and Kunal Karamchandani and Ashish K Khanna and Jarva Chow and Federico Bilotta and Alisha Sachdev and Roshni Sreedharan and Shahla Siddiqui and Paul E Wischmeyer and Christian Stoppe and Jeffrey I Mechanick and D Dante Yeh and Ronald G Pearl and Todd W Rice and Hassan S Dashti and Michael DeWane and Martin Rosenthal and Richard P Dutton and Alexander Nagrebetsky and ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding and ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding},
  journal = {Anesthesiology open},
  year = {2026},
  month = oct,
  doi = {10.1097/ao9.0000000000000037},
  url = {https://europepmc.org/article/PMC/PMC13718895},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - American Society of Anesthesiologists Guidance on Periprocedural Fasting in Patients Receiving Tube Feeding
AU  - Jamie L Sparling
AU  - Thomas Edmiston
AU  - Prashant Nasa
AU  - Ravindra A Gupta
AU  - Kunal Karamchandani
AU  - Ashish K Khanna
AU  - Jarva Chow
AU  - Federico Bilotta
AU  - Alisha Sachdev
AU  - Roshni Sreedharan
AU  - Shahla Siddiqui
AU  - Paul E Wischmeyer
AU  - Christian Stoppe
AU  - Jeffrey I Mechanick
AU  - D Dante Yeh
AU  - Ronald G Pearl
AU  - Todd W Rice
AU  - Hassan S Dashti
AU  - Michael DeWane
AU  - Martin Rosenthal
AU  - Richard P Dutton
AU  - Alexander Nagrebetsky
AU  - ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding
AU  - ASA Committee on Critical Care Medicine Task Force on Periprocedural Fasting in Patients Who Receive Tube Feeding
PY  - 2026
DA  - 2026/10/01
JO  - Anesthesiology open
DO  - 10.1097/ao9.0000000000000037
UR  - https://europepmc.org/article/PMC/PMC13718895
AB  - 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.
SN  - 3068-4129
ER  -