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Journal of Parenteral and Enteral
Nutrition
http://pen.sagepub.com/
A.S.P.E.N. Clinical Guidelines : Nutrition Screening, Assessment, and Intervention in Adults
Charles Mueller, Charlene Compher, Druyan Mary Ellen and the American Society for Parenteral and Enteral Nutrition
(A.S.P.E.N.) Board of Directors
JPEN J Parenter Enteral Nutr 2011 35: 16
DOI: 10.1177/0148607110389335
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http://pen.sagepub.com/content/35/1/16
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Clinical Guidelines Journal of Parenteral and
Enteral Nutrition
Volume 35 Number 1
A.S.P.E.N. Clinical Guidelines January 2011 16-24
© 2011 American Society for
Parenteral and nteral Nutrition
1011014601103335
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utrition creenin
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A.S.P.E.N. Clinical Guidelines / Mueller et al 1
3
Figure . Nutrition care alorit m
dianoe 1 starvation-related malnutrition
ic i ee intrument ere enerally deeloed to redict or
c ronic taration it out inflammation
2 chronic dis- ae undernutrition ¥ernutrition and obeity are en-
ease–related malnutrition
ere inflammation i c ronic erally aeed uin t e body ma inde andor ait
and of mild to moderate deree
and 3 acute disease or circumference uideline in able 2
injur–related malnutrition
ere inflammation i acute ee linical ¤uideline ill comare clinical out-
and eere come aociated it ubli ed nutrition creenin and
nflammation and related comenatory mec anim aement tool and t e imact of furt er clinical ae-
aociated it dieae or inury may caue anoreia and ment and nutrition interention on clinical outcome
alteration in body comoition and tre metabolim
etabolic alteration aociated it inflammation are
redominantly cytoine mediated and erit a lon a Methods
t e inflammatory timulu i reent ee metabolic
alteration include eleated enery eenditure
lean ti- ASPN conit of ealt care rofeional rereentin
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fluid ift to t e etracellular t e diciline of medicine
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armacy
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acute ae rotein c ane
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cemia ecreaed ynt ei of neatie acute ae ro- imroe atient care by adancin t e cience and ractice
tein ill reult in reduced erum albumin
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of nutrition uort t eray ASPN iorouly or to
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field of nutrition and metabolic uort in all ealt care
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ued in iolation to ae nutrition tatu becaue t ey t e uidance of t e ASPN oard of irector
are fundamentally marer of inflammatory metabo- Promotion of afe and effectie atient care by nutrition
-11
lim Poitie acute ae rotein uc a -reactie uort ractitioner i a critical role of ASPN e
rotein are alo otent redictor of morbidity and mortal- ASPN oard of irector a ubli ed linical
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ity and are eleated in t e reence of inflammation ¤uideline ince 16 ASPN ealuate in an ono-
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commonly cited in t e literature and ued in t e article udated
ealuated for t ee linical ¤uideline e table ere- ee ASPN linical ¤uideline are baed uon
ate arameter ued in t ee intrument t at are ri- eneral concluion of ealt rofeional o
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rimarily related oin uc uideline
ae balanced otential benefit to
to eerity of illne dieae and trauma
or ot er includ- be deried from a articular mode of medical t eray
in yical and yc oloical ariable alnouri ed aaint certain ri in erent it uc t eray oeer
tate are aociated it metabolic alteration caued by t e rofeional udment of t e attendin ealt rofe-
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1 ournal o Parenteral and Enteral Nutrition / Vol 35
No 1
January 2011
ale . Selected Nutrition Screenin and Aement ntrument Parameter
¥t er P yical
Ant roometry andor iet- Pyc oloical Variable or
ntrument elated Seerity of llne Symtom
Screening tools
13
irmin am Nutrition i Score ei t lo
aetite
Stre factor
eerity of
ability to eat dianoi
14
alnutrition Screenin ool Aetite
unintentional ei t
lo
alnutrition nieral Screenin
c ane in ei t Preence of acute dieae
ool15
aatric t nde16 Percentae ideal body ei t Albumin
realbumin
lym-
ocyte count
1
Nutrition i laification ei t lo
ercentae ideal ¤atrointetinal function
body ei t
dietary intae
Nutritional i nde1 Preent and uual body ei t Albumin
1
Nutritional i Screenin 2002 ei t lo
food intae ianoi eerity
Pronotic nflammatory and Albumin
realbumin
Nutritional nde20 -reactie rotein
α1-acid
lycorotein
Pronotic Nutritional nde21 rice in fold Albumin
tranferrin
in
enitiity
22
Simle Screenin ool
ercentae ei t lo Albumin
S ort Nutrition Aement ecent ei t itory
aetite
§uetionnaire23 ue of oral ulement or
tube feedin
Nutrition assessment tools
24
ini Nutritional Aement ei t data
ei t
mid-arm Albumin
realbumin
Self-ercetion of nutrition
circumference
calf circum- c oleterol
lym ocyte and ealt tatu
ference
diet itory
aetite
count
feedin mode
25
Subectie ¤lobal Aement ei t itory
diet itory Primary dianoi
tre leel P yical ymtom
ubcutaneou fat
mu-
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anle edema
acral edema
acite
functional caacity
a-
trointetinal ymtom
body ma inde
ale . ¥beity laification and i ecaue uideline cannot account for eery ariation in
circumtance
t e ractitioner mut alay eercie ro-
2
¥beity la
m feional udment in t eir alication ee linical
nderei t ¨15 ¤uideline are intended to ulement
but not relace
Normal 15–24 rofeional trainin and udment
¥erei t 25–2 ee linical ¤uideline ere created in accord-
¥beity
cla 30–34 ance it ntitute of edicine recommendation a
¥beity
cla 35–3 “ytematically deeloed tatement to ait ractitioner
¥beity
cla ≥ 40 and atient deciion about aroriate ealt care for
2
i i ait ircumference
cm ecific clinical circumtance” ee linical
en ª 102 ¤uideline are for ue by ealt care rofeional o
omen ª roide nutrition uort erice and offer clinical adice
body ma inde for manain adult and ediatric includin adolecent
Adated from linical ¤uideline on t e dentification
atient in inatient and outatient ambulatory
ome
aluation
and reatment of ¥erei t and ¥beity in Adult
and eciali¦ed care ettin e utility of t e linical
e idence eort N Publication No -403
Setember ¤uideline i atteted to by t e fre£uent citation of t ee
1
National ntitute of ealt National eart
lood
and document in eer-reieed ublication and t eir fre-
un ntitute in cooeration it t e National ntitute of £uent ue by ASPN member and ot er ealt care
iabete and ietie and «idney ieae rofeional in clinical ractice
academia
reearc
and
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