Category: Clinical guidelines

Contrary to the traditional 'NPO after midnight' rule, evidence shows that prolonged fasting often provides no additional safety benefit and can negatively impact patient comfort and recovery. This shift toward more liberal, evidence-based practices is changing how long can you keep a patient NPO for a variety of medical procedures.

According to extensive research, the early initiation of specialized nutritional support, specifically within 24 to 48 hours of a patient's admission to the Intensive Care Unit (ICU), is a standard practice recommended by numerous international guidelines. This approach is crucial for patients who cannot maintain adequate oral intake, though careful consideration must be given to clinical stability before initiating enteral nutrition.

According to the United States Pharmacopeia (USP) guidelines, Total Parenteral Nutrition (TPN) solutions have a maximum hang time of 24 hours to prevent microbial contamination. Therefore, yes, unused portions of a TPN bag must be discarded to maintain patient safety.

Medical guidelines suggest that Peripheral Parenteral Nutrition (PPN) is designed for short-term use, typically lasting no more than 10-14 days due to the risk of vein irritation. The specific timeframe for how long you can stay on PPN is determined by a patient's clinical needs and progress toward alternative feeding methods, such as oral or enteral nutrition.

While historically used to prevent aspiration, recent evidence suggests that routine measurement of gastric residual volume (GRV) can lead to unnecessary interruptions in feeding. Understanding how much residual is too much for tube feeding is crucial for balancing aspiration risk with adequate nutritional delivery.

According to the National Institute for Health and Care Excellence (NICE), malnutrition is a state where a deficiency of nutrients has adverse effects on body composition or clinical outcome. This comprehensive guide explores what is the NICE guideline for malnutrition, outlining its key recommendations for screening, assessment, and management of adults in both hospital and community settings.

Research from landmark trials has shifted clinical practice, revealing that withholding supplemental parenteral nutrition (PN) for the first week in certain intensive care unit (ICU) patients is clinically beneficial. This raises a critical question for healthcare teams and patients' families: **in which population should you delay initiating parenteral nutrition?**