A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part II. selection and initiation of enteral feeding routes

Purpose: We developed evidence-based recommendations for selecting and initiating the enteral nutrition (EN) delivery route in adult and pediatric patients to improve safety and standardize practice in Korea.Methods: Key questions covered feeding tube selection, methods to verify tube placement, confirmation in pediatric patients, and timing of EN following percutaneous endoscopic gastrostomy (PEG). Recommendations were drafted and refined through multidisciplinary expert consensus under the Korean Society for Parenteral and Enteral Nutrition (KSPEN).Results: Feeding tube selection should be based on gastrointestinal anatomy, function, and expected EN duration. Short-term feeding is recommended with nasogastric or orogastric tubes, whereas long-term feeding should use percutaneous or surgical routes such as PEG. Tube position must always be verified before use, preferably with radiography or pH testing; auscultation alone is unreliable and should not be used. In pediatric patients, radiographic confirmation remains the gold standard, although pH testing and insertion-length assessment may be considered when imaging is not feasible. After PEG, EN can be initiated safely within 4 hours in both adults and children without increasing complications if trained staff monitor for leakage or infection.Conclusion: This guideline offers a structured framework for safe and timely EN tailored to patient characteristics. Early verification and multidisciplinary collaboration help reduce complication, improving outcomes of EN therapy.

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Publication Details

Journal
Annals of Clinical Nutrition and Metabolism
Published
2025-12-01
DOI
https://doi.org/10.15747/acnm.25.0037
Primary Topic
Clinical Nutrition and Gastroenterology
Type
article
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article

A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part II. selection and initiation of enteral feeding routes

Eun‐Mi Seol, Minji Seok, Ja Kyung Min, Kyung Won Seo et al.
Annals of Clinical Nutrition and Metabolism
Clinical Nutrition and Gastroenterology
article

A practical guide for enteral nutrition from the Korean Society for Parenteral and Enteral Nutrition: Part II. selection and initiation of enteral feeding routes

Eun‐Mi Seol, Minji Seok, Ja Kyung Min, Kyung Won Seo, Jeong-Meen Seo, Chi-Min Park, Bo-Eun Kim, Seung Wan Ryu, Youn Soo Cho, Eunhee Kong, Jaechol Yoon, Sung‐Sik Han, Jeong Yun Park, Jung Mi Song, Hyunjung Kim, Eun-Jung Kim, Ye Rim Chang, Sung Shin Kim, Jae Hak Kim, In Seok Lee, Jeong Wook Kim
article en

Abstract

Purpose: We developed evidence-based recommendations for selecting and initiating the enteral nutrition (EN) delivery route in adult and pediatric patients to improve safety and standardize practice in Korea.Methods: Key questions covered feeding tube selection, methods to verify tube placement, confirmation in pediatric patients, and timing of EN following percutaneous endoscopic gastrostomy (PEG). Recommendations were drafted and refined through multidisciplinary expert consensus under the Korean Society for Parenteral and Enteral Nutrition (KSPEN).Results: Feeding tube selection should be based on gastrointestinal anatomy, function, and expected EN duration. Short-term feeding is recommended with nasogastric or orogastric tubes, whereas long-term feeding should use percutaneous or surgical routes such as PEG. Tube position must always be verified before use, preferably with radiography or pH testing; auscultation alone is unreliable and should not be used. In pediatric patients, radiographic confirmation remains the gold standard, although pH testing and insertion-length assessment may be considered when imaging is not feasible. After PEG, EN can be initiated safely within 4 hours in both adults and children without increasing complications if trained staff monitor for leakage or infection.Conclusion: This guideline offers a structured framework for safe and timely EN tailored to patient characteristics. Early verification and multidisciplinary collaboration help reduce complication, improving outcomes of EN therapy.

Annals of Clinical Nutrition and MetabolismVol. 17(3)
Inje University (KR), Ulsan College (KR), Soonchunhyang University (KR), Severance Hospital (KR), Kosin University Gospel Hospital (KR), Asan Medical Center (KR), Samsung Medical Center (KR), Seoul National University Hospital (KR), Kyung Hee University (KR), University of Ulsan (KR), National Cancer Center (KR), Myongji Hospital (KR), Yonsei University Health System (KR), Keimyung University (KR), Bucheon University (KR), Chung-Ang University (KR), Sungkyunkwan University (KR), Kosin University (KR)
Openalex Percentile: Top 54%
Clinical Nutrition and Gastroenterology
DOIOpen Access PDFOpenAlex
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