<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0212-1611</journal-id>
<journal-title><![CDATA[Nutrición Hospitalaria]]></journal-title>
<abbrev-journal-title><![CDATA[Nutr. Hosp.]]></abbrev-journal-title>
<issn>0212-1611</issn>
<publisher>
<publisher-name><![CDATA[Grupo Arán]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0212-16112020000500031</article-id>
<article-id pub-id-type="doi">10.20960/nh.03116</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Guías Clínicas ASPEN-FELANPE: Terapia Nutricional en Pacientes Adultos con Fístulas Enterocutáneas]]></article-title>
<article-title xml:lang="en"><![CDATA[ASPEN-FELANPE Clinical Guidelines: Nutrition Support of Adult Patients with Enterocutaneous Fistula]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Pizarro Graf]]></surname>
<given-names><![CDATA[José Ignacio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kumpf]]></surname>
<given-names><![CDATA[Vanessa J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar-Nascimento]]></surname>
<given-names><![CDATA[José Eduardo de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Amber Hall]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[McKeever]]></surname>
<given-names><![CDATA[Liam]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Steiger]]></surname>
<given-names><![CDATA[Ezra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Winkler]]></surname>
<given-names><![CDATA[Marion F]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Charlene Compher]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Anáhuac y Hospital Ángeles Lomas  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Vanderbilt University Medical Center  ]]></institution>
<addr-line><![CDATA[Nashville Tennessee]]></addr-line>
<country>EE. UU</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Universitário Várzea Grande Escuela de Medicina ]]></institution>
<addr-line><![CDATA[Cuiaba ]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Boston Children&#8217;s Hospital  ]]></institution>
<addr-line><![CDATA[Boston Massachusetts]]></addr-line>
<country>EE. UU</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,University of Illinois at Chicago  ]]></institution>
<addr-line><![CDATA[Chicago Illinois]]></addr-line>
<country>EUA</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Cleveland Clinic Cleveland Clinic Lerner College of Medicine of Case Western Reserve University ]]></institution>
<addr-line><![CDATA[Cleveland Ohio]]></addr-line>
<country>EUA</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Alpert Medical School of Brown University and Rhode Island Hospital  ]]></institution>
<addr-line><![CDATA[Providence Rhode Island]]></addr-line>
<country>EE. UU</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,University of Pennsylvania  ]]></institution>
<addr-line><![CDATA[Philadelphia Pennsylvania]]></addr-line>
<country>EE. UU</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2020</year>
</pub-date>
<volume>37</volume>
<numero>4</numero>
<fpage>875</fpage>
<lpage>885</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0212-16112020000500031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0212-16112020000500031&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0212-16112020000500031&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: el manejo de las fístulas enterocutáneas (FEC) es un reto que requiere un enfoque interdisciplinario y plantea un desafío importante. Las guías para optimizar el estado nutricional en estos pacientes están basadas en estudios que dependen de la experiencia individual y, ocasionalmente, institucional; que se focalizan en el tratamiento integral de las FEC, centrándose en el manejo médico y quirúrgico, mientras que la terapia nutricional se revisa solo superficialmente. Los requerimientos nutricionales, la vía de administración, el uso de inmunonutrición y el de análogos de la somatostatina en el tratamiento de estos pacientes no están bien definidos. El objetivo de esta guía clínica es desarrollar recomendaciones específicas para la terapia nutricional de los pacientes adultos con FEC.  Método: revisión sistemática de la mejor evidencia disponible para responder a una serie de preguntas sobre la terapia nutricional de los adultos con FEC, evaluada utilizando la metodología GRADE. Se utilizó un proceso de consenso anónimo para desarrollar las recomendaciones de la guía clínica antes de la revisión por pares y la aprobación por las Juntas Directivas de ASPEN y FELANPE.  Preguntas: 1) ¿Qué factores describen mejor el estado nutricional de los adultos con FEC? 2) ¿Cuál es la mejor vía para administrar la terapia nutricional (oral, nutrición enteral o parenteral)? 3) ¿Qué aporte energético y proteico proporciona mejores resultados clínicos? 4) ¿El uso de la fistuloclisis se asocia a mejores resultados? 5) ¿Las fórmulas inmunomoduladoras se asocian a mejores resultados? 6) ¿El uso de la somatostatina proporciona mejores resultados? 7) ¿Cuándo está indicada la terapia nutricional parenteral domiciliaria?]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: the management of patients with enterocutaneous fistula (ECF) requires an interdisciplinary approach and poses a significant challenge to surgeons, gastroenterologists, intensivists, wound/stoma care specialists, and nutrition support clinicians. Available guidelines for optimizing nutritional status in these patients are often vague, based on limited and dated clinical studies, and typically rely on individual or institutional experience. Specific nutrient requirements, appropriate route of feeding, role of immune-enhancing nutrients, and use of somatostatin analogs in the management of patients with ECF remain a challenge for the clinician. The purpose of this clinical guideline is to develop recommendations for the nutritional care of adult patients with ECF.  Methods: a systematic review of the best available evidence to answer a series of questions regarding clinical management of adults with ECF was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group. An anonymous consensus process was used to develop the clinical guideline recommendations prior to peer review and approval by the A.S.P.E.N. and FELANPE Board of Directors.  Questions: in adult patients with enterocutaneous fistula: 1) What factors best describe nutritional status? 2) What is the preferred route of nutritional therapy (oral diet, EN or PN)? 3) What protein and energy intake provide best clinical outcomes? 4) Is fistuloclysis associated with better outcomes than standard care? 5) Are immune-enhancing nutrients associated with better outcomes? 6) Does the use of somatostatin provide better outcomes than standard medical therapy? 7) When is home parenteral nutrition support indicated?]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fístula del tracto gastrointestinal]]></kwd>
<kwd lng="es"><![CDATA[Fístula enterocutánea]]></kwd>
<kwd lng="es"><![CDATA[Terapia nutricional]]></kwd>
<kwd lng="en"><![CDATA[Gastrointestinal tract fistula]]></kwd>
<kwd lng="en"><![CDATA[Enterocutaneous fistula]]></kwd>
<kwd lng="en"><![CDATA[Nutritional therapy]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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