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Clinical nutrition guidelines

Guidelines are documents created by leading institutions to help professionals make decisions about patient care. There are general guidelines and those for more specific clinical situations, such as oncology, diabetes, kidney disease, malnutrition, pressure ulcers, among others.

Guidelines in nutrition are nothing more than directives formed through scientific research specified in levels of evidence that guide the professional nutritionist in the clinical nutritional care of patients. Currently, the main guidelines come from the American Society for Enteral and Parenteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), which cover enteral and parenteral nutritional therapy for adults and children. There is also the Brazilian guideline, drawn up by the Brazilian Medical Association and the Federal Council of Medicine in partnership with specialty societies such as the Brazilian Parenteral and Enteral Nutrition Society, the Brazilian Pediatrics Society and the Brazilian Nephrology Society, among others. These Brazilian guidelines were published in 2011 under the name Projeto Diretrizes.

It is of great importance that these guidelines are taken into account by various health professionals, such as nutritionists, doctors, nurses, pharmacists, among others involved in treating patients.

The degrees Each scientific body has its own guidelines and recommendations for choosing the best nutrient, access route or type of enteral nutrition according to the specific conditions of each patient. The guidelines are basically recommendations supported by large studies, national and international institutions and, in some cases, a mixture of opinions from leading experts in clinical practice. ASPEN's grades of recommendation, for example, range from A to E, from the highest to the lowest level of evidence of studies and results. ESPEN, on the other hand, adopts a different criterion for selecting studies. The institution classifies its recommendations into 3 grades of recommendation and each grade also has a sub-classification with 1 to 3 levels of evidence with their respective requirements. The Brazilian grades of recommendation range from A to D.

See the tables below for the selection criteria for classifying the Degree of Evidence of the three institutions:

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