168 Used with permission of SCCM and A.S.P.E.N. If no grade is listed after the guideline, it is ungraded; based on expert consensus. * Updates were made to the guidelines in 2022, but they currently do not fully replace the 2016 guidelines. Compher C, et al. J Parenter Enteral Nutr . 2022;46(1):12-41. References: 1. Taylor BE, et al. Crit Care Med. 2016;44(2):390-438. 2. McClave SA, et al. JPEN J Parenter Enteral Nutr. 2016;40(2):159-211. PRIMARY ISSUE Product Benefits ASPEN Adult Nutrition Support Therapy Guidelines 1,2 – Updates Made in 2022* TOLERANCE GI intolerance Malabsorption Tube-feeding- associated diarrhea Pancreatitis Transitioning from TPN VITAL ® HP • Peptides • High protein • Low fat • MCT • Omega-3 fatty acids (fish oil) • Vitamin D VITAL ® AF 1.2 CAL • Peptides • MCT • Omega-3 fatty acids (fish oil) • Vitamin D VITAL ® 1.5 CAL • Peptides • MCT VITAL ® 1.0 CAL • Peptides • MCT C4 C4 E4b E4b E4b E4b E4 a E4 c P1 M1 a Q4 D3 b Q6