A fistula producing 260 mL/day falls under which PN indication status according to the material?

• A. Yes
• B. No
• C. Only if malnourished
• D. Only if infection present

Answer: (B)

The key idea is that deciding on parenteral nutrition for a fistula depends on whether enteral nutrition can meet the patient’s energy and protein needs given the fistula losses. A fistula output of 260 mL/day is not considered high-output, so it generally doesn’t by itself trigger PN. With moderate losses, nutritional needs can often be supported through the gut (and/or oral intake) without parenteral nutrition. PN would be considered only if enteral intake cannot meet requirements, or if there are complicating factors like severe malnutrition or infection that prevent adequate EN. Therefore, there is no PN indication for a fistula producing 260 mL/day.