Sioson Marianna S, Martindale Robert, Abayadeera Anuja, Abouchaleh Nabil, Aditianingsih Dita, Bhurayanontachai Rungsun, Chiou Wei-Chin, Higashibeppu Naoki, Mat Nor Mohd Basri, Osland Emma, Palo Jose Emmanuel, Ramakrishnan Nagarajan, Shalabi Medhat, Tam Luu Ngan, Ern Tan Jonathan Jit
Section of Nutrition, Department of Medicine, The Medical City, Pasig, Metro Manila, Philippines.
Division of Gastrointestinal and General Surgery, Oregon Health and Sciences University, Portland, OR, USA.
Clin Nutr ESPEN. 2018 Apr;24:156-164. doi: 10.1016/j.clnesp.2017.11.008. Epub 2018 Jan 3.
BACKGROUND & AIMS: Guidance on managing the nutritional requirements of critically ill patients in the intensive care unit (ICU) has been issued by several international bodies. While these guidelines are consulted in ICUs across the Asia-Pacific and Middle East regions, there is little guidance available that is tailored to the unique healthcare environments and demographics across these regions. Furthermore, the lack of consistent data from randomized controlled clinical trials, reliance on expert consensus, and differing recommendations in international guidelines necessitate further expert guidance on regional best practice when providing nutrition therapy for critically ill patients in ICUs in Asia-Pacific and the Middle East.
The Asia-Pacific and Middle East Working Group on Nutrition in the ICU has identified major areas of uncertainty in clinical practice for healthcare professionals providing nutrition therapy in Asia-Pacific and the Middle East and developed a series of consensus statements to guide nutrition therapy in the ICU in these regions.
Accordingly, consensus statements have been provided on nutrition risk assessment and parenteral and enteral feeding strategies in the ICU, monitoring adequacy of, and tolerance to, nutrition in the ICU and institutional processes for nutrition therapy in the ICU. Furthermore, the Working Group has noted areas requiring additional research, including the most appropriate use of hypocaloric feeding in the ICU.
The objective of the Working Group in formulating these statements is to guide healthcare professionals in practicing appropriate clinical nutrition in the ICU, with a focus on improving quality of care, which will translate into improved patient outcomes.
多个国际机构已发布关于重症监护病房（ICU）危重症患者营养需求管理的指南。尽管亚太地区和中东地区的ICU会参考这些指南，但针对这些地区独特的医疗环境和人口统计学特征的指导却很少。此外，由于缺乏来自随机对照临床试验的一致数据、依赖专家共识以及国际指南中存在不同建议，在为亚太地区和中东地区ICU的危重症患者提供营养治疗时，需要进一步的专家指导以明确区域最佳实践。
亚太地区和中东地区ICU营养工作组确定了在亚太地区和中东地区为患者提供营养治疗的医护人员在临床实践中的主要不确定领域，并制定了一系列共识声明以指导这些地区ICU的营养治疗。
据此，工作组针对ICU中的营养风险评估、肠外和肠内喂养策略、监测ICU营养的充足性和耐受性以及ICU营养治疗的机构流程提供了共识声明。此外，工作组还指出了需要进一步研究的领域，包括ICU中低热卡喂养的最恰当使用。
工作组制定这些声明的目的是指导医护人员在ICU中实施恰当的临床营养，重点是提高护理质量，这将转化为改善患者预后。
