Service of Adult Intensive Care and Burns, Lausanne University Hospital - CHUV, Lausanne, Switzerland.
Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia; Department of Intensive Care Medicine, Lucern Cantonal Hospital, Lucerne, Switzerland.
Clin Nutr. 2019 Apr;38(2):584-593. doi: 10.1016/j.clnu.2018.07.009. Epub 2018 Jul 20.
BACKGROUND & AIMS: This position paper summarizes theoretical and practical aspects of the monitoring of artificial nutrition and metabolism in critically ill patients, thereby completing ESPEN guidelines on intensive care unit (ICU) nutrition.
Available literature and personal clinical experience on monitoring of nutrition and metabolism was systematically reviewed by the ESPEN group for ICU nutrition guidelines.
We did not identify any studies comparing outcomes with monitoring versus not monitoring nutrition therapy. The potential for abnormal values to be associated with harm was clearly recognized. The necessity to create locally adapted standard operating procedures (SOPs) for follow up of enteral and parenteral nutrition is emphasised. Clinical observations, laboratory parameters (including blood glucose, electrolytes, triglycerides, liver tests), and monitoring of energy expenditure and body composition are addressed, focusing on prevention, and early detection of nutrition-related complications.
Understanding and defining risks and developing local SOPs are critical to reduce specific risks.
本立场文件总结了危重症患者人工营养和代谢监测的理论和实践方面，从而完成了关于重症监护病房（ICU）营养的 ESPEN 指南。
ESPEN 重症监护营养指南小组对营养和代谢监测的现有文献和个人临床经验进行了系统回顾。
我们没有发现任何研究比较过监测与不监测营养治疗的结果。人们清楚地认识到，异常值有可能与伤害有关。强调需要制定适用于肠内和肠外营养的本地适应性标准操作程序（SOP）。本文件讨论了临床观察、实验室参数（包括血糖、电解质、甘油三酯、肝功能检查）以及能量消耗和身体成分的监测，重点是预防和早期发现与营养相关的并发症。
了解和定义风险并制定本地 SOP 对于降低特定风险至关重要。
