Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
J Crit Care. 2022 Dec;72:154144. doi: 10.1016/j.jcrc.2022.154144. Epub 2022 Sep 15.
There is limited understanding of fasting practices and reported safety concerns for airway procedures in critically ill adults.
To describe fasting practices including safety concerns for airway procedures in critically ill adult patients in the reported literature.
Studies conducted in adult critically ill patients receiving enteral nutrition (EN) and undergoing an airway procedure (endotracheal intubation, endotracheal extubation, and tracheostomy) were included if EN fasting practices and/or prespecified nutrition and clinical outcomes were reported.
A scoping review using the Joanna Briggs Institute methodology was conducted. MEDLINE, Embase, and CINAHL were searched from 2000 to January 19, 2022. Results are presented via narrative synthesis.
Fourteen studies were included, with only one randomised control trial (RCT). Twelve studies reported on fasting practices with varied EN fasting durations (0-34 h) and two reported data on nutrition adequacy. Three studies investigated continued EN in one study arm and four studies minimised fasting duration by including gastric suctioning prior to the airway procedure. Safety concerns primarily related to aspiration events (61%) were reported in nine studies.
In the reported literature, there is wide variation in EN fasting practices for airway procedures in critically ill patients with limited evidence to inform practice.
目前对于危重症成人气道操作时的禁食实践及其安全性顾虑知之甚少。
描述危重症成人患者在气道操作时的禁食实践，包括文献中报告的安全性顾虑。
纳入了接受肠内营养（EN）并接受气道操作（气管内插管、气管内拔管和气管切开术）的成年危重症患者的研究，如果报告了 EN 禁食实践和/或规定的营养和临床结局，则将其纳入研究。
采用 Joanna Briggs 研究所的方法进行范围综述。从 2000 年到 2022 年 1 月 19 日，对 MEDLINE、Embase 和 CINAHL 进行了检索。结果通过叙述性综合呈现。
纳入了 14 项研究，其中只有 1 项随机对照试验（RCT）。12 项研究报告了禁食实践，EN 禁食时间（0-34 小时）不一，2 项研究报告了营养充足的数据。3 项研究在一个研究组中继续进行 EN，4 项研究通过在气道操作前进行胃抽吸来尽量缩短禁食时间。9 项研究报告了主要与吸入事件（61%）相关的安全性顾虑。
在报告的文献中，危重症患者气道操作时的 EN 禁食实践存在广泛的差异，实践依据有限。
