Department of Pharmacy, Clinical Programs, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Nutrition Services, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Nutr Clin Pract. 2024 Oct;39(5):1055-1068. doi: 10.1002/ncp.11188. Epub 2024 Jul 30.
An update to the American Society for Parenteral and Enteral Nutrition guidelines for nutrition provision in critically ill adults was published in 2022. In contrast to the previous set of guidelines published in 2016, the revised guidelines selected only studies meeting specific criteria for scientific rigor and only considered publications reflecting more modern intensive care unit (ICU) practices (studies between January 1, 2001, and July 15, 2020). No consensus recommendations were included. Although these methods limited the number of recommendations made and the applicability to current ICU practices, important implications for patient care were evaluated and acknowledged. The literature supporting guideline recommendations that impact parenteral nutrition management is summarized in this review, along with key studies published after the guidelines were revised. Considerations for practical application of this evidence, along with limitations and future guideline directions, are also described.
2022 年发布了美国肠外与肠内营养学会(American Society for Parenteral and Enteral Nutrition,ASPEN)危重症成人营养供给指南的更新版。与 2016 年发布的上一版指南不同,修订版指南仅选择了符合科学严谨性特定标准的研究,并且仅考虑反映更现代的重症监护病房(intensive care unit,ICU)实践的出版物(2001 年 1 月 1 日至 2020 年 7 月 15 日之间的研究)。未纳入共识推荐。尽管这些方法限制了建议的数量和对当前 ICU 实践的适用性,但对患者护理的重要影响进行了评估和认可。本文总结了支持影响肠外营养管理的指南建议的文献,并结合指南修订后发表的关键研究进行了介绍。还描述了对该证据进行实际应用的考虑因素、局限性和未来的指南方向。