Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)

摘要: This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition of Critical Care Medicine-to describe best practices in nutrition therapy critically ill children. The target these guidelines is intended to be pediatric patient (>1 month 2-3 days a PICU admitting medical, surgical, cardiac patients. In total, 2032 citations were scanned relevance. PubMed/MEDLINE search resulted 960 clinical trials 925 cohort studies. EMBASE culled 1661 citations. yielded 1107 citations, whereas 925. After careful review, 16 randomized controlled 37 studies appeared answer 1 8 preidentified question groups this guideline. We used GRADE criteria (Grading Recommendations, Assessment, Development, Evaluation) adjust evidence grade based on assessment quality study design execution. These are not neonates or adult reiterate importance assessment-particularly, detection malnourished patients who most vulnerable therefore may benefit from timely intervention. There need renewed focus accurate estimation energy needs attention optimizing protein intake. Indirect calorimetry, where feasible, cautious use estimating equations increased surveillance unintended caloric underfeeding overfeeding recommended. Optimal intake its correlation with outcomes areas great interest. optimal route timing nutrient delivery intense debate investigations. remains preferred delivery. Several strategies optimize enteral during critical illness have emerged. role supplemental parenteral has been highlighted, delayed approach appears beneficial. Immunonutrition cannot currently Overall, care population heterogeneous, nuanced individualizing support aim improving necessary.