成人脓毒症患者肠内营养干预策略的最佳证据总结

Evidence summary for enteral nutrition interventions in adult sepsis patients

摘要

目的：系统总结成人脓毒症患者肠内营养干预的最佳证据，以指导脓毒症营养管理临床实践。方法：在国内外循证资源数据库、指南网站和国内外专业社团网站中，以2020年1月至2024年12月为检索时限，检索成人脓毒症患者肠道营养支持的文献资料。2位研究者对文献进行质量评价，结合专业判断，提取、汇总数据。结果：本文总结了10篇文献，涵盖4篇临床指南，3篇专家共识及3篇系统评价。24个最佳证据汇总于7个方面：营养风险评估、启动时机、能量和蛋白质目标、耐受性管理、血糖监测、补充微量元素、监测。结论：本研究总结了成人脓毒症患者肠内营养实施策略的最佳证据，为临床制定个体化营养方案提供循证参考。

Abstract

Objective: To systematically summarize the best evidence for enteral nutrition intervention in adult patients with sepsis to guide clinical practice in sepsis nutrition management. Methods: Systematic searches were conducted in domestic and international evidence-based resource databases, guideline websites, and professional association websites for Chinese and English literature on enteral nutrition support for adult patients with sepsis. The search period was from January 2022 to December 2024. Two researchers independently evaluated the quality of the literature, and evidence was extracted and summarized based on professional judgment. Results: This summary includes 10 literatures, covering 4 clinical guidelines, 3 expert consensuses and 3 systematic reviews. Twenty-four pieces of best evidence were summarized across seven aspects: nutritional risk assessment, initiation timing, energy and protein targets, tolerance management, blood glucose monitoring, trace element supplementation, and monitoring. Conclusion: This study summarizes the best evidence on enteral nutrition implementation strategies for adult patients with sepsis, providing an evidence-based reference for the formulation of individualized nutrition plans in clinical practice.

关键词

脓毒症 / 肠内营养 / 循证实践 / 证据总结

Key words

Sepsis / Enteral Nutrition / Evidence-Based Practice / Evidence Summary

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基金资助

新发突发与重大传染病防控国家科技重大专项资助项目(2025ZD01902600)