Background This document represents the first evidence-based guidelines to describe best practices in nutrition therapy in critically ill children (>1 month and <18 years), who are expected to require a length o...Background This document represents the first evidence-based guidelines to describe best practices in nutrition therapy in critically ill children (>1 month and <18 years), who are expected to require a length of stay more than 2 or 3 days in a Pediatric Intensive Care Unit admitting medical patients domain. Methods A total of 25,673 articles were scanned for relevance. After careful review, 88 studies appeared to answer the pre-identified questions for the guidelines. We used the grading of recommendations, assessment, development and evaluation criteria to adjust the evidence grade based on the quality of design and execution of each study. Results The guidelines emphasise the importance of nutritional assessment, particularly the detection of malnourished patients. Indirect calorimetry (IC) is recommended to estimate energy expenditure and there is a creative value in energy expenditure, 50 kcal/kg/day for children aged 1–8 years during acute phase if IC is unfeasible. Enteral nutrition (EN) and early enteral nutrition remain the preferred routes for nutrient delivery. A minimum protein intake of 1.5 g/kg/day is sug-gested for this patient population. The role of supplemental parenteral nutrition (PN) has been highlighted in patients with low nutritional risk, and a delayed approach appears to be beneficial in this group of patients. Immune-enhancing cannot be currently recommended neither in EN nor PN. Conclusion Overall, the pediatric critically ill population is heterogeneous, and an individualized nutrition support with the aim of improving clinical outcomes is necessary and important.展开更多
目的系统评价隔物灸治疗肠易激综合征的临床疗效及安全性。方法通过计算机检索中国期刊全文数据库、维普数据库、万方数据库、pubmed数据库,起止时间均为1995年1月至2017年6月。收集隔物灸治疗肠易激综合征临床随机对照试验,纳入隔物灸...目的系统评价隔物灸治疗肠易激综合征的临床疗效及安全性。方法通过计算机检索中国期刊全文数据库、维普数据库、万方数据库、pubmed数据库,起止时间均为1995年1月至2017年6月。收集隔物灸治疗肠易激综合征临床随机对照试验,纳入隔物灸与中药或西药对照治疗肠易激综合征的随机和半随机对照临床试验,由2名研究者按照Cochrane Handbook标准对每个纳入试验进行偏倚风险和质量评估,并使用Rev Man 5.3软件进行Meta分析。结果共计纳入9个研究,合计657名患者。Meta分析显示隔物灸法在有效率[RR=1.23,95%CI(1.15,1.33)]上优于中西药物对照组。结论隔物灸治疗肠易激综合征优于常规中西药物治疗组。展开更多
文摘Background This document represents the first evidence-based guidelines to describe best practices in nutrition therapy in critically ill children (>1 month and <18 years), who are expected to require a length of stay more than 2 or 3 days in a Pediatric Intensive Care Unit admitting medical patients domain. Methods A total of 25,673 articles were scanned for relevance. After careful review, 88 studies appeared to answer the pre-identified questions for the guidelines. We used the grading of recommendations, assessment, development and evaluation criteria to adjust the evidence grade based on the quality of design and execution of each study. Results The guidelines emphasise the importance of nutritional assessment, particularly the detection of malnourished patients. Indirect calorimetry (IC) is recommended to estimate energy expenditure and there is a creative value in energy expenditure, 50 kcal/kg/day for children aged 1–8 years during acute phase if IC is unfeasible. Enteral nutrition (EN) and early enteral nutrition remain the preferred routes for nutrient delivery. A minimum protein intake of 1.5 g/kg/day is sug-gested for this patient population. The role of supplemental parenteral nutrition (PN) has been highlighted in patients with low nutritional risk, and a delayed approach appears to be beneficial in this group of patients. Immune-enhancing cannot be currently recommended neither in EN nor PN. Conclusion Overall, the pediatric critically ill population is heterogeneous, and an individualized nutrition support with the aim of improving clinical outcomes is necessary and important.
文摘目的系统评价隔物灸治疗肠易激综合征的临床疗效及安全性。方法通过计算机检索中国期刊全文数据库、维普数据库、万方数据库、pubmed数据库,起止时间均为1995年1月至2017年6月。收集隔物灸治疗肠易激综合征临床随机对照试验,纳入隔物灸与中药或西药对照治疗肠易激综合征的随机和半随机对照临床试验,由2名研究者按照Cochrane Handbook标准对每个纳入试验进行偏倚风险和质量评估,并使用Rev Man 5.3软件进行Meta分析。结果共计纳入9个研究,合计657名患者。Meta分析显示隔物灸法在有效率[RR=1.23,95%CI(1.15,1.33)]上优于中西药物对照组。结论隔物灸治疗肠易激综合征优于常规中西药物治疗组。
