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[成人脓毒症患者医学营养治疗指南(2025版)]

[Guidelines for medical nutritional therapy in adult sepsis patients (2025 edition)].

出版信息

Zhonghua Yi Xue Za Zhi. 2025 Feb 18;105(7):510-528. doi: 10.3760/cma.j.cn112137-20240813-01859.

Abstract

Although medical nutritional therapy affects the prognosis of sepsis patients, there is controversy over its clinical implementation process. To further standardize the medical nutrition therapy of sepsis patients, the Chinese Society of Parenteral and Enteral Nutrition (CSPEN) organized more than 50 experts from critical care medicine, clinical nutrition, evidence based medicine and statistics to formulate the guidelines. The guideline was based on grading of recommendations, development and evaluations (GRADE) standards and procedures, through systematic retrieval and evidence sorting, and combined with the practical experience of clinical experts. The guidelines provide recommendations on nutritional risk screening in medical nutrition therapy for sepsis patients, early medical nutrition therapy (enteral nutrition, parenteral nutrition, energy intake, optimal target for protein delivery), enteral nutrition infusion mode, traditional Chinese medicine and protecting intestinal function, nutritional supplements (vitamin, glutamine, omega-3 fatty acids, selenium), probiotics, and the use of proton pump inhibitors. Ultimately, 14 questions and 14 recommendations were formed in order to improve the medical nutrition therapy process for sepsis patients.

摘要

尽管医学营养治疗会影响脓毒症患者的预后,但其临床实施过程仍存在争议。为进一步规范脓毒症患者的医学营养治疗,中国肠外肠内营养学会(CSPEN)组织了50余位来自重症医学、临床营养、循证医学及统计学领域的专家制定本指南。该指南基于推荐分级的评估、制定与评价(GRADE)标准及程序,通过系统检索和证据整理,并结合临床专家的实践经验制定而成。本指南针对脓毒症患者医学营养治疗中的营养风险筛查、早期医学营养治疗(肠内营养、肠外营养、能量摄入、蛋白质供给的最佳目标)、肠内营养输注方式、中医药与肠道功能保护、营养补充剂(维生素、谷氨酰胺、ω-3脂肪酸、硒)、益生菌以及质子泵抑制剂的使用等方面给出了推荐意见。最终形成了14个问题及14条推荐意见,以改进脓毒症患者的医学营养治疗流程。

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