Publication: Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: introduction and methodology.
Identifiers
Date
2011-11
Authors
Mesejo, A.
Vaquerizo Alonso, C.
Acosta Escribano, J.
Ortiz Leiba, C.
Montejo González, J. C.
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
Aula Médica Ediciones
Abstract
El Grupo de trabajo de Metabolismo y Nutrición de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) elaboró en 2005 unas recomendaciones para el soporte nutricional especializado del paciente crítico. Dado el tiempo transcurrido se consideró oportuno la revisión y actualización de dichas recomendaciones, planificándolas como un documento de consenso con la Sociedad Española de Nutrición parenteral y Enteral (SENpE). El objetivo primario planteado para el establecimiento de las recomendaciones fue evaluar la mejor evidencia científica disponible para las indicaciones del soporte nutricional y metabólico especializado en el paciente crí- tico. Las recomendaciones se han realizado por un panel de expertos con amplia experiencia en el soporte nutricional y metabólico de los pacientes en situación crítica y se han llevado a cabo entre octubre de 2009 y marzo de 2011. Se analizaron metaanálisis, estudios clínicos aleatorizados y observacionales, revisiones sistemáticas y puestas al día referentes a pacientes críticos en edad adulta en MEDLINE de 1966 a 2010, EMBASE reviews de 1991 a 2010 y Cochrane Database of Systematic Reviews hasta 2010. Se seleccionaron los criterios metodológicos establecidos en la Scottish Intercollegiate Guidelines Network y los de la Agency for Health Care policy and Research, además de la escala de valoración de la calidad de Jadad, ajustando la gradación de la evidencia y la potencia de las recomendaciones siguiendo la propuesta del Grupo GRADE (Grading of Recommendations Assessment, Development and Evaluation Working Group). Se seleccionaron 16 situaciones patológicas que fueron desarrolladas, cada una, por grupos de 3 expertos, estableciéndose un sistema de feedback con los 5 miembros del Comité de Redacción y con la totalidad del Grupo de trabajo. En diferentes reuniones se discutieron y consensuaron todas las discrepancias, poniéndose especial énfasis en el repaso de los niveles de evidencia y grados de recomendación establecidos. El Comité de Redacción procedió al ajuste final para su presentación y aproba ción definitiva por todos los miembros del Grupo de trabajo. Finalmente el documento se presentó a los comités científicos de las dos sociedades participantes del consenso para su aprobación definitiva. Las presentes recomendaciones pretenden servir de guía para los clínicos con responsabilidades en el manejo y tratamiento de los pacientes críticos y para todos los especialistas interesados en el tratamiento nutricional del paciente hospitalizado.
The Recommendations for Specialized Nutritional Support in Critically-Ill patients were drafted by the Metabolism and Nutrition Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) in 2005. Given the time elapsed since then, these recommendations have been reviewed and updated as a Consensus Document in collaboration with the Spanish Society of Parenteral and Enteral Nutrition (SENPE). The primary aim of these Recommendations was to evaluate the best available scientific evidence for the indications of specialized nutritional and metabolic support in critically-ill patients. The Recommendations have been formulated by an expert panel with broad experience in nutritional and metabolic support in critically-ill patients and were drafted between October 2009 and March 2011. The studies analyzed encompassed metaanalyses, randomized clinical trials, observational studies, systematic reviews and updates relating to critically-ill adults in MEDLINE from 1966 to 2010, EMBASE reviews from 1991 to 2010 and the Cochrane Database of Systematic Reviews up to 2010. The methodological criteria selected were those established in the Scottish Intercollegiate Guidelines Network and the Agency for Health Care policy and Research, as well as those of the Jadad Quality Scale. Adjustment for the level of evidence and grade of recommendation was performed following the proposal of the GRADE group (Grading of Recommendations Assessment, Development and Evaluation Working Group). Sixteen pathological scenarios were selected and each of them was developed by groups of three experts. A feedback system was established with the five members of the Editorial Committee and with the entire Working Group. All discrepancies were discussed and consensus was reached over several meetings, with special emphasis placed on reviewing the levels of evidence and grades of recommendation. The Editorial Committee made the final adjustments before the document was approved by all the members of the Working Group. Finally, the document was submitted to the Scientific Committees of the two Societies participating in the Consensus for final approval. The present Recommendations aim to serve as a guide for clinicians involved in the management and treatment of critically-ill patients and for any specialists interested in the nutritional treatment of hospitalized patients.
The Recommendations for Specialized Nutritional Support in Critically-Ill patients were drafted by the Metabolism and Nutrition Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) in 2005. Given the time elapsed since then, these recommendations have been reviewed and updated as a Consensus Document in collaboration with the Spanish Society of Parenteral and Enteral Nutrition (SENPE). The primary aim of these Recommendations was to evaluate the best available scientific evidence for the indications of specialized nutritional and metabolic support in critically-ill patients. The Recommendations have been formulated by an expert panel with broad experience in nutritional and metabolic support in critically-ill patients and were drafted between October 2009 and March 2011. The studies analyzed encompassed metaanalyses, randomized clinical trials, observational studies, systematic reviews and updates relating to critically-ill adults in MEDLINE from 1966 to 2010, EMBASE reviews from 1991 to 2010 and the Cochrane Database of Systematic Reviews up to 2010. The methodological criteria selected were those established in the Scottish Intercollegiate Guidelines Network and the Agency for Health Care policy and Research, as well as those of the Jadad Quality Scale. Adjustment for the level of evidence and grade of recommendation was performed following the proposal of the GRADE group (Grading of Recommendations Assessment, Development and Evaluation Working Group). Sixteen pathological scenarios were selected and each of them was developed by groups of three experts. A feedback system was established with the five members of the Editorial Committee and with the entire Working Group. All discrepancies were discussed and consensus was reached over several meetings, with special emphasis placed on reviewing the levels of evidence and grades of recommendation. The Editorial Committee made the final adjustments before the document was approved by all the members of the Working Group. Finally, the document was submitted to the Scientific Committees of the two Societies participating in the Consensus for final approval. The present Recommendations aim to serve as a guide for clinicians involved in the management and treatment of critically-ill patients and for any specialists interested in the nutritional treatment of hospitalized patients.
Description
Introductory Journal Article;
MeSH Terms
Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness
Medical Subject Headings::Health Care::Health Services Administration::Quality of Health Care::Quality Assurance, Health Care::Guidelines as Topic
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Meta-Analysis as Topic
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Nutritional Support
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Methods::Research Design
Medical Subject Headings::Information Science::Information Science::Communication::Language::Linguistics::Terminology as Topic
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus
Medical Subject Headings::Health Care::Health Services Administration::Quality of Health Care::Quality Assurance, Health Care::Guidelines as Topic
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Meta-Analysis as Topic
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Nutrition Therapy::Nutritional Support
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Clinical Trials as Topic::Controlled Clinical Trials as Topic::Randomized Controlled Trials as Topic
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Methods::Research Design
Medical Subject Headings::Information Science::Information Science::Communication::Language::Linguistics::Terminology as Topic
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus
DeCS Terms
CIE Terms
Keywords
Recommendations, Clinical evidence, Specialized nutritional support, Critically-illpatient, Recomendaciones, Evidencia clínica, Diseño de la investigación, Terminología como asunto, Soporte nutricional especializado, Paciente crítico
Citation
Mesejo A, Vaquerizo Alonso C, Acosta Escribano J, Ortiz Leiba C, Montejo González JC. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: introduction and methodology. Nutr Hosp. 2011; 26 Suppl 2:1-6