目的 系统评价营养支持疗法(简称“营养支持”)在急性呼吸系统疾病应用的临床指南,以期为新型冠状病毒肺炎(COVID-19)等冠状病毒感染的营养支持提供循证参考。方法 计算机检索Pubmed、EMBASE、CNKI等数据库,全球主要营养学会网站、指南网站。纳入急性呼吸系统疾病营养支持指南,提取资料并进行质量评价,列出主要推荐意见。结果 最终纳入10篇指南,制定时间为2006~2019年。指南质量为A级6篇,B级3篇,C级1篇。在指南研究与评价工具(AGREE)Ⅱ涉及各领域中,范围与目的、清晰性、独立性的总分最高,应用性普遍得分较低。各指南侧重点不同,可互为补充,对同一问题的推荐意见基本一致。结论 COVID-19营养支持策略可遵循既往在重症、急性呼吸窘迫综合征、肺炎等发表的高质量指南推荐意见。
Abstract
OBJECTIVE To systematically review the related guidelines of nutrition support therapy (hereinafter referred to as nutrition support) in acute respiratory disease, and to provide evidence-based evidences for clinical nutrition in coronavirus disease 2019 (COVID-19). METHODS Retrieved from PubMed, EMBase, CNKI, etc., websites of association in nutrition and global guideline databases. The guidelines in nutrition support for related diseases were collected. Recommendations were summarized after data extraction and quality evaluation. RESULTS A total of 10 guidelines were enrolled, with development time ranging from 2006 to 2019. There were 6 guidelines with quality of level A, 3 with level B, and 1 with level C. “scope and purpose”, “clarity” and “independence” showed the higher scores in AGREE Ⅱ, and “applicability” showed generally low scores. There were differences among emphases of guidelines, however, supplements for each other, and the recommendations for the same questions showed substantial agreement. CONCLUSION The recommendations, in high quality guidelines of critical illness, acute respiratory distress syndrome, pneumonia, etc., could be applied to nutrition support in COVID-19.
关键词
急性呼吸系统疾病 /
营养支持 /
指南评价工具 /
系统评价 /
循证
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Key words
acute respiratory disease /
nutrition support /
guideline evaluation /
systematic review /
evidence based
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参考文献
[1] ZHAO R S, YANG Y H, YANG L, et al. Cronavirus SARS-CoV-2 infection: expert consensus on guidance and prevention strategies for hospital pharmacists and the pharmacy workforce [J]. Chin Pharm J(中国药学杂志), 2020, 55(4):268-277.
[2] Health Emergency Response Office. Feb 16 Daily briefing on novel coronavirus cases in China [EB/OL]. 2020-2-16 [2020-2-17]. http://en.nhc.gov.cn/2020-02/16/c_76584.htm.
[3] ZHU N, ZHANG D, WANG W, et al. A novel coronavirus from patients with pneumonia in China, 2019 [J]. N Engl J Med, 382:727-733.
[4] WU F, ZHAO S, YU B, et al. A new coronavirus associated with human respiratory disease in China [J]. Nature, 2020-02-06 [2020-02-17]. https://www.nature.com/articles/s41586-020-2008-3.
[5] ZHOU P, YANG X L, WANG X G, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin [J]. Nature, 2020-02-03 [2020-02-17]. https://www.nature.com/articles/s41586-020-2012-7.
[6] CHEN N, ZHOU M, DONG X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China:a descriptive study [J]. Lancet, 2020, 395(10223):507-513.
[7] HUANG C, WANG Y, LI X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [J]. Lancet, 2020, 395(10223):497-506.
[8] WANG D, HU B, HU C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China [J]. JAMA, 2020-02-07[2020-02-17]. https://jamanetwork.com/journals/jama/fullarticle/2761044.
[9] GUAN W J, NI Z Y, HU Y, et al. Clinical characteristics of coronavirus disease 2019 in China [J]. N Engl J Med, 2020-02-28 [2020-03-10]. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032.
[10] HOLSHUE M L, DEBOLT C, LINDQUIST S, et al. First case of 2019 novel coronavirus in the United States [J]. N Engl J Med, 382 (10):929-936.
[11] General Office of National Health Commission. Notice on Printing and Issuing the Diagnosis and Treatment Standard (the 5th trial ed.) of Novel Coronavirus, 2020 [EB/OL]. 2020-02-08 [2020-02-17]. http://www.nhc.gov.cn/yzygj/s7653p/202002/d4b895337e19445f8d728fcaf1e3e13a.shtml.
[12] Chinese Medical Association. Clinical Practice Guidelines:Parenteral and Enteral Nutrition(临床诊疗指南:肠外肠内营养分册) [M]. 1st ed. Beijing:People's Medical Publishing House, 2008.
[13] ELKE G, HARTL W H, KREYMANN K G, et al. Clinical nutrition in critical care medicine-guideline of the German Society for Nutritional Medicine(DGEM) [J]. Clin Nutr ESPEN, 2019,33:220-275.
[14] JIE B, JIANG Z M, NOLAN M T, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk:a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals[J]. Nutrition, 2010,26(11-12):1088-1093.
[15] SCHUETZ P, FEHR R, BAECHLI V, et al. Individualised nutritional support in medical inpatients at nutritional risk:a randomised clinical trial[J]. Lancet, 2019,393(10188):2312-2321.
[16] Department of Food Safety Standards, Risk Surveillance and Assessment. Instruction on Diet of Nutrition Against Novel Coronavirus [EB/OL]. 2020-02-08 [2020-02-17]. http://www.nhc.gov.cn/sps/s7886/202002/a69fd36d54514c5a9a3f456188cbc428.shtml .
[17] General Office of National Health Commission. Notice on Printing and Issuing the Diagnosis and Treatment Standard (the 2nd trial ed.) of Novel Coronavirus Critically illness [EB/OL]. 2020-02-08 [2020-02-17]. http://www.nhc.gov.cn/yzygj/s7653p/202002/d4b895337e19445f8d728fcaf1e3e13a.shtml.
[18] XU J Q, ZENG F, WU Y, et al. Clinical nutrition suggestion for the severe pneumonia patients infected by novel coronavirus[J]. Chin J Hosp Pharm (中国医院药学杂志), 2020,40(5):1-3.
[19] BROUWERS M C, KHO M E, BROWMAN G P, et al. AGREE Ⅱ:advancing guideline development, reporting, and evaluation in health care[J]. Prev Med, 2010,51(5):421-424.
[20] RIOS E, SERON P, LANAS F, et al. Evaluation of the quality of clinical practice guidelines for the management of esophageal or gastric variceal bleeding[J]. Eur J Gastroenterol Hepatol, 2014,26(4):422-431.
[21] DHALIWAL R, CAHILL N, LEMIEUX M, et al. The Canadian critical care nutrition guidelines in 2013:an update on current recommendations and implementation strategies[J]. Nutr Clin Pract, 2014,29(1):29-43.
[22] GOMES F, SCHUETZ P, BOUNOURE L, et al. ESPEN guidelines on nutritional support for polymorbid internal medicine patients[J]. Clin Nutr, 2018,37(1):336-353.
[23] MCCLAVE S A, DIBAISE J K, MULLIN G E, et al. ACG clinical gideline: nutrition therapy in the adult hospitalized patient[J]. Am J Gastroenterol, 2016,111(3):315-334.
[24] MCCLAVE S A, TAYLOR B E, MARTINDALE R G, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically Ⅲ patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN) [J]. JPEN, 2016,40(2):159-211.
[25] SINGER P, BLASER A R, BERGER M M, et al. ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr, 2019,38(1):48-79.
[26] UKLEJA A, GILBERT K, MOGENSEN K M, et al. Standards for nutrition support:adult hospitalized patients[J]. Nutr Clin Pract, 2018,33(6):906-920.
[27] NUTRITION C C. Canadian Clinical Practice guidelines 2015:summary of revisions to the recommendations 2015 [R]. [2020-02-10]. https://www.criticalcarenutrition.com/docs/CPGs%202015/Summary%20CPGs%202015%20vs%202013.pdf.
[28] RHODES A, EVANS L E, ALHAZZANI W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock:2016[J]. Intensive Care Med, 2017,43(3):304-377.
[29] Chinese Society of Critical Care Medicine. Guidelines for the diagnosis and treatment of acute lung injure/aute respiratory distress syndrome 2006[J]. Chin J Pract Surg(中国实用外科杂志),2007,27(1):1-6.
[30] Scottish Intercollegiate Guidelines Network (SIGN). SIGN 50: A Guideline Developer's Handbook[M]. Revised version ed. Edinburgh:SIGN, 2014.
[31] BALSHEM H, HELFAND M, SCHUNEMANN H J, et al. GRADE guidelines:3. Rating the quality of evidence[J]. J Clin Epidemiol, 2011,64(4):401-406.
[32] GUYATT G H, OXMAN A D, KUNZ R, et al. GRADE guidelines:2. Framing the question and deciding on important outcomes[J]. J Clin Epidemiol, 2011,64(4):395-400.
[33] GUYATT G H, OXMAN A D, VIST G, et al. GRADE guidelines:4. Rating the quality of evidence--study limitations (risk of bias)[J]. J Clin Epidemiol, 2011,64(4):407-415.
[34] DURIEUX N, VANDENPUT S, PASLEAU F. OCEBM levels of evidence system[J]. Rev Med Liege, 2013,68(12):644-649.
[35] MUELLER C, COMPHER C, ELLEN D M, et al. ASPEN clinical guidelines: nutrition screening, assessment, and intervention in adults[J]. JPEN, 2011,35(1):16-24.
[36] NATIONAL HEALTH AND FANILY PLANNING COMMISSION. Profession Standard on Health Area of the People's Republic of China:Nutritional Risk Screening (WS/T427-2013)[S]. Beijing:China Standards Press 2013.
[37] REEVES M M, CAPRA S. Predicting energy requirements in the clinical setting:are current methods evidence based?[J]. Nutr Rev, 2003,61(4):143-151.
[38] MUELLER C. The ASPEN Adult Nutrition Support Core Curriculum[M]. 3rd ed. Silver Spring, MD:ASPEN, 2017.
[39] FOWLER A A 3RD, TRUWIT J D, HITE R D, et al. Effect of vitamin C infusion on organ failure and biomarkers of inflammation and vascular injury in patients with sepsis and severe acute respiratory failure:The CITRIS-ALI Randomized Clinical Trial[J]. JAMA, 2019,322(13):1261-1270.
[40] FOWLER A A, 3RD, SYED A A, KNOWLSON S, et al. Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis[J]. J Transl Med, 2014,12:32.
[41] ZABET M H, MOHAMMADI M, RAMEZANI M, et al. Effect of high-dose ascorbic acid on vasopressor's requirement in septic shock[J]. J Res Pharm Pract, 2016,5(2):94-100.
[42] Critical Care Nutrition. Systematic Reviews-Vitamin C 2019[R]. 2019-10 [2020-02-17]. https://www. criticalcarenutrition. com/docs/systematic_reviews_2018/11.3%20Intravenous%20Vitamin%20C%20Supplementation%20%202019.pdf.
[43] YU K Y, SHI H P. The interpretation of the instruction on diet of nutrition against novel coronavirus[J]. Natl Med J China(中华医学杂志),2020,100(10):724-728.
[44] YANG J K, FENG Y, YUAN M Y, et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS[J]. Diabet Med, 2006,23(6):623-628.
[45] GUO L M, LIN S S, YANG J K. Expression of angiotensin-converting enzyme 2 in rats & mince pancreas tissue[J]. J Pract Med (实用医学杂志), 2010,26(15):2708-2710.
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脚注
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基金
国家科技重大专项课题资助(2017ZX09304012-008)
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