Abstract：
Nutritional therapy should follow evidence-based practice, thus several societies regarding nutrition and critical care have developed specific Clinical Practice Guidelines (CPG). However, to be regarded as trustworthy, the quality of the CPG for critically ill patients and its recommendations need to be high. This systematic review aimed to appraise the methodology and recommendations of nutrition CPG for critically ill patients. We performed a systematic review (protocol number CRD42020184199) with literature search conducted on PubMed, Embase, Cochrane Library and other four specific databases of guidelines up to October 2021. Two reviewers, independently, assessed titles and abstracts and potentially eligible full-text reports to determine eligibility and subsequently four reviewers appraised the guidelines quality using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE-II) and AGREE-Recommendation Excellence (AGREE-REX). Ten CPG for nutrition in critically ill patients were identified. Only Academy of Nutrition and Dietetics and European Society of Intensive Care Medicine had a total acceptable quality and were recommended for daily practice according AGREE-II. None of the CPG recommendations had an overall quality score above 70 %, thus being classified as moderate quality according AGREE-REX. The methodological evaluation of the critically ill adult patient CPG revealed significant discrepancies and showed a need for improvement in its development and/or reporting. In addition, recommendations about nutrition care process presented a moderate quality.
摘要：
营养治疗应遵循循证实践，因此,几个关于营养和重症监护的学会制定了具体的临床实践指南(CPG).然而,危重患者的CPG质量值得信赖，其建议必须很高。本系统综述旨在评估危重患者营养CPGs的方法和建议。我们进行了系统评价（方案编号CRD42020184199），并在Pubmed上进行了文献检索，Embase,科克伦图书馆,以及截至2021年10月的其他四个具体指南数据库。两位审稿人,独立,评估标题和摘要以及潜在合格的全文报告，以确定资格，随后四名审稿人使用《推进指南发展》评估了指南质量，医疗保健工具II（AGREE-II）和AGREE-RecommendationExcellence（AGREE-REX）中的报告和评估。确定了10例用于危重患者营养的CPG。根据AGREE-II，只有营养与饮食学会和欧洲重症监护医学学会的质量总体可接受，并建议进行日常实践。CPG建议的总体质量得分均未超过70％，因此根据AGREE-REX被归类为中等质量。对危重成年患者CPG的方法学评估显示出明显差异，并显示需要改进其开发和/或报告。此外,关于营养护理过程的建议提出了中等质量。
