Abstract：
Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. Recent research has shown the importance of MNs in common pathologies, with significant deficiencies impacting the outcome.
This guideline aims to provide information for daily clinical nutrition practice regarding assessment of MN status, monitoring, and prescription. It proposes a consensus terminology, since many words are used imprecisely, resulting in confusion. This is particularly true for the words \"deficiency\", \"repletion\", \"complement\", and \"supplement\".
The expert group attempted to apply the 2015 standard operating procedures (SOP) for ESPEN which focuses on disease. However, this approach could not be applied due to the multiple diseases requiring clinical nutrition resulting in one text for each MN, rather than for diseases. An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL. The search focused on physiological data, historical evidence (published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations.
There was a limited number of interventional trials, preventing meta-analysis and leading to a low level of evidence. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90% of votes. Altogether the guideline proposes sets of recommendations for 26 MNs, resulting in 170 single recommendations. Critical MNs were identified with deficiencies being present in numerous acute and chronic diseases. Monitoring and management strategies are proposed.
This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases. In particular, it offers practical advice on MN provision and monitoring during nutritional support.
This guideline aims to provide information for daily clinical nutrition practice regarding assessment of MN status, monitoring, and prescription. It proposes a consensus terminology, since many words are used imprecisely, resulting in confusion. This is particularly true for the words \"deficiency\", \"repletion\", \"complement\", and \"supplement\".
The expert group attempted to apply the 2015 standard operating procedures (SOP) for ESPEN which focuses on disease. However, this approach could not be applied due to the multiple diseases requiring clinical nutrition resulting in one text for each MN, rather than for diseases. An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL. The search focused on physiological data, historical evidence (published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations.
There was a limited number of interventional trials, preventing meta-analysis and leading to a low level of evidence. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90% of votes. Altogether the guideline proposes sets of recommendations for 26 MNs, resulting in 170 single recommendations. Critical MNs were identified with deficiencies being present in numerous acute and chronic diseases. Monitoring and management strategies are proposed.
This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases. In particular, it offers practical advice on MN provision and monitoring during nutritional support.
摘要：
微量元素和维生素，一起命名为微量营养素(MNs)，对人体新陈代谢至关重要。最近的研究表明，MNs在常见病理中的重要性，具有影响结果的重大缺陷。
本指南旨在为每日临床营养实践提供有关MN状态评估的信息。监测,和处方。它提出了一个协商一致的术语，由于许多单词使用不准确，造成混乱。“不足”一词尤其如此，\"重新完成\",\"补码\",和“补充”。
专家组试图将2015年标准操作程序（SOP）应用于ESPEN，重点关注疾病。然而,由于多种疾病需要临床营养，导致每个MN都有一个文本，因此无法应用此方法。而不是疾病。在Medline数据库中对文献进行了广泛的搜索，PubMed,科克伦,谷歌学者，和CINAHL。搜索的重点是生理数据，历史证据（在1996年PubMed发布之前发布），以及观察性和/或随机试验。对于每个MN，主要功能,最优分析方法，炎症的影响，潜在毒性,并在肠内或肠外营养期间提供营养。SOP措辞是为了加强建议。
介入试验数量有限,防止荟萃分析，导致证据水平低。这些建议经历了一个协商一致的过程，这导致了一定比例的协议(%)：超过90%的选票需要强有力的共识。该指南总共为26个MN提出了一系列建议，产生170个单一的建议。在许多急性和慢性疾病中发现了严重的MN存在缺陷。提出了监测和管理策略。
本指南应能够解决高危疾病中一组MNs的次优和缺陷状态。特别是,它为营养支持期间的MN提供和监测提供实用建议。
本指南旨在为每日临床营养实践提供有关MN状态评估的信息。监测,和处方。它提出了一个协商一致的术语，由于许多单词使用不准确，造成混乱。“不足”一词尤其如此，\"重新完成\",\"补码\",和“补充”。
专家组试图将2015年标准操作程序（SOP）应用于ESPEN，重点关注疾病。然而,由于多种疾病需要临床营养，导致每个MN都有一个文本，因此无法应用此方法。而不是疾病。在Medline数据库中对文献进行了广泛的搜索，PubMed,科克伦,谷歌学者，和CINAHL。搜索的重点是生理数据，历史证据（在1996年PubMed发布之前发布），以及观察性和/或随机试验。对于每个MN，主要功能,最优分析方法，炎症的影响，潜在毒性,并在肠内或肠外营养期间提供营养。SOP措辞是为了加强建议。
介入试验数量有限,防止荟萃分析，导致证据水平低。这些建议经历了一个协商一致的过程，这导致了一定比例的协议(%)：超过90%的选票需要强有力的共识。该指南总共为26个MN提出了一系列建议，产生170个单一的建议。在许多急性和慢性疾病中发现了严重的MN存在缺陷。提出了监测和管理策略。
本指南应能够解决高危疾病中一组MNs的次优和缺陷状态。特别是,它为营养支持期间的MN提供和监测提供实用建议。
