重症成年患者营养管理的临床实践指南（CPG）在营养护理过程（NCP）的建议上存在分歧，这给它们的应用带来了困难。我们旨在比较这些CPG的建议，并为重症监护病房（ICU）设置中NCP的每个步骤提供它们的综合。
ICU中CPGs营养护理的系统评价，截至2022年1月，在六个数据库中进行了搜索。我们提取了有关CPG的数据，NCP的步骤，和每个建议的证据质量。我们为NCP的每个步骤编制了每个CPG的建议，并计算了它们之间的相对一致频率。
对10个CPG进行了审查，并提出了9项能源需求建议，时间开始，以及营养支持的途径；然而，只有3人提出了关于营养监测的建议.CPG建议之间的相对一致性频率范围从11%到100%。最高的共识是通过间接量热法确定能量需求，并为肥胖患者提供高蛋白（100％）。CPG之间的最低共识是将肠内营养或肠胃外营养（PN）视为可接受的途径（11％）以及何时开始PN（16.7％）。大多数建议是基于专家共识。
对危重病患者的NCP的建议存在很大差异。本系统评价总结了ICU设置中循证实践的建议，以促进专业人员的日常决策。
Clinical practice guidelines (CPGs) for the nutrition management of adult patients who are critically ill present divergences on recommendations regarding the nutrition care process (NCP), which bring difficulties in their application. We aimed to compare the recommendations from these CPGs and present a synthesis of them for each step of the NCP in intensive care unit (ICU) settings.
Systematic
review of CPGs on nutrition care in ICU, searched in six databases up to January 2022. We have extracted data about CPGs, steps of the NCP, and quality of evidence for each recommendation. We compiled the recommendations from each CPG for each step of the NCP and calculated the relative frequency of agreement between them.
Ten CPGs were reviewed, and 9 made recommendations for energy requirement, time to start, and route for nutrition support; however, only 3 presented recommendations on nutrition monitoring. The relative frequency of agreement between the recommendations of the CPGs ranges from 11% to 100%. The highest agreement was for the determination of energy requirements by indirect calorimetry and the provision of high protein for patients who are obese (100%). The lowest agreement among the CPGs was for considering either enteral nutrition or parenteral nutrition (PN) as an acceptable route (11%) and when to start PN (16.7%). Most recommendations were based on expert consensus.
There is a wide divergence on the recommendations to NCP of patients who are critically ill. This systematic
review summarizes recommendations to evidence-based practice in ICU settings to facilitate the daily decisions of professionals.
