DGEM-Leitlinie: Klinische Ernährung in der Intensivmedizin – Kurzversion

TY - JOUR

T1 - DGEM-Leitlinie: Klinische Ernährung in der Intensivmedizin – Kurzversion

AU - Elke, Gunnar

AU - Hartl, Wolfgang H

AU - Kreymann, K Georg

AU - Adolph, Michael

AU - Felbinger, Thomas W

AU - Graf, Tobias

AU - de Heer, Geraldine

AU - Heller, Axel R

AU - Kampa, Ulrich

AU - Mayer, Konstantin

AU - Muhl, Elke

AU - Niemann, Bernd

AU - Rümelin, Andreas

AU - Steiner, Stephan

AU - Stoppe, Christian

AU - Weimann, Arved

AU - Bischoff, Stephan C

N1 - Empfehlungen/Leitlinien

PY - 2019/1

Y1 - 2019/1

N2 - PURPOSE: Variations of clinical nutrition may affect outcome of critically ill patients. Here we present the short version of the updated consenus-based guideline (S2k classification) "Clinical nutrition in critical care medicine" of the German Society for Nutritional Medicine (DGEM) in cooperation with 7 other national societies. The target population of the guideline was defined as critically ill adult patients who suffer from at least one acute organ dysfunction requiring specific drug therapy and/or a mechanical support device (e.g. mechanical ventilation) to maintain organ function.METHODS: The former guidelines of the German Society for Nutritional Medicine (DGEM) were updated according to the current instructions of the Association of the Scientific Medical Societies in Germany (AWMF) valid for a S2k-guideline. We considered and commented the evidence from randomized-controlled trials, meta-analyses and observational studies with adequate sample size and high methodological quality (until May 2018) as well as from currently valid guidelines of international societies. The liability of each recommendation was indicated using linguistic terms. Each recommendation was finally validated and consented by a Delphi process.RESULTS: The short version presents a summary of all 69 consented recommendations for essential, practice-relevant elements of clinical nutrition in the target population. A specific focus is the adjustment of nutrition according to the phases of critical illness, and to the individual tolerance to exogenous substrates. Among others, recommendations include the assessment of nutritional status, the indication for clinical nutrition, the timing, route, magnitude and composition of nutrition (macro- and micronutrients) as well as distinctive aspects of nutrition therapy in obese critically ill patients and those with extracorporeal support devices.CONCLUSION: The current short version of the guideline provides a concise summary of the updated recommendations for enteral and parenteral nutrition of adult critically ill patients who suffer from at least one acute organ dysfunction requiring pharmacological and/or mechanical support. The validity of the guideline is approximately fixed at five years (2018 - 2023).

AB - PURPOSE: Variations of clinical nutrition may affect outcome of critically ill patients. Here we present the short version of the updated consenus-based guideline (S2k classification) "Clinical nutrition in critical care medicine" of the German Society for Nutritional Medicine (DGEM) in cooperation with 7 other national societies. The target population of the guideline was defined as critically ill adult patients who suffer from at least one acute organ dysfunction requiring specific drug therapy and/or a mechanical support device (e.g. mechanical ventilation) to maintain organ function.METHODS: The former guidelines of the German Society for Nutritional Medicine (DGEM) were updated according to the current instructions of the Association of the Scientific Medical Societies in Germany (AWMF) valid for a S2k-guideline. We considered and commented the evidence from randomized-controlled trials, meta-analyses and observational studies with adequate sample size and high methodological quality (until May 2018) as well as from currently valid guidelines of international societies. The liability of each recommendation was indicated using linguistic terms. Each recommendation was finally validated and consented by a Delphi process.RESULTS: The short version presents a summary of all 69 consented recommendations for essential, practice-relevant elements of clinical nutrition in the target population. A specific focus is the adjustment of nutrition according to the phases of critical illness, and to the individual tolerance to exogenous substrates. Among others, recommendations include the assessment of nutritional status, the indication for clinical nutrition, the timing, route, magnitude and composition of nutrition (macro- and micronutrients) as well as distinctive aspects of nutrition therapy in obese critically ill patients and those with extracorporeal support devices.CONCLUSION: The current short version of the guideline provides a concise summary of the updated recommendations for enteral and parenteral nutrition of adult critically ill patients who suffer from at least one acute organ dysfunction requiring pharmacological and/or mechanical support. The validity of the guideline is approximately fixed at five years (2018 - 2023).

KW - English Abstract

KW - Journal Article

KW - Critical Care/standards

KW - Enteral Nutrition

KW - Evidence-Based Medicine

KW - Germany

KW - Guidelines as Topic

KW - Humans

KW - Nutrition Therapy/standards

KW - Nutritional Support

KW - Parenteral Nutrition

U2 - 10.1055/a-0805-4118

DO - 10.1055/a-0805-4118

M3 - Andere (Vorworte u.ä.)

C2 - 30620956

VL - 54

SP - 63

EP - 73

JO - ANASTH INTENSIV NOTF

JF - ANASTH INTENSIV NOTF

SN - 0939-2661

IS - 1

ER -