[Evidence summary on enteral and parenteral nutrition for adult patients with sepsis]

To search, evaluate, and summarize the best available evidence regarding enteral and parenteral nutrition support for adult patients with sepsis, in order to provide an evidence-based foundation for the nutritional management of these patients.

A systematic search was conducted in the following databases and resources for clinical guidelines, clinical decisions, evidence summaries, expert consensus statements, systematic reviews, randomized controlled trials (RCTs), and quasi-experimental studies related to enteral and parenteral nutrition in adult septic patients: the Cochrane Library, UpToDate, the JBI Evidence-Based Healthcare Center Database, BMJ Best Practice, official websites of professional societies including the American College of Critical Care Medicine, the American Society for Parenteral and Enteral Nutrition (ASPEN), the European Society of Intensive Care Medicine, the European Society for Parenteral and Enteral Nutrition (ESPEN), the Chinese Society of Critical Care Medicine, and the Chinese Society for Parenteral and Enteral Nutrition, ScienceDirect, PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Chinese Medical Journal Full-text Database, Chinese Biomedical Literature Service System, Wanfang Data, China National Knowledge Infrastructure, the VIP Chinese Science and Technology Core Journal Database, Guidelines International Network, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, and Registered Nurses' Association of Ontario, and Medlive Guide. The search timeframe was from January 1, 2014, to June 30, 2024. Two researchers with evidence-based research backgrounds independently conducted the literature quality appraisal. Evidence was extracted and summarized from the included literature, incorporating expert opinion.

After rigorous screening, 25 high-quality publications were included, comprising 5 clinical guidelines, 1 clinical decision, 2 evidence summaries, 5 expert consensus statements, 5 systematic reviews, 6 RCTs, and 1 quasi-experimental study. Focusing on key aspects of nutritional management (encompassing 7 major themes: nutritional screening and assessment, mode of nutritional support, timing of initiating nutritional support, energy and protein requirements, nutritional components, monitoring tolerance to nutritional support therapy, and complication prevention and management), 33 core recommendations were ultimately formulated and refined.

This study provides evidence-based recommendations for the enteral and parenteral nutrition management in adult patients with sepsis, aiming to enhance the effectiveness of nutritional support and improve patient clinical outcomes.