集中治疗室营养研究:证据有没有变得更好? 其余的偏见来源是偏见的其他来源
1Emeritus Professor Clinical Medicine, UCLA Medical Center Olive View, Sylmar, California.
Current opinion in clinical nutrition and metabolic care
|November 8, 2024
概括
最近关于为重症患者提供营养支持的研究揭示了低质量的证据. 大多数试验存在重大偏差风险,限制了重症监护室营养干预措施的可靠结论.
科学领域:
- 临界护理医学 临界护理医学
- 临床营养学 临床营养学
- 基于证据的医学 基于证据的医学
背景情况:
- 营养支持对于重症患者至关重要.
- 需要高质量的证据来指导营养干预.
- 最近的文献质量需要评估.
研究的目的:
- 评估近期随机试验和对严重病成人营养支持的系统审查的质量.
- 为了确定在过去18个月内发表的研究中的偏差风险.
主要方法:
- 系统搜索2022年10月至2024年4月期间发表的随机试验和系统评论.
- 纳入标准:成年患者,营养干预比较,临床相关结果.
- 使用偏差风险评估进行质量评估,用于包含的试验和审查.
主要成果:
- 确定了13项随机试验和4项系统性审查.
- 大多数试验 (11/13) 和评论 (24/4) 存在偏见的风险或高风险.
- 没有试验将营养支持与真正的对照进行比较 (没有干预).
- 较旧的试验没有显示出一致的临床结果差异.
结论:
- 最近对重症监护病房营养支持的随机试验的整体质量是不理想的.
- 严重的偏差风险限制了当前证据的可靠性.
- 需要进一步进行高质量的研究,以建立有效的营养策略.
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