International clinical practice guidelines have been developed for nutritional therapy in criticallyill patients. These recommendations are based on several levels of supporting evidencefrom various studies and on expert opinions.Oh et al. [1] retrospectively studied use of a multidisciplinary nutritional support team(NST) in trauma patients in the intensive care unit (ICU). Nutritional support in the form oftotal calories or protein consumed relative to those recommended were higher in the NSTgroup than in the controls. In addition, clinical outcomes of ICU stay, duration of hospitalization,and mortality were not different between the two groups. The groups were divided basedon physician-requested NST consultation in the study period. Another small pre- and postimplementationretrospective study evaluated the effectiveness of NST in the same ICU [2].Under guidance of an NST, patients showed more frequent achievement of nutritional goals(total calorie or proteins delivered as percentage of the recommended). Though not significant,the post-NST group showed downward trends of ICU stay, hospital duration, and mortality.Percentage of calories consumed/required was associated significantly with mortalityrate (odds ratio, 0.997; 95% confidential interval [CI], 0.959 to 0.996; P = 0.016). The study populationsof these two studies were very different, and outcome results could not be compareddue to the disparate designs of the pre- and post-implementation study and the observationstudy. Cochran Reviews show a lack of evidence indicating that nutritional support decreasesmortality [3]. However, at long-term follow-up, serious adverse events were reduced in patientsreceiving nutritional support (relative risk, 0.91; 95% CI, 0.85 to 0.97; P = 0.004).
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机译：批评患者的营养治疗已经开发了国际临床实践指南。这些建议基于各种研究和专家意见的几个级别的支持证据.Oh等人。 [1]回顾性地研究了在重症监护室（ICU）的创伤患者中使用多学科营养支持团队（NST）。在第N组中消耗的蛋白质或相对于那些推荐的蛋白质的营养支持比对照组更高。此外，ICU的临床结果，两组之间的住院期间和死亡率与死亡率不同。该团体在研究期间分为大量的医生请求的NST协商。另一种小的预期和后期后期研究评估了NST在同一个ICU中的有效性[2]。NST的指导，患者的营养目标的频繁成就（作为推荐的百分比提供的总卡路里或蛋白质）。虽然没有显着，但后期第一个集团显示了ICU住宿，医院持续时间和死亡率的下行趋势。消耗/所需的卡路里的Percentage与念珠菌有关（赔率比，0.997; 95％机密间隔[CI]，0.959至0.996 ; p = 0.016）。这两项研究的研究人群均非常不同，结果结果不能与实施前和实施后的研究和观察研究的不同设计比较。 Cochran评论显示缺乏证据表明营养支持减少[3]。然而，在长期随访中，患者的营养载体（相对风险，0.91; 95％CI，0.85至0.97; P = 0.004），减少严重不良事件。
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