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首页> 外文期刊>JPEN. Journal of parenteral and enteral nutrition. >Does a multidisciplinary total parenteral nutrition team improve patient outcomes? A systematic review.
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Does a multidisciplinary total parenteral nutrition team improve patient outcomes? A systematic review.

机译：多学科全胃肠外营养团队是否可以改善患者预后？系统的审查。

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BACKGROUND: Total parenteral nutrition (TPN) is a specialized form of nutrition support. The complexity associated with the management of patients receiving TPN therapy has led to the development of multidisciplinary TPN teams. The purpose of this review was to critically analyze the literature and present the best available evidence that investigated the effectiveness of multidisciplinary TPN teams in the provision of TPN to adult hospitalized patients. METHODS: A systematic review of studies identified from the Cochrane Library (2001, Issue 4), CINAHL, Complete MEDLINE, Complete Biomedical Collection, Complete Nursing Collection, and EMBASE, published in any language. RESULTS: Eleven studies, 4 with concurrent controls and 7 with historical controls, were eligible for inclusion in the review. Results of the studies indicate that the incidence of total mechanical complications is reduced in patients managed by the TPN team. However, the benefit of the TPN team in the reduction of catheter-related sepsis remains inconclusive. Four of the 5 studies reported fewer total metabolic and electrolyte abnormalities in patients cared for by the team, and these patients were more likely to receive their optimal caloric intake. However it was unclear if the management of the patients by the TPN team prevented the inappropriate use of TPN therapy. Although only 2 studies (n = 356) investigated total costs associated with management of patients by the TPN teams, there was evidence that a team approach is a cost-effective strategy. CONCLUSIONS: Overall, the general effectiveness of the TPN team has not been conclusively demonstrated. There is evidence that patients managed by TPN teams have a reduced incidence of total mechanical complications; however, it is unclear if there is a reduction in catheter-related sepsis and metabolic and electrolyte complications. The available evidence, although limited, suggests financial benefits from the introduction of multidisciplinary TPN teams in the hospital setting.
机译：背景：全胃肠外营养（TPN）是营养支持的一种特殊形式。与接受TPN治疗的患者管理相关的复杂性导致了多学科TPN团队的发展。这篇综述的目的是批判性地分析文献，并提供调查跨学科TPN小组在为成人住院患者提供TPN方面的有效性的最佳可用证据。方法：对以任何语言发表的Cochrane图书馆（2001年第4期），CINAHL，Complete MEDLINE，Complete Biomedical Collection，Complete Nursing Collection和EMBASE所鉴定研究的系统评价。结果：11项研究，4项同时进行对照，7项进行历史对照，符合纳入评价的条件。研究结果表明，由TPN小组管理的患者总体机械并发症的发生率降低了。但是，TPN团队在减少与导管相关的败血症方面的益处尚无定论。 5项研究中有4项报告说，该团队所照顾的患者的总代谢和电解质异常更少，这些患者更有可能获得最佳热量摄入。但是，尚不清楚TPN团队对患者的管理是否可以防止TPN治疗的不当使用。尽管只有2项研究（n = 356）调查了与TPN团队管理患者相关的总费用，但有证据表明，团队方法是一种具有成本效益的策略。结论：总体而言，TPN团队的总体有效性尚未得到最终证明。有证据表明，由TPN小组管理的患者总机械并发症的发生率降低;然而，尚不清楚导管相关败血症，代谢和电解质并发症是否减少。尽管证据有限，但现有证据表明，在医院中引入多学科TPN团队可带来经济利益。

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