A multidisciplinary group of international physicians involved in the medical nutrition therapy (MNT) of adult critically ill patients met to discuss the value, role, and open questions regarding supplemental parenteral nutrition (SPN) along with oral or enteral nutrition (EN), particularly in the intensive care unit (ICU) setting. This manuscript summarizes the discussions and results to highlight the importance of SPN as part of a comprehensive approach to MNT in critically ill adults and for researchers to generate new evidence based on well-powered randomized controlled trials (RCTs). The experts agreed on several key points: SPN has shown clinical benefits, resulting in this strategy being included in American and European guidelines. Nevertheless, its use is heterogeneous across European countries, due to the persistence of uncertainties, such as the optimal timing and the risk of overfeeding in absence of indirect calorimetry (IC), which results in divergent opinions and barriers to SPN implementation. Education is also insufficient. The experts agreed on actions needed to increase evidence quality on SPN use in specific patients at a given time point during acute critical illness or recovery.

中文翻译：

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2022 年的临床营养问题：信任 ICU 患者的补充肠外营养 (SPN) 缺少什么？

一个参与成人危重患者医学营养治疗 (MNT) 的多学科国际医师小组开会讨论补充肠外营养 (SPN) 以及口服或肠内营养 (EN) 的价值、作用和未解决的问题，特别是在重症监护病房 (ICU) 环境。本手稿总结了讨论和结果，以强调 SPN 作为危重成人 MNT 综合方法的一部分的重要性，以及研究人员根据有力的随机对照试验 (RCT) 生成新证据的重要性。专家们在几个关键点上达成一致：SPN 已显示出临床益处，导致该策略被纳入美国和欧洲指南。然而，由于不确定性的持续存在，其在欧洲国家的使用情况不同，例如最佳时机和在没有间接量热法 (IC) 的情况下过度喂养的风险，这导致了 SPN 实施的不同意见和障碍。教育也不够。专家们同意在急性危重疾病或康复期间的特定时间点提高特定患者使用 SPN 的证据质量所需的行动。