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Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.

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收录情况： ◇ SCIE

作者：
Lu Ke[1,2] * ; Jiajia Lin[1] * ; Gordon S. Doig[3] ; Arthur R. H. van Zanten[4] ; Yang Wang[5] ; Juan Xing[6] ; Zhongheng Zhang[7] ; Tao Chen[8] ; Lixin Zhou[9] ; Dongpo Jiang[10] ; Qindong Shi[11] ; Jiandong Lin[12] ; Jun Liu[13] ; Aibin Cheng[14] ; Yafeng Liang[15] ; Peiyang Gao[16] ; Junli Sun[17] ; Wenming Liu[18] ; Zhenyu Yang[19] ; Rumin Zhang[20] ; Wei Xing[21] ; An Zhang[22] ; Zhigang Zhou[23] ; Tingfa Zhou[24] ; Yang Liu[25] ; Fei Tong[26] ; Qiuhui Wang[27] ; Aijun Pan[28] ; Xiaobo Huang[29] ; Chuming Fan[30] ; Weihua Lu[31] ; Dongwu Shi[32] ; Lei Wang[33] ; Wei Li[34] ; Liming Gu[35] ; Yingguang Xie[36] ; Rongqing Sun[37] ; Feng Guo[38] ; Lin Han[39] ; Lihua Zhou[40] ; Xiangde Zheng[41] ; Feng Shan[42] ; Jianbo Liu[43] ; Yuhang Ai[44] ; Yan Qu[45] ; Liandi Li[42] ; Hailing Li[46] ; Zhiguo Pan[47] ; Donglin Xu[48] ; Zhiqiang Zou[49] ; Yan Gao[50] ; Chunli Yang[51] ; Qiuye Kou[52] ; Xijing Zhang[53] ; Jinglan Wu[54] ; Chuanyun Qian[55] ; Weixing Zhang[56] ; Minjie Zhang[57] ; Yuan Zong[58] ; Bingyu Qin[59] ; Fusen Zhang[60] ; Zhe Zhai[61] ; Yun Sun[62] ; Ping Chang[63] ; Bo Yu[64] ; Min Yu[65] ; Shiying Yuan[66] ; Yijun Deng[67] ; Liyun Zhao[68] ; Bin Zang[69] ; Yuanfei Li[70] ; Fachun Zhou[71] ; Xiaomei Chen[72] ; Min Shao[73] ; Weidong Wu[74] ; Ming Wu[75] ; Zhaohui Zhang[76] ; Yimin Li[77] ; Qiang Guo[78] ; Zhiyong Wang[79] ; Yuanqi Gong[80] ; Yunlin Song[81] ; Kejian Qian[82] ; Yongjian Feng[83] ; Baocai Fu[84] ; Xueyan Liu[85] ; Zhiping Li[86] ; Chuanyong Gong[87] ; Cheng Sun[88] ; Jian Yu[89] ; Zhongzhi Tang[90] ; Linxi Huang[91] ; Biao Ma[92] ; Zhijie He[93] ; Qingshan Zhou[94] ; Rongguo Yu[95] ; Zhihui Tong[1] ; Weiqin Li[1,2] ; the Chinese Critcal Care Nutrition Trials Group (CCCNTG)[96] ;
机构： [1]Department of Critical Care Medicine, Jinling Hospital, No.305 ZhongshanEast Road, Nanjing 210000, Jiangsu Province, China [2]National Institute of Health care Data Science, Nanjing University, Nanjing, China [3]Northern Clinical School, Royal North Shore Hospital, University of Sydney, Sydney,Australia [4]Department of Intensive Care Medicine, Gelderse Vallei Hospital,Willy Brandtlaan 10, 6716 RP Ede, The Netherlands [5]Department of Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing,China [6]Benq Medical Center, Nanjing, China [7]Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine,Hangzhou, China [8]Tropical Clinical Trials Unit, Department of Clinical Sciences,Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK [9]First People’s Hospital of Foshan, Foshan, China [10]Daping Hospital, Army Medical University,Chongqing, China [11]First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an,China [12]First Affiliated Hospital of Fujian Medical University, Fuzhou, China [13]Suzhou Municipal Hospital, Suzhou, China [14]North China University of Science and Technology Affiliated Hospital, Tangshan, China [15]Qindao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai,China [16]Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, China [17]Luoyang Central Hospital Affiliated To Zhengzhou University, Luoyang, China [18]Changzhou No.2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China [19]The Second Affiliated Hospital of Harbin Medical University, Harbin, China [20]Zibo Central Hospital,Zibo, China [21]Department of Intensive Care Medicine, The Third Xiangya Hospital of Central South University, Changsha, China [22]The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China [23]First People’s Hospital of Kunming, Kunming, China [24]Linyi City People Hospital,Shandong,China [25]Tangshan Gongren Hospital, Tangshan, China [26]Hebei Medical University Second Affiliated Hospital, Shijiazhuang, China [27]Wuxi People’s Hospital, Wuxi, China [28]Anhui Provincial Hospital, Hefei, China [29]Department of Critical Care Medicine, Sichuan Provincial People’s Hospital, Universityof Electronic Science and Technology of China, Chengdu 610072, China [30]First People’s Hospital of Yunnan, Kunming, China [31]Yijishan Hospital of Wannan Medical College, Wuhu, China [32]Shanxi Provincial People’s Hospital, Taiyuan,China [33]Shanxi Medical University First Affiliated Hospital, Taiyuan, China [34]The People’s Hospital of Fujian Province, Fuzhou, China [35]People’s Hospital of Yuxi City, Yuxi, China [36]Jining First People’s Hospital, Jining, China [37]The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China [38]Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China [39]People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China [40]Affiliated Hospital of Inner Mongolia Medical College, Huhehaote, China [41]Dazhou Central Hospital, Dazhou, China [42]Qindao University Medical College Affiliated Hospital, Qindao, China [43]Inner Mongolia People’s Hospital, Huhehaote, China [44]Xiangya Hospital Central South University, Changsha, China [45]Qingdao Municipal Hospital Group,Qingdao, China [46]No.971 Hospital of People’s Liberation Army Navy, Qingdao,China [47]General Hospital of Southern Theatre Command, Guangzhou, China [48]Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China [49]Union Hospitalof Fujian Medical University, Fuzhou, China [50]The General Hospital of Shenyang Military, Shenyan, China [51]Jiangxi Provincial People’s Hospital, Nanchang,China [52]The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China [53]Department of Anaesthesiology and Perioperative Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China [54]Shenzhen Nanshan People’s Hospital, Shenzhen, China [55]Kuming Medical University First Affiliated Hospital, Kuming, China [56]Peking University Shenzhen Hospital,Guandong, China [57]General ICU, Jinan University First Affiliated Hospital, Jinan,China [58]Shaanxi Provincial People’s Hospital, Xi’an, China [59]Henan Provincial People’s Hospital, Zhengzhou, China [60]Tai’an City Central Hospital, Tai’an,China [61]The Fourth Hospital of Harbin Medical University, Harbin, China [62]Anhui Medical University Second Affiliated Hospital, Hefei, China [63]Southern Medical University Zhujiang Hospital, Guangzhou, China [64]Department of Critical Care Medicine, the Second Xiangya Hospital of Central South University, Changsha 410000, Hunan, China [65]First People’s Hospital of Yichang, Yichang, China [66]Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China [67]Yancheng First People’s Hospital, Yancheng, China [68]Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China [69]China Medical University Affiliated Shengjing Hospital, Shenyang, China [70]Changsha Central Hospital Affiliated to University of South China, Changsha, China [71]Chongqing Medical University First Affiliated Hospital, Chongqing, China [72]Departmentof Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine,Shandong University, Jinan, China [73]The First Affiliated Hospital of Anhui Medical University, Hefei, China [74]Shanxi Bethune Hospital, Taiyuan, China [75]Health Science Center, The Second People’s Hospital of Shenzhen, First Affiliated Hospital of Shenzhen University, Shenzhen, China [76]Yichang Central People’s Hospital, Yichang, China [77]First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China [78]First Affiliated Hospital of Soochow University, Suzhou, China [79]Hebei Medical University, Third Affiliated Hospital,Shijiazhuang, China [80]The Second Affiliated Hospital of Nanchang University,Jiangxi, China [81]The First Affiliated Hospital of Xinjiang Medical University,Xinjiang, China [82]The First Affiliated Hospital of Nanchang University, Jiangxi,China [83]Neurosurgical ICU, Jinan University First Affiliated Hospital, Jinan,China [84]Yantai Mountain Hospital, Yantai, China [85]Shenzhen People’s Hospital,Shenzhen, China [86]Hunan Provincial People’s Hospital, Changsha, China [87]Tianjing Hospital of Integration of Chinese and Western Medicine, Tianjing,China [88]Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China [89]The Second Hospital of Dalian Medical University, Liaoning, China [90]Wuhan General Hospital of Guangzhou Military Region, Wuhan, China [91]Shantou University Medical College First Affiliated Hospital, Shantou, China [92]Jining Medical College Affiliated Hospital,Jining, China [93]Sun Yat‑Sen Memorial Hospital, Sun Yat-Sen University,Guangzhou, China [94]Hubei Provincial People’s Hospital, Wuhan, China [95]Fujian Provincial Hospital, Fujian, China [96]Chinese Critcal Care Nutrition Trials Group (CCCNTG), No.22 Hankou Road, Nanjing 210093, China
出处：
DOI： 10.1186/s13054-022-03921-5
ISSN：

关键词： Intensive care unit Cluster-randomized trial Nutrition therapy Evidence-based guideline

摘要：
Previous cluster-randomized controlled trials evaluating the impact of implementing evidence-based guidelines for nutrition therapy in critical illness do not consistently demonstrate patient benefits. A large-scale, sufficiently powered study is therefore warranted to ascertain the effects of guideline implementation on patient-centered outcomes.We conducted a multicenter, cluster-randomized, parallel-controlled trial in intensive care units (ICUs) across China. We developed an evidence-based feeding guideline. ICUs randomly allocated to the guideline group formed a local "intervention team", which actively implemented the guideline using standardized educational materials, a graphical feeding protocol, and live online education outreach meetings conducted by members of the study management committee. ICUs assigned to the control group remained unaware of the guideline content. All ICUs enrolled patients who were expected to stay in the ICU longer than seven days. The primary outcome was all-cause mortality within 28 days of enrollment.Forty-eight ICUs were randomized to the guideline group and 49 to the control group. From March 2018 to July 2019, the guideline ICUs enrolled 1399 patients, and the control ICUs enrolled 1373 patients. Implementation of the guideline resulted in significantly earlier EN initiation (1.20 vs. 1.55 mean days to initiation of EN; difference - 0.40 [95% CI - 0.71 to - 0.09]; P = 0.01) and delayed PN initiation (1.29 vs. 0.80 mean days to start of PN; difference 1.06 [95% CI 0.44 to 1.67]; P = 0.001). There was no significant difference in 28-day mortality (14.2% vs. 15.2%; difference - 1.6% [95% CI - 4.3% to 1.2%]; P = 0.42) between groups.In this large-scale, multicenter trial, active implementation of an evidence-based feeding guideline reduced the time to commencement of EN and overall PN use but did not translate to a reduction in mortality from critical illness.ISRCTN, ISRCTN12233792 . Registered November 20th, 2017.© 2022. The Author(s).

基金：
The study was funded partly by the Key Research and Development Program Foundation of Jiangsu Province of China (no. BE2015685) and partly by the Nutricia Research.
语种：
外文
被引次数：
WOS：
PubmedID：
JCR分区：
出版当年[2021]版：
Q1 CRITICAL CARE MEDICINE
最新[2023]版：
Q1 CRITICAL CARE MEDICINE

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者机构： [1]Department of Critical Care Medicine, Jinling Hospital, No.305 ZhongshanEast Road, Nanjing 210000, Jiangsu Province, China [2]National Institute of Health care Data Science, Nanjing University, Nanjing, China
共同第一作者：
通讯作者：
通讯机构： [1]Department of Critical Care Medicine, Jinling Hospital, No.305 ZhongshanEast Road, Nanjing 210000, Jiangsu Province, China [2]National Institute of Health care Data Science, Nanjing University, Nanjing, China
推荐引用方式(GB/T 7714)：
Lu Ke,Jiajia Lin,Gordon S. Doig,et al.Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.[J].Critical Care (London, England).2022,26(1):46.doi:10.1186/s13054-022-03921-5.
APA：
Lu Ke,Jiajia Lin,Gordon S. Doig,Arthur R. H. van Zanten,Yang Wang...&the Chinese Critcal Care Nutrition Trials Group (CCCNTG).(2022).Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial..Critical Care (London, England),26,(1)
MLA：
Lu Ke,et al."Actively implementing an evidence-based feeding guideline for critically ill patients (NEED): a multicenter, cluster-randomized, controlled trial.".Critical Care (London, England) 26..1(2022):46

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