Clinical Practice Guideline for Nutrition Support in the Mechanically Ventilated, Critically ill Adult Patient

Updated January 2008

Background

What are the Clinical Practice Guidelines?

The Clinical Practice Guidelines for Nutrition Support in the Mechanically Ventilated, Critically ill Adult (CPGs) are a set of recommendations that have been systematically developed by reviewing the evidence on nutrition support interventions in critically ill adults. These CPGs were first developed in September 2003 and have been updated on a regular basis (at least annually) since then.

Click here for published version of CPGs Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P, for the Guidelines Committee: Clinical practice guidelines for nutrition support in the adult critically ill patient. J Parenter Enteral Nutr 2003; 27:355-373

Click here for Table of Contents for complete summaries of evidence, discussion, recommendations and article inclusion logs for each topic

Who developed the Clinical Practice Guidelines?

A panel of representatives from key disciplines i.e. epidemiologists, intensivists, surgeons, gastroenterologists, RD's, RN's and pharmacists from across Canada were appointed to develop the guidelines. External reviewers included international experts and industry representatives (see below). The panel is called the Critical Care Clinical Practice Guidelines Committee. For a complete listing of committee members, please click here.


2002 CPG Committee
CPG Committee Meeting Toronto 2004

How were the guidelines developed?

Refer to Methods section of the Protocol document (here).


What are all the forms under each section?

Under each section you will find the following:

  • A scoring sheet that scores the values of each intervention (i.e. effect size, confidence intervals, validity, safety, etc). This illustrates the weights used to derive the summary recommendations. Also on this sheet you will find a discussion and a recommendation made based on the scoring.
  • Summary of evidence which includes details about the studies reviewed and the effects of the intervention on outcomes. Tables are included showing the results of the studies and meta-analysis graphs are included where applicable.
  • Article inclusion logs which list the articles that were included, those excluded and the reasons why.

What can I do with these Clinical Practice Guidelines?

You can compare your current practice to these guidelines to illuminate any gaps there maybe between what is done and what the best nutrition support practice should be. We have developed benchmarking reports that compares one site’s performance to other similar sites. Click here for a sample site report.

You can proceed to the next step of implementing these guidelines in your institution. Click here for tools and training kits that will assist you

Find out how you can illuminate gaps in your practice and also compare the practice in your ICU to other ICU's by filling out a survey on-line. Click here to find out more.


Will these Clinical Practice Guidelines be updated?

Absolutely! There is a process in place to update these guidelines on an annual basis to incorporate new trials. The date of revision appears on the table of contents page . This date will also appear on the upper right hand corner of the first 2 pages of the individual sections (i.e. the Scoring Sheet and the Summaries of Evidence).

If you are aware of any studies that may be relevant, please contact Rupinder Dhaliwal, RD, Project Leader, at: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it