重症患者喂养不耐受预测因子指标体系的构建及适用性分析

doi:10.3761/j.issn.2096-7446.2026.04.001

Abstract

Abstract:

Objective To construct a scientific，systematic，and clinically applicable predictive indicator system for feeding intolerance in critically ill patients，providing a basis for early identification of high-risk patients and the development of predictive models. Methods Evidence on existing predictive factors was integrated through a systematic review，and indicators were screened via two rounds of Delphi expert consultation. A meta-analysis of 27 studies was conducted，and 17 experts in critical care medicine，nursing，and nutrition were invited to rate the importance of indicators using the Likert 5-point scale. Indicators were selected based on mean score，coefficient of variation，and full-score rate. Results A predictive indicator system comprising 6 first-level indicators and 29 second-level indicators was established，covering individual characteristics，disease severity，biochemical indicators，treatment factors，nutritional support strategies，and gastrointestinal function factors. The expert authority coefficients were 0.920 and 0.923，and the coordination coefficients were statistically significant（P<0.05）. Key indicators，including APACHE Ⅱ score，SOFA score，mechanical ventilation，intra-abdominal pressure，and antral motility index，achieved high consensus. Conclusion This study systematically integrated evidence-based findings and expert consensus to develop a clinically applicable predictive indicator system for feeding intolerance in critically ill patients，providing a scientific foundation for precise nutritional management. Future research should focus on model development and clinical validation to translate the system into practical tools.

Key words: Critically Ill Patients, Feeding Intolerance, Predictive Factors, Indicator System, Delphi Method, Systematic Review

ZHAO Mingxi, LUO Hongbo, XU Yuan, LAN Yuanmei, WAN Zhaoyang, QIU Bofeng, LI Zunzhu, JING Jie, CHANG Xiaowei, WU Xinjuan. Construction of a predictive indicator system for feeding intolerance in critically ill patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 389-395.

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References 24

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Construction of a predictive indicator system for feeding intolerance in critically ill patients

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