2020年 · 第100卷第08期

chronic subdural hematoma (CSDH) is a chronic space-occupying lesion formed by blood gathering between the arachnoid and the dura mater. It often forms after 3 weeks of head trauma. The incidence rate of CSDH is 1/10~13.1/100,000 population. With the aging of the population, the incidence rate of CSDH continues to increase, and the annual incidence rate of CSDH in the elderly over 80 years old can reach 127/100,000 people^[1,2]。 CSDH is generally believed to be caused by trauma, but about 50% of patients deny a history of trauma^[3,4]。 In addition to trauma, common risk factors associated with the onset, malabsorption, or recurrence of CSDH include: (1) long-term use of anticoagulants and antiplatelet drugs; (2) Repeated or sudden increase in thoracic and abdominal pressure (such as dystocia and constipation); (3) Craniotomy; (4) Blood diseases.

In recent years, for the clinical implementation of nutritional support treatment for critically ill patients, international guidelines developed by the American Critical Care Association (SCCM), the American Association for Parenteral and Enteral Nutrition (ASPEN, 2016), and the European Association for Parenteral and Enteral Nutrition (ESPEN, 2018) have issued clear recommendations. However, patients with critical respiratory illness have their own particularities in disease metabolism and treatment modes, and there is no unified consensus and guideline recommendation on nutritional support treatment strategies for critical respiratory illness. With the rapid development of clinical nutrition, there are increasing researches at home and abroad on whether patients with critical respiratory illness can improve survival rate, shorten ICU stay and improve patients' quality of life through nutritional support therapy. In order to standardize the nutritional support treatment of respiratory critical patients, domestic respiratory critical care and nutrition experts systematically retrieved, screened and evaluated relevant evidence-based medical evidence, including high-quality systematic review, meta-analysis and related RCT studies. Multiple rounds of discussion were conducted on 22 issues that medical staff paid most attention to during the implementation of nutritional support treatment for respiratory critical patients, and 24 recommendations were finally determined by expert voting and scoring.