重症监护病房成人气管插管拔除后氧合策略的最佳证据总结
Evidence-based practice of oxygenation strategies therapy for intensive care unit adult patients with tracheal intubation after extubation
胡采霞 1陈蕊 1李月凤 1谭妙青 1刘淑莹 1江敏青 1魏琳2
作者信息
- 1. 广州中医药大学第二附属医院脑血管病科(广州 510120)
- 2. 广州中医药大学第二临床医学院中医证候全国重点实验室(广州 510405)
- 折叠
摘要
目的 评价、汇总重症监护病房成人气管插管拔除后氧合策略的相关证据,为制定科学、有效的成人气管拔除后氧合策略方案提供循证依据.方法 计算机检索循证数据库、相关指南网站、协会网站及原始数据库中有关重症监护病房成人气管插管拔除后氧合策略的相关文献.检索时限为建库至2023年5月.由经过循证培训的2名研究人员对所纳入的文献进行质量评价,并对符合质量评价标准的文献进行证据提取.结果 共纳入18篇文献,其中指南7篇、临床决策4篇,专家共识2篇、系统评价4篇和随机对照试验1篇,共形成最佳证据22条,包括基本原则、评估、选择、参数设置、撤机、效果评价及注意事项7个方面.结论 医护人员应结合实际临床情况及患者自身需求选择最佳证据,并针对性调整氧合策略以降低气管插管再插率,改善患者预后.
Abstract
Objective To evaluate and summarize the relevant evidence of oxygenation strategies with tracheal intubation after extubation for adult in intensive care unit(ICU),and to provide evidence-based practice for the development of scientific and effective strategies tracheal intubation after extubation for ICU adult patients.Methods Evidence-based databases,related guideline websites,association websites and original databases were searched by computer for literature about oxygenation strategies with tracheal intubation after extubation for ICU adults patients was extracted.The retrieval time was from the establishment of the databases to May 2023.Two researchers trained in evidence-based practice evaluated the quality of the included literature and extracted evidence from the literature that met the quality evaluation criteria.Results A total of 18 articles were included,including 7 guidelines,4 clinical decisions,2 expert consensus,4 systematic reviews and 1 randomized controlled trial.A total of 22 pieces of best evidence were formed,including 7 aspects of basic principles,evaluation,selection,parameter setting,withdrawal,effect evaluation and precautions.Conclusion The medical staff should select the best evidence based on the actual clinical situation and the patient's own needs,and adjust the oxygenation strategies to reduce the rate of tracheal intubation and improve the prognosis of patients.
关键词
重症监护病房/气管插管拔除/氧合策略/最佳证据总结Key words
Intensive care unit/tracheal intubation after extubation/oxygenation strategy/evidence-based practice引用本文复制引用
基金项目
国家卫生健康委科学技术研究所项目(2021KYSHX016010201)
出版年
2024
NETL
NSTL
万方数据