目的 检索并筛选利用床旁超声评估成年重症患者肌肉质量的相关证据，并对最佳证据进行总结。 方法 计算机检索BMJ最佳临床实践、UpToDate、PubMed、中国知网等国内外数据库、指南网和专业协会网站中有关成年重症患者床旁超声测量肌肉质量的相关文献。检索时限为建库至2023年8月30日。由4名经过系统循证课程培训的研究人员根据文献类型分别对文献质量进行评价。 结果 共纳入15篇文献，包括2篇指南、4篇专家共识、5篇系统评价和4篇随机对照试验。共总结22条证据，包括体位及患者准备、护理人员实施可行性、探头选择及注意事项、肌肉定位、超声对肌肉形态学进行评估及超声评估肌肉质量的指导意义6个方面。 结论 该研究总结的床旁超声评估成年重症患者肌肉质量的最佳证据具有科学性和系统性，为临床建立标准化超声评估流程提供了循证依据。 Objective The evidence on the use of bedside ultrasound to assess muscle mass in critically ill adults was retrieved and screened, and the best evidence was summarized. Methods A computer search was conducted for relevant literature on ultrasound measurement of muscle mass in critically ill adults in domestic and foreign databases such as BMJ Best Clinical Practice, UpToDate, PubMed, CNKI, and guide website and professional association website. The search time limit was from the establishment of the database to August 30, 2023. Literature quality was evaluated by four researchers trained in systematic evidence-based courses according to literature type. Results A total of 15 literatures were included, including 2 guideline, 4 expert consensus, 5 systematic reviews and 4 randomized controlled studies. A total of 22 pieces of evidence were summarized, including 6 aspects: position and patient preparation, feasibility of implementation by nursing staff, selection of probe and matters needing attention, muscle positioning, evaluation of muscle structure by ultrasound and the guiding significance of ultrasound evaluation of muscle mass. Conclusions The best evidence summary of bedside ultrasound assessment of muscle mass in critically ill adults summarized in this study is scientific and systematic, and provides evidence-based basis for establishing standardized ultrasound assessment procedures in clinic.
Summary of best evidence for bedside ultrasound assessment of muscle mass in critically ill adults
Objective The evidence on the use of bedside ultrasound to assess muscle mass in critically ill adults was retrieved and screened, and the best evidence was summarized. Methods A computer search was conducted for relevant literature on ultrasound measurement of muscle mass in critically ill adults in domestic and foreign databases such as BMJ Best Clinical Practice, UpToDate, PubMed, CNKI, and guide website and professional association website. The search time limit was from the establishment of the database to August 30, 2023. Literature quality was evaluated by four researchers trained in systematic evidence-based courses according to literature type. Results A total of 15 literatures were included, including 2 guideline, 4 expert consensus, 5 systematic reviews and 4 randomized controlled studies. A total of 22 pieces of evidence were summarized, including 6 aspects: position and patient preparation, feasibility of implementation by nursing staff, selection of probe and matters needing attention, muscle positioning, evaluation of muscle structure by ultrasound and the guiding significance of ultrasound evaluation of muscle mass. Conclusions The best evidence summary of bedside ultrasound assessment of muscle mass in critically ill adults summarized in this study is scientific and systematic, and provides evidence-based basis for establishing standardized ultrasound assessment procedures in clinic.
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