摘要
目的:检索并汇总有创机械通气患儿早期肺康复的证据,为临床实践提供循证依据.方法:系统检索国内外数据库中机械通气患儿早期肺康复的相关证据,检索时限为建库至2024年6月10日.对检索到的文献进行评价和证据提取.结果:共纳入18篇文献,其中专家共识5篇、证据总结1篇、系统评价2篇、随机对照试验3篇、类实验研究7篇.从早期肺康复的组织环境、康复评定、康复方式、康复剂量、风险管理5个主题总结了 31条证据.结论:本研究总结的证据可为有创机械通气患儿早期肺康复的实施提供循证依据.应用证据前,医护人员应评估临床情景及障碍因素,充分考虑患儿身体情况,为其制订个性化的早期肺康复方案.
Abstract
Objective:To retrieve and summarize the evidence on early pulmonary rehabilitation in children with invasive mechanical ventilation,and to offer evidence-based recommendations for clinical practice.Methods:We systematically searched the literature related to early pulmonary rehabilitation in children with invasive mechanical ventilation in databases,and the search time was from the establishment of the databases to June 10,2024.The included studies and extracted evidence were evaluated.Results:A total of 18 articles were included,including 5 expert consensuses,1 evidence summary,2 systematic reviews,3 Randomized Controlled Trials,and 7 quasi-experimental studies.This paper summarized 31 pieces of evidence from 5 aspects:organizational environment,rehabilitation assessment,modalities,dose,and risk management.Conclusion:The evidence summarized in this study provides evidence-based recommendations for implementing early pulmonary rehabilitation in children with invasive mechanical ventilation.Before applying the evidence,medical staff should evaluate the clinical scenario and obstacle factors,and fully consider the physical condition of the child to formulate a personalized early pulmonary rehabilitation plan.
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