成人急性呼吸窘迫综合征患者俯卧位通气管理的最佳证据总结  

Best evidence summary for prone ventilation management in adults with acute respiratory distress syndrome

作　　者：蒋燕 陆叶 蒋旭琴 王娟[1] 崔静萍 JIANG Yan;LU Ye;JIANG Xuqin;WANG Juan;CUI Jingping

机构地区：[1]中国科学技术大学附属第一医院呼吸与危重症医学科,合肥市230001 [2]蚌埠医学院护理学院

出　　处：《中华护理杂志》2022年第15期1878-1885,共8页Chinese Journal of Nursing

基　　金：2021年国家自然科学基金项目(S2000018);2021年安徽省医疗卫生重点专科建设项目(2021szdzk05)。

摘　　要：目的总结成人急性呼吸窘迫综合征患者俯卧位通气管理的最佳证据,为俯卧位通气护理实践提供参考。方法基于PIPOST工具确定循证问题,检索国内外数据库及相关网站中关于成人急性呼吸窘迫综合征患者俯卧位通气管理的临床决策、指南、证据总结、系统评价、推荐实践及专家共识,检索时限为建库至2022年2月10日,并对符合纳入标准的文献进行质量评价及证据提取。结果共纳入13篇文献,其中临床决策1篇、指南7篇、专家共识2篇及系统评价3篇。从操作前评估、操作的实施、结束俯卧位通气的时机、并发症的预防及人员组织管理5个方面进行证据汇总,形成34条最佳证据。结论该研究汇总的最佳证据可为临床医护人员实施俯卧位通气提供参考,但在临床实践中还需结合具体情况,有针对性地选择、应用证据,从而提高俯卧位通气的安全性及治疗效果。Objective To summarize the best evidence for the management of prone ventilation in adult patients with acute respiratory distress syndrome,so as to provide references for the nursing practice of prone position ventilation.Methods Based on the PIPOST tool to establish evidence-based issues,relevant domestic and foreign databases and websites were searched for clinical decisions,guidelines,evidence summaries,systematic reviews,recommended practices,and expert consensuses on the management of prone ventilation in adults with acute respiratory distress syndrome.The retrieval time was from the establishment of the database to February 10,2022,and the quality evaluation and evidence extraction of the literature that met the inclusion criteria were carried out.Results A total of 13 articles were included,including 1 clinical decision,7 guidelines,2 expert consensuses and 3 systematic evaluations.34 pieces of best evidence were summarized from 5 dimensions,namely pre-operation evaluation,operation implementation,end of prone ventilation,complication prevention and personnel organization management.Conclusion The best evidence summarized in this study can provide a reference for clinical medical staff to implement prone position ventilation,but in clinical practice,it is necessary to select and apply evidence in a targeted manner in combination with specific circumstances,so as to improve the safety and therapeutic effect of prone position ventilation.

关 键 词：呼吸窘迫综合征 成人 俯卧位 机械通气 证据总结 循证护理学 

分 类 号：R473.5[医药卫生—护理学]