脉搏指示连续心排血量监测护理的最佳证据总结  

Evidence summary for pulse indicator continuous cardiac output monitoring

作　　者：王丽竹[1] 李茜[1] 陈媛儿 王紫薇 向艳 祁学峰 胡亚玲[1] 鲁海飞[1] WANG Lizhu;LI Qian;CHEN Yuaner;WANG Ziwei;XIANG Yan;QI Xuefeng;HU Yaling;LU Haifei

机构地区：[1]浙江大学医学院附属第二医院护理部,杭州市310009

出　　处：《中华急危重症护理杂志》2023年第6期554-561,共8页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：目的 总结脉搏指示连续心排血量(Pulse indicator Continous Cadiac Output,PiCCO)监测护理的相关证据,为提高临床PiCCO操作规范性与测量准确性提供循证依据。方法 计算机检索UpToDate、英国国家临床医学研究所指南库、美国重症医学会网站、美国重症护理协会网站、英国重症监护护士协会网站、PubMed、Embase、万方数据库、中国知网等关于PiCCO监测护理的相关研究,包括证据总结、临床决策、推荐实践、技术报告、临床实践指南、系统评价、随机对照试验、类实验研究、诊断性研究、观察性研究等,检索时限为1997年1月1日-2022年4月30日。2名研究者进行质量评价后,根据主题对证据进行提取与汇总。结果 共纳入18篇文献,包括2篇专家共识、1篇随机对照试验、9篇类实验研究、4篇队列研究、2篇诊断性试验。最终形成23条最佳证据,包括PiCCO管路管理、指示剂推注、校准时机、特定情形下的监测、人员培训5个主题。结论 应加强医护人员关于PiCCO监测操作技术的培训,根据实际情境选择实践证据,提高PiCCO操作的规范性与测量的准确性。Objective To summarize the evidence of PiCCO monitoring and provide evidence for improving the accuracy of clinical PiCCO measurement and standardization of operation.Methods We searched UpToDate,UK National Institute for Health and Care Excellence,American Society of Critical Care Medicine,American Association of Critical Care Nurses,British Association of Critical Care Nurses,PubMed,Embase,Wanfang database,China Knowledge Network and so on for studies related to PiCCO technical operations,including evidence summaries,clinical decisions,recommended practices,technical reports,clinical practical guidelines,systematic reviews,randomized controlled trials,quasi-experimental studies,diagnostic studies,and observational studies.The retrieval time limit was from January 1,1997,to April 30,2022.After methodological quality evaluation by two researchers,the evidence was extracted and summarized according to the theme.Results A total of 18 articles were included,including two expert consensus papers,one randomized controlled trial,nine quasi-randomized controlled trials,four cohort studies,and two diagnostic trials.23 best evidences were obtained,including five topics,namely PiCCO pipeline management,indicator injection,calibration timing,parameter monitoring under specific conditions and personnel training.Conclusion It is necessary to strengthen the training of medical staff on PiCCO monitoring operation technology,follow the evidence-based nursing standards,select practical evidence according to the actual situation,improve the accuracy of PiCCO measurement and the standardization of operation,and promote the transformation of evidence-based knowledge to practice.

关 键 词：脉搏指示连续心排血量 心排血量 血流动力学监测 证据总结 循证护理学 

分 类 号：R473[医药卫生—护理学]