危重症患者无创心输出量监测管理的文献总结  

Contemporary Evidence Summary of Management of Non-invasive Cardiac Output Monitoring Management in Critically Ill Patients

作　　者：袁鸣 姚惠萍[2] 华佳丽 徐秋雯 何文娟[2] YUAN Ming;YAO Huiping;HUA Jiali;XU Qiuwen;HE Wenjuan(School of Nursing,Zhejiang Chinese Medicine University,Hangzhou 310051,China;Department of Critical Care Medicine,Zhejiang Provincial People's Hospital(The People's Hospital Affiliated to Hangzhou Medical College),Hangzhou 310000,China)

机构地区：[1]浙江中医药大学护理学院,杭州310051 [2]浙江省人民医院(杭州医学院附属人民医院)重症医学科,杭州310000

出　　处：《中国循环杂志》2025年第2期175-180,共6页Chinese Circulation Journal

基　　金：浙江省医药卫生科技计划项目(2023KY056)。

摘　　要：目的:总结危重症患者无创心输出量监测管理的证据,为加强临床医护人员无创心输出量监测操作规范性和测量准确性提供循证依据。方法:检索UpToDate、英国医学杂志最佳临床实践数据库(BMJ Best Practice)、英国国家临床医学研究所指南库、PubMed、Embase、美国重症医学会网站、美国重症护理协会网站、万方数据库、中国知网、中国生物医学文献数据库等数据库中无创心输出量监测管理相关研究,包括临床决策、指南、专家共识、证据总结、最佳实践、系统评价、Meta分析、随机对照试验,检索时限为自建库起至2023年8月。循证团队人员对文献进行筛选、质量评价后,提取符合标准的相关证据。结果:共纳入11篇文献,包括系统评价7篇、专家共识4篇。形成20条关于危重症患者无创心输出量监测管理的证据,证据包括无创心输出量监测所适宜的患者、与有创心输出量监测的相关性、监测过程中的误差来源等,内容涉及监测人群、临床应用、干扰因素、注意事项、人员培训5方面。结论:应加强临床医护人员关于无创心输出量监测技术的培训,结合具体临床情境选择合适的实践证据,以提高无创心输出量监测的操作规范性与测量准确度。Objectives:To summarize the relevant evidence of non-invasive cardiac output monitoring management in critically ill patients and provide evidence-based basis for strengthening the standardization and accuracy of non-invasive cardiac output monitoring by clinical medical staff.Methods:We searched UpToDate,British Medical Journal Best Practice Database,The UK National Institute of Clinical Medicine guideline library,PubMed,Embase,American Society of Critical Care Medicine,American Association of Critical Care Nurses,Wanfang database,China Knowledge Network,SinoMed and other databases to collect relevant clinical decisions,guidelines,best practices,evidence summaries,systematic reviews,expert consensuses and randomized controlled trials related to non-invasive cardiac output monitoring management.The search period is from the inception to August 2023.After screening and quality evaluation by the evidence-based team,relevant evidence that meets the standards was extracted.Results:A total of 11 articles were obtained,including 7 systematic reviews,4 expert consensus.Finally,20 best evidences were obtained about the non-invasive cardiac output monitoring management in critically ill patients,including the patients suitable for non-invasive cardiac output monitoring,correlation with the invasive cardiac output monitoring,and the source of error in the monitoring process,involving 5 aspects such as monitoring population,clinical application,interference factors,precautions and personnel training.Conclusions:Clinical medical staff should strengthen the training of non-invasive cardiac output monitoring technology in critically ill patients,and appropriate practical evidence should be selected in combination with the specific clinical situation to improve the application standardization and measurement accuracy of non-invasive cardiac output monitoring in critically ill patients.

关 键 词：无创心输出量 血液动力学监测 证据总结 循证护理学 

分 类 号：R54[医药卫生—心血管疾病]