成人脓毒症患者液体复苏的最佳证据总结

doi:10.3761/j.issn.2096-7446.2024.07.016

摘要/Abstract

摘要： 目的系统总结成人脓毒症患者液体复苏的最佳证据,为临床实践提供参考依据。方法系统检索BMJ Best Practice、UpToDate、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、英国国家临床医学研究所指南库、苏格兰院际指南网、美国国立指南库、加拿大安大略医学会、澳大利亚国家健康和医学研究委员会、新西兰指南协作网、世界卫生组织指南网、国际指南协作网、医脉通、Cochrane Library、PubMed、Embase、Web of Science、CINAHL、中国知网、万方数据库、维普数据库、中国生物医学文献服务系统和中华医学会期刊全文数据库等有关脓毒症液体复苏的临床指南、最佳实践、专家共识、系统评价、证据总结以及与本研究相关的随机对照试验,按照纳入与排除标准筛选文献并对其进行质量评价,提取和汇总证据。检索时限为建库至2023年4月20日。结果共纳入11篇文献。其中指南2篇、专家共识7篇、系统评价2篇。从脓毒症早期筛查与识别、液体复苏处理措施、容量反应监测3个方面汇总了17条证据。结论该研究总结了成人脓毒症患者的液体复苏的最佳证据,为临床医护人员实施成人脓毒症患者液体复苏的整体流程提供借鉴和参考依据。

关键词: 脓毒症, 液体复苏, 证据总结, 循证护理学

Abstract: Objective To systematically summarize the best evidence for fluid resuscitation in adult patients with sepsis to provide a reference for clinical practice. Methods We comprehensively searched BMJ Best Practice,Up To Date,JBI Evidence-Based Health Care Centre database,National Institute for Health and Clinical Excellence in the UK,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,Registered Nurses‘ Association of Ontario,National Health and Medical Research Council in Australia,New Zealand Guidelines Collaboration Network,World Health Organization Guidelines Network,International Guidelines Collaboration Network,Medlive,The Cochrane Library,PubMed,Embase,Web of Science,CINAHL,CNKI,Wanfang,VIP,SinoMed,and the Chinese Medical Association Journal Full Text Database for clinical guidelines,best practices,expert consensus,systematic reviews,and evidence summaries related to fluid resuscitation in sepsis and randomized controlled trials related to this study. The literature was screened according to the inclusion and exclusion criteria and evaluated for quality,extraction and summarization of evidence were performed. The search limit was from the time of database establishment to April 20,2023. Results A total of 11 literature were included,including 2 guidelines,7 expert consensuses,and 2 systematic reviews. Seventeen pieces of evidence were summarized in 3 aspects：early screening and recognition of sepsis,fluid resuscitation management measures,and volume response monitoring. Conclusion This study summarizes the best evidence summary for fluid resuscitation in adult patients with sepsis and provides a reference point for clinical providers to implement the overall process of fluid resuscitation in adult patients with sepsis.

Key words: Sepsis, Fluid Resuscitation, Evidence Summary, Evidence-Based Nursing

张浩, 代敏, 杨柳, 李宁香, 姜静媛, 高永莉. 成人脓毒症患者液体复苏的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(7): 662-668.

ZHANG Hao, DAI Min, YANG Liu, LI Ningxiang, JIANG Jingyuan, GAO Yongli. Evidence summary for fluid resuscitation in adults with sepsis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(7): 662-668.

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