收稿日期: 2024-02-28
网络出版日期: 2025-01-14
基金资助
2022年度甘肃省卫生健康行业科研计划项目(GSWSHL2022-01)
Summary of evidence on the management of ventilator-induced diaphragmatic dysfunction in ICU patients
目的 总结ICU患者呼吸机相关性膈肌功能障碍管理的相关证据，为临床提供实践依据。方法 系统检索指南网站、专业协会网站及国内外数据库中关于ICU患者呼吸机相关性膈肌功能障碍管理的相关证据，检索时限为建库至2023年9月20日。纳入证据类型包括临床决策、指南、证据总结、最佳实践、推荐实践、专家共识、系统评价、Meta分析和随机对照试验。由2名研究者独立进行文献质量评价、证据提取和整合。结果 共纳入22篇文献，包括1篇指南、1篇临床决策、4篇专家共识、1篇Meta分析、1篇证据总结及14篇随机对照试验。从评估、组建团队、呼吸机管理、药物管理、营养管理、康复训练管理及物理治疗7个维度归纳了共29条证据。结论 该研究总结了ICU患者呼吸机相关性膈肌功能障碍管理的最佳证据，具有一定的科学性与全面性，可为临床实践提供参考依据。
关键词： 重症监护病房; 呼吸机相关性膈肌功能障碍; 证据总结; 循证护理学
吉莉 , 吴慧 , 景晨阳 , 岳伟岗 , 汪袁云子 , 汪托红 , 何国宝 , 樊落 . ICU患者呼吸机相关性膈肌功能障碍管理的证据总结[J]. 中华急危重症护理杂志, 2025 , 6(1) : 100 -106 . DOI: 10.3761/j.issn.2096-7446.2025.01.017
Objective To summarize the relevant evidence of ventilator-induced diaphragmatic dysfunction management in ICU patients，and to provide practical basis for clinical practice. Methods The relevant evidence on the management of ventilator-induced diaphragmatic dysfunction in ICU patients was retrieved from the guidelines website，professional association website and domestic and foreign databases. The retrieval time limit was from the establishment of the database to September 20，2023. The types of evidence included clinical decision-making，guidelines，evidence summary，best practice，recommended practice，expert consensus，systematic review，meta-analysis and randomized controlled trials. Two researchers evaluated the quality of literature independently，extracted and integrated the evidence. Results A total of 22 articles were included，including one guideline，one clinical decision，four expert consensuses，one meta-analysis，one evidence summary and 14 randomized controlled trials. A total of 29 evidences were summarized from seven dimensions，including evaluation，team building，ventilator management，drug management，nutrition management，rehabilitation training management and physical therapy. Conclusion This study summarizes the best evidence for the management of ventilator-induced diaphragmatic dysfunction in ICU patients，which is scientific and comprehensive，and can provide reference for clinical practice.
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