收稿日期: 2024-07-16
网络出版日期: 2025-04-28
Summary of best evidence on monitoring and management for hypothermia in patients with continuous renal replacement therapy
目的 检索、评价并综合连续性肾脏替代治疗患者低体温监测和管理的相关证据，为临床护理实践提供参考。方法 系统检索UpToDate、BMJ Best Practice、英国国家卫生与临床优化研究所、国际指南协作网、加拿大安大略护士协会、苏格兰院际间指南网、中国医脉通指南网、Cochrane Library、PubMed、Embase、Web of Science、CINAHL、中国知网、万方数据库中关于连续性肾脏替代治疗患者低体温相关的证据，包括指南、专家共识、专家推荐、系统评价、临床决策、最佳实践及原始研究。检索时限为建库至2024年6月2日。由2名研究者独立进行文献质量评价和资料提取。结果 共纳入15篇文献，包括1篇临床决策、2篇指南、2篇专家共识、1篇专家推荐、3篇系统评价、3篇随机对照试验、2篇病例对照、1篇队列研究。汇总、提取18条最佳证据，包括团队组成、危险因素识别、监测频率、监测部位、预防及管理5个类别。结论 该研究总结的连续性肾脏替代治疗患者低体温监测和管理的最佳证据具有科学性和全面性，为医护人员规范管理连续性肾脏替代治疗低体温患者提供了循证依据。
陈丽花 , 盛青青 , 黄瑶 , 王新宁 , 谭玉凤 , 何婷婷 , 张书琴 . 连续性肾脏替代治疗患者低体温监测与管理的最佳证据总结[J]. 中华急危重症护理杂志, 2025 , 6(5) : 610 -615 . DOI: 10.3761/j.issn.2096-7446.2025.05.019
Objective To retrieve，evaluate and synthesize the best evidence on monitoring and management for hypothermia in patients with continuous renal replacement therapy，and to provide reference for clinical evidence-based practice. Methods We searched UpToDate，BMJ Best Practice，National Institute for Health and Clinical Excellence，Guidelines International Network，Registered Nurses Association of Ontario，Scottish Intercollegiate Guidelines Network，Yimaitong guide network，Cochrane Library，PubMed，Embase，Web of Science，CINAHL，CNKI，Wanfang for guidelines，expert consensus，expert recommendations，systematic reviews，clinical decisions，best practices，and original studies on monitoring and management for hypothermia in patients with continuous renal replacement therapy. The search limit was from the time of database establishment to June 2，2024. Two researchers independently assessed methodological quality of included papers and extracted data. Results A total of 15 articles were included，including one clinical decision，two guidelines，two expert consensuses，one expert recommendation，three systematic reviews，three randomized controlled trials，two case-controlled studies，one cohort study. Finally，18 pieces of best evidence were summarized from 5 aspects，namely the team composition，risk factor identification，monitoring frequency，monitoring location，prevention and management. Conclusion The best evidence on monitoring and management for hypothermia in patients with continuous renal replacement therapy summarized in this study is scientific and comprehensive，and provides evidence-based basis for medical staff in standardized management for hypothermia in patients with continuous renal replacement therapy.
| [1] | 中华医学会肾脏病学分会专家组. 连续性肾替代治疗容量评估与管理专家共识[J]. 中华肾脏病杂志, 2024, 40(1):74-81. |
| Expert Group of Nephrology Branch of Chinese Medical Asso-ciation. Expert consensus on fluid volume assessment and ma-nagement in continuous renal replacement therapy[J]. Chin J Ne-phrol, 2024, 40(1):74-81. | |
| [2] | Tandukar S, Palevsky PM. Continuous renal replacement thera-py:who,when,why,and how[J]. Chest, 2019, 155(3):626-638. |
| [3] | Evren G, Zengin N. The effect of therapeutic hypothermia on prognosis in patients receiving continuous renal replacement therapy[J]. Ther Hypothermia Temp Manag, 2024, 14(1):52-58. |
| [4] | 杭永青, 汪媛媛, 刘志敏, 等. 四种加温干预方法在ICU连续性肾脏替代治疗中的应用研究[J]. 中国实用护理杂志, 2021, 37(19):1462-1467. |
| Hang YQ, Wang YY, Liu ZM, et al. A study of effect and safety of different heating methods in continuous renal re-placement therapy treatment[J]. Chin J Pract Nurs, 2021, 37(19):1462-1467. | |
| [5] | 国家麻醉专业质量控制中心. 围术期患者低体温防治专家共识(2023版)[J]. 协和医学杂志, 2023, 14(4):734-743. |
| National Center for Quality Control of Anesthesia. 2023 Chinese expert consensus statement for prevention and management of perioperative hypothermia[J]. Med J Peking Union Med Coll Hosp,2023, 14(4):734-743. | |
| [6] | Morsch CMF, Haas JS, Plotnick R, et al. Hypothermia related to continuous renal replacement therapy:incidence and associated factors[J]. Rev Bras Ter Intensiva, 2021, 33(1):111-118. |
| [7] | 张鹏, 江海娇, 叶小铭, 等. 连续性肾脏替代治疗的低体温发生率及相关因素分析[J]. 中华危重病急救医学, 2023, 35(4):387-392. |
| Zhang P, Jiang HJ, Ye XM, et al. Analysis of the incidence and related factors of hypothermia in patients with continuous renal replacement therapy[J]. Chin Crit Care Med, 2023, 35(4):387-392. | |
| [8] | Pornsirirat T, Kasemvilawan N, Pattanacharoenwong P, et al. In-cidence of hypothermia in critically ill patients receiving con-tinuous renal replacement therapy in Siriraj Hospital,Thailand[J]. Acute Crit Care, 2024, 39(3):379-389. |
| [9] | Nishimi S, Sugawara H, Onodera C, et al. Complications during continuous renal replacement therapy in critically ill neonates[J]. Blood Purif, 2019, 47(Suppl 2):74-80. |
| [10] | Doddi A, Abbasi A, Ramesh A, et al. Impact of using blood warmer during continuous kidney replacement therapy in patients with acute kidney injury[J]. J Intensive Care Med, 2024, 39(4):387-394. |
| [11] | Dicenso A, Bayley L, Haynes RB. Accessing pre-appraised evi-dence:fine-tuning the 5S model into a 6S model[J]. Evid Based Nurs, 2009, 12(4):99-101. |
| [12] | Brouwers MC, Lavis JN, Spithoff K, et al. Assessment of health systems guidance using the appraisal of guidelines for re-search and evaluation-health systems(AGREE-HS) instrument[J]. Health Policy, 2019, 123(7):646-651. |
| [13] | 胡雁, 郝玉芳. 循证护理学(第二版)[M]. 北京: 人民卫生出版社, 2018. |
| Hu Y, Hao YF. Evidence-based nursing(2nd edition)[M]. Beijing: People’s Medical Publishing House, 2019. | |
| [14] | 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967. |
| Wang CQ, Hu Y. JBI evidence pre-classification and evidence recommendation level system(2014 edition)[J]. J Nurses Train, 2015, 30(11):964-967. | |
| [15] | Connor MJ, Tolwani AJ. Prescription of continuous kidney re-placement therapy in acute kidney injury in adults[EB/OL].(2024-06-04)[2024-09-27]. https://www.uptodate.cn/contents/pre-scription-of-continuous-kidney-replacement-therapy-in-acute-kid-ney-injury-in-adults. |
| [16] | Torossian A, Brauer A, Hocker J, et al. Preventing inadvertent perioperative hypothermia[J]. Dtsch Arztebl Int, 2015, 112(10):166-172. |
| [17] | Geijer H, Udumyan R, Lohse G, et al. Temperature measure-ments with a temporal scanner:systematic review and meta-analysis[J]. BMJ Open, 2016, 6(3):e009509. |
| [18] | Niven DJ, Gaudet JE, Laupland KB, et al. Accuracy of peri-pheral thermometers for estimating temperature:a systematic review and meta-analysis[J]. Ann Intern Med, 2015, 163(10):768-777. |
| [19] | Yeong Brigitte WF, Childs C. A systematic review on the role of extremity skin temperature as a non-invasive marker for hypoperfusion in critically ill adults in the intensive care setting[J]. JBI Libr Syst Rev, 2012, 10(26):1504-1548. |
| [20] | Rickard CM, Couchman BA, Hughes M, et al. Preventing hypo-thermia during continuous veno-venous haemodiafiltration:a randomized controlled trial[J]. J Adv Nurs, 2004, 47(4):393-400. |
| [21] | 许文冰, 许奕. 置换液预加温预防连续性肾脏替代治疗患者低体温的临床研究[J]. 中国实用护理杂志, 2019, 35(14):1055-1059. |
| Xu WB, Xu Y. Clinical study on preheating of substitution fluid to prevent hypothermia in patients with continuous renal replacement therapy[J]. Chin J Nurs, 2019, 35(14):1055-1059. | |
| [22] | 仇丽华, 赵振华, 冯波, 等. ICU患者连续性肾脏替代治疗24 h内低体温研究[J]. 护理学杂志, 2021, 36(10):26-29. |
| Qiu LH, Zhao ZH, Feng B, et al. Hypothermia in ICU patients during the first 24 hours of continuous renal replacement therapy[J]. J Nurs Sci, 2021, 36(10):26-29. | |
| [23] | NICE. Hypothermia:prevention and management in adults hav-ing surgery[M]. London:National Institute for Health and Care Excellence(NICE): London, 2016. |
| [24] | Richardson A, Whatmore J. Nursing essential principles:conti-nuous renal replacement therapy[J]. Nurs Crit Care, 2015, 20(1):8-15. |
| [25] | Niven DJ, Stelfox HT, Laupland KB. Hypothermia in adult ICUs:changing incidence but persistent risk factor for mortality[J]. J Intensive Care Med, 2016, 31(8):529-536. |
| [26] | 刘嘉龙, 郭文超, 滕娇, 等. 成人急性肾损伤患者连续性肾脏替代治疗管理的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(2):172-180. |
| Liu JL, Guo WC, Teng J, et al. Summary of best evidence for the management of continuous renal replacement therapy in adults with acute kidney injury[J]. Chin J Emerg Crit Care Nurs, 2024, 5(2):172-180. | |
| [27] | 伍姣. 危重患者连续性肾脏替代治疗相关性低体温的研究进展[J]. 中华急危重症护理杂志, 2020, 1(2):182-185. |
| Wu J. Research progress of hypothermia associated with continuous renal replacement therapy in critically ill patients[J]. Chin J Emerg Crit Care Nurs, 2020, 1(2):182-185. |
/
| 〈 |
|
〉 |