ICU人工气道患者气囊周围微误吸预防及护理的证据总结

doi:10.3761/j.issn.1672-9234.2023.07.018

摘要/Abstract

摘要：

目的检索、评价和总结成人ICU人工气道患者气囊周围微误吸的预防及护理最佳证据。方法系统检索UpToDate、BMJ、英国国家卫生与临床优化研究所、Cochrane图书馆、JBI循证卫生保健中心数据库、Embase、PubMed、CNKI、万方数据库、医脉通等国内外数据库及指南网关于人工气道患者气囊周围微误吸预防及护理相关证据。检索时限为2012年1月1日—2022年12月31日。对文献质量进行评价并提取证据。结果共纳入18篇文献，包括3篇临床决策、4篇指南、2篇专家共识、3篇证据总结、6篇系统评价。形成包括危险因素识别、体位管理、导管及气囊选择、气囊管理、机械通气管理、口腔及气囊上分泌物清除、判断依据7个方面，共22条最佳证据。结论本研究总结了ICU人工气道患者气囊周围微误吸预防及护理的最佳证据，为ICU医护人员规范化落实微误吸及其相关并发症的预防管理措施提供依据。

关键词: 护理, 重症监护, 微误吸, 人工气道, 预防

Abstract:

Objective To search，evaluate and summarize the best evidence for the prevention and management of microaspiration around the cuff in adult ICU patients with artificial airway. Methods Systematic searching were conducted with database and website including UpToDate，BMJ Best Practice，NICE，Cochrane Library，JBI，Embase，PubMed，CNKI，Wanfang and Yimaitong from January 1，2012 to December 31，2022. The quality of literature and extract evidence were evaluated. Results A total of 22 pieces of best evidence were extracted from 18 literatures，including 3 clinical decisions，4 guidelines，2 expert consensuses，3 evidence summaries，and 6 systematic reviews. The best evidence was then summarized into 7 aspects，including risk factor identification，position management，tracheal tube and cuff selection，cuff management，mechanical ventilation management，oropharyngeal and subglottic secretion clearance，and monitoring of microaspiration. Conclusion This study summarizes the best evidence for the prevention and management of microaspiration around the cuff，and provides evidence for ICU medical staffs to standardize the prevention and management measures of microaspiration and its related complications.

Key words: Nursing Care, Intensive Care, Microaspiration, Artificial airway, Prevention

邓伟, 闫静, 吴伶慧, 刘鹏程, 王英, 李小珍. ICU人工气道患者气囊周围微误吸预防及护理的证据总结[J]. 中华护理教育, 2023, 20(7): 870-877.

DENG Wei, YAN Jing, WU Linghui, LIU Pengcheng, WANG Ying, LI Xiaozhen. Evidence summary for the prevention and management of microaspiration around the cuff in adult ICU patients with artificial airway[J]. Chinese Journal of Nursing Education, 2023, 20(7): 870-877.

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