体外膜肺氧合支持下患者院际转运安全管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.10.015

摘要/Abstract

摘要：

目的评价并总结体外膜肺氧合支持下患者院际转运安全管理的相关证据，为临床实践提供依据。方法系统检索BMJ Best Practice、UpToDate、乔安娜布里格斯研究所循证卫生保健中心数据库、国际指南协作网、美国卫生保健质量与研究机构网站、加拿大医学会临床实践指南库、Cochrane Library、医脉通指南网、体外生命支持组织网站、PubMed、Web of Science、CINAHL、Embase、中国知网、维普数据库、万方数据库中关于体外膜肺氧合支持下患者院际转运管理的相关证据，包括临床决策、指南、证据总结、最佳实践、专家共识、推荐意见、系统评价及Meta分析，检索时限为建库至2022年9月。由4名研究者独立进行文献质量评价和资料提取。结果共纳入13篇文献，其中指南2篇、专家共识8篇、系统评价3篇。从团队组成、响应和准备、转运实践、管理和质量控制4个方面总结了37条证据。结论该研究总结了体外膜肺氧合支持下患者院际转运安全管理的最佳证据，为临床开展院际转运实践提供依据。

关键词: 体外膜肺氧合, 院际转运, 患者转运, 安全管理, 循证护理学

Abstract:

Objective To retrieve，evaluate and summarize relevant evidence of safety management of inter-hospital transport in patients on extracorporeal membrane oxygenation（ECMO），so as to provide references for clinical practice. Methods We searched BMJ Best Practice，UpToDate，Joanna Briggs Institute，Guidelines International Network，Agency for Healthcare Research and Quality，Canadian Medical Association CPG Infobase，Cochrane Library，Yimaitong，Extracorporeal Life Support Organization Website，PubMed，Web of Science，CINAHL，Embase，MEDLINE，CNKI，Wanfang database and VIP database on all evidence related to the management of inter-hospital transport in patients on ECMO，including clinical decisions，guidelines，evidence summaries，best practices，expert consensuses，systematic reviews and meta-analysis. The retrieval time limit is from the establishment to September 2022. There were 4 investigators who independently assessed the quality of the literature，and also extracted，integrated and graded the evidence from the included literature. Results Totally 13 articles were included，involving 2 guidelines，8 expert consensuses and 3 systematic reviews. Finally，37 pieces of best evidence were summarized from 4 dimensions，namely team composition，response and preparation，transportation practice，management and quality control. Conclusion This study summarized the best evidence which can provide a basis for the implementation of inter-hospital transport supported by ECMO to promote patient safety during inter-hospital transport.

Key words: Extracorporeal Membrane Oxygenation, Inter-Hospital Transport, Transportation of Patients, Safety Management, Evidence-Based Nursing

余安琪, 邓娟, 周欣宇, 严丽, 黄素芳, 张梦, 王逸, 熊杰. 体外膜肺氧合支持下患者院际转运安全管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(10): 1245-1252.

YU Anqi, DENG Juan, ZHOU Xinyu, YAN Li, HUANG Sufang, ZHANG Meng, WANG Yi, XIONG Jie. Best evidence summary for safety management of inter-hospital transport of patients on extracorporeal membrane oxygenation[J]. Chinese Journal of Nursing, 2023, 58(10): 1245-1252.

图/表 4

图1 文献检索筛选流程图注：JBI为乔安娜布里格斯研究所，CPG Infobase为加拿大医学会临床实践指南库，AHRQ为美国卫生保健质量与研究机构，ELSO为体外生命支持组织。

Figure 1 Flow chart of literature search and screening

表1 纳入文献的基本特征（n=13）

Table 1 The basic characteristics of the included literature（n=13）

表2 专家共识的质量评价结果（n=8）

Table 2 The quality evaluation results of included consensuses（n=8）

表3 体外膜肺氧合支持下患者院际转运安全管理的最佳证据总结

Table 3 Evidence summary of safety management of inter-hospital transport in patients on ECMO

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