ICU患者人工气道气囊管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2022.24.016

摘要/Abstract

摘要：

目的检索、评价并总结国内外关于ICU患者人工气道气囊管理的最佳证据，为临床实践与标准制订提供参考。方法系统检索UpToDate、BMJ Best Practice、国际指南协作网、美国国立指南网、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库、Cochrane Library、PubMed、Embase、Web of Science、CINAHL、英国国家卫生与临床优化研究所网站、中国临床指南文库、医脉通、万方数据库、中国生物医学文献数据库、中国知网关于ICU患者人工气道气囊管理的所有证据，包括临床决策、指南、系统评价及专家共识等。检索时限为2012年1月—2022年2月。由4名研究者对纳入的文献质量进行评价，2名研究者对符合质量标准的文献进行证据提取。结果共纳入22篇文献，其中临床决策3篇、指南7篇、专家共识3篇、系统评价9篇。总结出29条最佳证据，包括人工气道评估、气囊的选择、气囊充气方法、气囊充气时机、气囊压力调节、气囊漏气评估、气囊上滞留物的清除、气囊漏气试验8个方面。结论 ICU患者人工气道气囊管理的最佳证据可为临床医护人员提供循证证据，以科学的方法管理人工气道气囊，有助于降低ICU患者呼吸机相关性肺炎的发生率。

关键词: 重症监护病房, 呼吸，人工, 气道管理, 气囊, 循证护理学

Abstract:

Objective To search，evaluate，and summarize the best evidence of endotracheal tube cuff management in adult ICU patients，and to provide a reference for clinical practice and standard formulation. Methods We searched UpToDate，BMJ Best Practice，Guidelines International Network（GIN），National Guideline Clearinghouse（NGC），Joanna Briggs Institute（JBI），Cochrane Library，PubMed，Embase，Web of Science，CINAHL，National Institute for Health and Care Excellence（NICE），China Clinical Guidelines Library，Yimaitong，Wanfang Database，China Biology Medicine（CBM），CNKI on artificial airway endotracheal tube cuff management in ICU adult patients，including clinical decision-making，guidelines，systematic reviews and expert consensuses published from January 2012 to February 2022. There were 4 researchers who evaluated the quality of the included articles and 2 researchers extracted evidence from the articles that met the quality standards. Results A total of 22 articles were included，including 3 clinical decision-makings，7 guidelines，3 expert consensuses，and 9 systematic reviews. 29 pieces of best evidence were summarized，including artificial airway evaluation，endotracheal tube cuff selection，cuff inflating method，cuff inflating time，cuff pressure regulation，cuff leakage evaluation，removal of secretions from the cuff，and cuff leakage test. Conclusion The best evidence of artificial airway endotracheal tube cuff management in ICU adult patients provides evidence-based evidence for clinical healthcare professionals. Scientific management of artificial airway endotracheal tube cuffs in ICU adults helps to reduce the incidence of ventilator-associated pneumonia.

Key words: Intensive Care Units, Respiration，Artificial, Airway Management, Endotracheal Tube Cuff, Evidence-Based Nursing

舒越, 毕蒙蒙, 张超, 龚艳艳, 李智欣, 周甜甜, 李星茹, 刘晓玉, 谢文广. ICU患者人工气道气囊管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(24): 3038-3045.

SHU Yue, BI Mengmeng, ZHANG Chao, GONG Yanyan, LI Zhixin, ZHOU Tiantian, LI Xingru, LIU Xiaoyu, XIE Wenguang. Summary of the best evidence of artificial airway endotracheal tube cuff management in ICU adult patients[J]. Chinese Journal of Nursing, 2022, 57(24): 3038-3045.

图/表 3

表1 纳入文献一般特征（n=22）

Table 1 Characteristics of included studies（n=22）

表2 纳入指南的质量评价结果（n=7）

Table 2 Quality evaluation of guidelines（n=7）

表3 ICU患者人工气道气囊管理的最佳证据总结

Table 3 Summary of the best evidence of artificial airway endotracheal tube cuff management in ICU patients

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