关键词: 重症监护病房，儿科, 机械通气, 气管插管, 非计划性拔管, 循证护理学

Abstract:

Objective Through systematic evidence retrieval and literature quality evaluation，the best evidence on the preventive strategies of unplanned extubation of tracheal tubes in pediatric intensive care units （PICU） was extracted and summarized，so as to provide research-based evidence for clinical practice. Methods The literature related to the preventive strategies of unplanned extubation of endotracheal intubation in children with mechanical ventilation were systematically searched in domestic and foreign computer decision support systems，guide networks，databases and websites of relevant societies. The retrieval time limit is from January 2010 to January 2022. The literature types cover clinical decision-making，clinical practice guidelines，evidence summaries，systematic evaluations and expert consensuses. 5 different types of publications were retrieved and evaluated by 4 experts. Results A total of 14 publications were included，involving 6 guidelines，2 expert consensuses，6 systematic reviews. 25 pieces of best evidence of preventive strategies in 6 aspects，namely risk factors，tracheal intubation and airway management，sedation evaluation and management，analgesia evaluation and management，delirium monitoring and prevention，and PICU human resources and facilities were summarized. Conclusion The best evidence summarized in this study provides an evidence-based basis for the prevention of unplanned extubation of tracheal intubation in children with PICU mechanical ventilation. Before applying the evidence，medical workers should evaluate the clinical situation and obstacle factors，so as to promote the effective and safe transformation of the evidence into clinical practice.

Key words: Intensive Care Units，Pediatric, Mechanical Ventilation, Endotracheal Intubation, Unplanned Extubation, Evidence-Based Nursing