严重烧伤患者脉搏轮廓心输出量监测的最佳证据总结

Summary of best evidence for pulse contour cardiac output monitoring in severe burn patients

目的总结严重烧伤患者脉搏轮廓心输出量(PiCCO)监测的最佳证据。方法采用文献计量学方法。系统检索UpToDate、BMJ Best Practice、Joanna Briggs Institute Evidence-Based Practice Database、Cochrane Library、PubMed、Web of Science、Embase、Medline、Guideline International Network等外文数据库以及中国知网、万方数据库、维普数据库等中文数据库,检索各数据库自建库起至2022年5月公开发表的关于严重烧伤患者PiCCO监测的所有证据,包括指南、专家共识、证据总结、系统评价和原始研究。筛选文献并评价文献质量,从中提取证据并进行评价分级,总结最佳证据。结果共检索纳入3篇指南、2篇专家共识、1篇证据总结(追溯2篇系统评价)、2篇系统评价、3篇随机对照试验、1篇队列研究和1篇病例对照研究,文献质量均较高。从操作前评估、置管操作、建立监测系统、管路维护、监管与教育方面总结出37条有关严重烧伤患者PiCCO监测的最佳证据。结论从5个方面总结出37条有关严重烧伤患者PiCCO监测的最佳证据,为临床实施科学、规范的PiCCO监测与护理管理提供了依据。

Objective To summarize the best evidence for pulse contour cardiac output(PiCCO)monitoring in severe burn patients.Methods A bibliometric approach was used.Foreign language databases including UpToDate,BMJ Best Practice,Joanna Briggs Institute Evidence-Based Practice Database,Cochrane Library,PubMed,Web of Science,Embase,Medline,and Guideline International Network,as well as Chinese databases such as China National Knowledge Infrastructure,Wanfang Database,and VIP Database were systematically retrieved to obtain all the publicly published evidence on PiCCO monitoring in severe burn patients in each database from the establishment of each database to May 2022,including guidelines,expert consensus,evidence summary,systematic review,and original research.The literature was screened and evaluated for the quality,from which the evidences were extracted,evaluated,and classified to summarize the best evidences.Results Three guidelines,two expert consensuses,one evidence summary(with two systematic reviews being traced),two systematic reviews,three randomized controlled trials,one cohort study,and one case-control study were retrieved and included,with good quality of literature.Totally 37 pieces of best evidences about PiCCO monitoring in severe burn patients were summarized from the aspects of pre-operation evaluation,pipe placement and operation,monitoring system establishment,pipeline maintenance,and supervision and education.Conclusions Totally 37 pieces of best evidences about PiCCO monitoring in severe burn patients are summarized from 5 aspects,providing a basis for the clinical implementation of scientific and standardized PiCCO monitoring and nursing management.