成人ICU病人睡眠促进策略的证据总结

Evidence summary for sleep promotion strategies of ICU patients

目的:总结国内外重症监护室(ICU)病人睡眠监测与睡眠促进的最佳证据。方法:计算机检索Up to Date、BMJ、国际指南协作网(GIN)、英国国家卫生与照护优化研究所(NICE)等数据库中关于ICU病人睡眠相关的证据,包括指南、证据总结、最佳实践信息册、专家共识、系统评价及与研究密切相关的原始研究。检索时间为2010年1月1日—2019年1月31日。根据纳入及排除标准,筛选相关文献,并由2名研究者独立对筛选出的文献进行质量评价,对符合质量评价标准的文献进行资料提取,形成证据汇总。结果:共纳入8篇文献,包括1篇指南,6篇系统评价、1篇队列研究。汇总出的最佳证据涉及睡眠监测、机械通气模式、音乐疗法、针灸疗法、背部按摩、声音及光照、夜间干预及药物共8个方面、10条目。结论:形成的最佳证据涉及睡眠监测、机械通气模式、音乐疗法、针灸疗法、背部按摩、声音及光照、夜间干预及药物8个方面,共10个条目。ICU工作者可基于以上证据,在充分考虑临床情景、结合专业人士的判断及病人的意愿后,审慎地将证据融入现有工作流程中。

Objective:To summarize the best evidence of sleep monitoring and sleep promotion methods in ICU patients at home and abroad.Methods:We searched Up to Date,BMJ,GIN,NICE and other databases for evidence related to sleep of ICU patients,including guidelines,evidence summary,best practice information book,expert consensus,systematic review and original research closely related to the research.The retrieval time was from January 1,2010 to January 31,2019.According to the inclusion and exclusion criteria,the relevant literatures were selected,and the quality of the selected literatures was evaluated by two researchers independently.The literatures meeting the quality evaluation criteria were extracted to form a summary of evidence.Results:A total of 8 literatures were included,including1 guideline,6 systematic reviews and 1 cohort study.The best evidences included sleep monitoring,mechanical ventilation mode,music therapy,acupuncture therapy,back massage,sound and light,night intervention and drugs,with 10 items.Conclusions:The best evidence includes sleep monitoring,mechanical ventilation mode,music therapy,acupuncture therapy,back massage,sound and light,night intervention and medicine.Based on the above evidences,ICU workers can carefully integrate the evidence into the existing workflow after fully considering the clinical situation,professionals and the wishes of patients.