Ⅱ型呼吸衰竭病人应用高流量湿化氧疗的最佳证据总结

Best evidence summary of high flow nasal cannula therapy in patients with typeⅡrespiratory failure

目的:检索并筛选国内外Ⅱ型呼吸衰竭病人应用高流量湿化氧疗的相关证据,并对最佳证据进行总结。方法:计算机检索the Cochrane Library、JBI循证卫生保健数据库、CINAHL数据库、PubMed、MedLine、EMBase、美国国立指南数据库、中国知网、万方数据库、中国生物医学文献数据库、维普数据库和相关的学会网站中有关Ⅱ型呼吸衰竭病人应用高流量湿化氧疗进行呼吸支持及管理的证据,包括指南、证据总结、系统评价、专家共识、原始研究等,检索时限为建库至2021年8月31日。由两名经过系统循证护理培训的研究人员独立对文献质量进行评价,同时提取和汇总相关证据。结果:共纳入22篇文献,其中指南4篇,系统评价4篇,证据总结1篇,随机对照研究5篇,专家共识4篇,队列研究4篇,共总结了14条证据,内容包括评估、流速设置、浓度设置、温度设置、鼻导管尺寸、效果评价、团队教育与管理等方面。结论:总结的最佳证据具有科学性和全面性,可为提高Ⅱ型呼吸衰竭病人应用高流量湿化氧疗的安全性与舒适度提供循证依据。

Objective:To search and screen the evidence of high flow nasal cannula therapy in patients with typeⅡrespiratory failure,and to summarize the best evidence.Methods:We retrieved the Cochrane Library,JBI,CINAHL,PubMed,MedLine,EMBase,NGC,CNKI,WanFang Data,CBM,VIP and related guideline sites,including guidelines,evidence summary,systematic review,expert consensus,and original studies.The retrieval period was from the database construction to August 31,2021.Two researchers trained in systematic evidence⁃based nursing independently evaluated the literature quality and extracted and summarized relevant evidence.Results:Finally,22 articles were included,including four guidelines,four systematic reviews,one evidence summary,five randomized controlled studies,four expert consensus and four cohort studies.14 pieces of evidence were summarized,including pre⁃application evaluation,concentration setting,temperature setting,nasal duct size,effect evaluation and team education and management.Conclusion:The study summarized the best evidence which is scientific and comprehensive,and could provid evidence-based basis for improving the safety and comfort for patients with typeⅡrespiratory failure.