危重症成人患者腹内压测量的最佳证据总结

Summary of best evidence for intra-abdominal pressure measurements in critically ill adult patients

目的检索、评价并总结危重症成人患者腹内压监测相关操作的最佳证据。方法计算机检索BMJ Best Practice、UpToDate、NICE、GIN、NGC、SIGN、WSACS、JBI、Web of Science、Cochrane、PubMed、Embase、医脉通、CNKI、Wanfang、VIP、CBM等数据库中有关腹内压监测的所有证据。检索时限为建库至2022年3月。结果共纳入17篇文献,其中包含指南2篇,临床决策1篇,专家共识2篇,系统评价1篇,随机对照试验11篇。最终从8个方面总结了26条最佳证据,包括政策管理、测量方式选择、监测时机、体位、零参考点、灌注量、灌注液温度、PEEP值。结论本研究总结了腹内压测量相关操作的最佳证据,为提高临床腹内压监测的准确性与操作的规范性提供了循证依据。

Objective To retrieve,evaluate,and summarize the best evidence for intra-abdominal pressure monitoring in critically ill adults.Methods All evidences related to intra-abdominal pressure monitoring were retrieved by computer from the databases of BMJ Best Practice,UpToDate,NICE,GIN,NGC,SIGN,WSACS,JBI,Web of Science,Cochrane,PubMed,Embase,Medlive,CNKI,Wanfang,VIP,and CBM.The retrieval time limit was from the establishment of the database to March 2022.Results A total of 17 articles were included,including 2 guides,1 clinical decision,2 expert consensus,1 systematic evaluation and 11 randomized controlled trials.Finally,26 best evidences were summarized from 8 aspects,including policy management,measurement method selection,monitoring opportunity,body position,zero reference point,perfusion volume,perfusion fluid temperature,and PEEP value.Conclusion This study summarizes the best evidence on the operation of intra-abdominal pressure measurement,and provides an evidence-based basis for improving the accuracy and standardization of clinical intra-abdominal pressure monitoring.