危重症患儿腹内高压预防及管理的最佳证据总结

Summary of the best evidence for the prevention and management of intra-abdominal hypertension in critically ill children

目的:检索、评价并整合国内外危重症患儿腹内高压预防及管理的相关证据,为临床实践提供参考。方法:系统检索国内外相关指南网站、专业学/协会网站以及PubMed、Embase、Ovid、Ebsco、Web of Science、万方数据库、中国知网、中国生物医学文献数据库等数据库中关于危重症患儿腹内高压预防及管理的所有证据,包括指南、专家共识、证据总结、最佳临床实践手册、推荐实践及系统评价,检索时限为建库至2022年9月。由2名研究者独立进行文献质量评价和资料提取。结果:共纳入13篇文献,其中指南2篇、推荐实践1篇、队列研究3篇,描述性横断面研究7篇。从评估与筛查、腹内压监测、减压干预、教育与培训4个方面汇总了25条最佳证据。结论:该研究总结了危重症患儿腹内高压预防及管理的最佳证据,可为临床规范危重症患儿腹内高压的预防及管理提供循证依据。

Objective:To retrieve,evaluate and integrate relevant evidence on the prevention and management of intra-abdominal hypertension of critically ill children to provide clinical references.Method:We searched relevant guideline networks and association websites,as well as PubMed,Embase,Ovid,Ebsco,Web of Science,Wanfang Database,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM)and other databases to collect clinical practice guidelines,expert consensuses,evidence summaries,best clinical practice information manuals,recommended practices and systematic reviews related to prevention and management of intra-abdominal hypertension in critically ill children published from the establishment of the database to September 2022.2 researchers evaluated the quality of various literature,and extracted relevant evidence from the included literature.Result:A total of 13 articles were included,including 2 guidelines,1 recommended practices,3 cohort studies and 7 cross-sectional studies.Finally,25 pieces of best evidence about assessment and screening,intra-abdominal pressure monitoring,interventions to decrease intra-abdominal pressure,education and training were summarized.Conclusion:This study summarized the best evidence on the prevention and management of intra-abdominal hypertension of critically ill children,which was capable of providing evidence-based basis for the prevention and management of abdominal hypertension in critically ill children.