成人体外膜肺氧合患者院内转运管理最佳证据总结

Best evidence for in-hospital transfer management of adult patients on ECMO

目的检索、评价并整合成人体外膜肺氧合患者院内转运管理相关证据,以期为转运决策提供循证依据。方法根据“循证6S金字塔证据模型”从上往下的原则,系统检索国内外网站和数据库中关于成人体外膜肺氧合患者院内转运管理的证据,包括临床决策、指南、最佳临床实践、系统评价、专家共识及原始研究等。检索时限从建库至2022年2月。文献质量评价由2名研究员单独完成,并结合专业人员意见,对质量达标的文献实施数据提取和总结。结果共纳入13篇文献,总结出19条最佳证据,包括院内转运原则、风险评估、转运计划、转运准备、转运监护、转运交接、质控和培训7个方面。结论成人体外膜肺氧合院内转运管理的最佳证据,可为临床医护人员提供循证依据,以科学的管理方式解决体外膜肺氧合患者院内转运问题,提高患者院内转运质量。

Objective To retrieve,evaluate and integrate the evidences about the management of in-hospital transfer of adult patients on ECMO(extracorporeal membrane oxygenation)so as to summarise the best evidence for decision making of in-hospital transfer Methods According to the top-down principle of"evidence-based 6S pyramid evidence model",we systematically searched all the evidences about management of in-hospital transfer of adult patients on ECMO from websites and databases at home and abroad,from the inceptions of the databases to February 2022,including clinical decision-making,best clinical practice,guidelines,evidence summaries,systematic evaluation,meta-analysis,expert consensus,randomised controlled trials,cohort studies and similar experimental studies.Two researchers trained in evidence-based nursing independently completed the quality evaluation of literatures,extracted and summarised the literatures that met the quality standards in accordance with the opinions of professionals.Results A total of 13 articles were included in the study.A total of 19 items of best evidences were abstracted and summarised,including the following 7 topics:principle of in-hospital transfer,risk assessment,transfer planning,transfer preparation,transfer monitoring,transfer handover,quality control and training.Conclusions The best evidence in management of in-hospital transfer of adult patients on ECMO provides medical staff with evidence-based practice.It helps medical staff to solve problems in in-hospital transfer of adult patients on ECMO for the purpose of improving the quality of in-hospital transfers.