成人心搏骤停患者体外心肺复苏急诊救治的最佳证据总结

Best evidence summary for emergency treatment of adult patients with cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation

目的检索、评价及总结成人心搏骤停患者体外心肺复苏管理的最佳证据,为临床实践提供参考。方法按照“6S”证据模型,系统检索UpToDate、BMJ Best Practicc、美国国立指南库等指南网站、美国心脏学会等专业学会网站、中国生物医学文献服务系统、中国知网、万方数据知识服务平台、Embase、PubMed、Cochrane Library、CINAHL、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库,采用主题词和自由词的方式进行检索。检索时限为建库至2022年7月10日,并对检索文献进行质量评价。结果共纳入12篇文献,其中临床决策1篇、指南6篇、专家共识5篇。从6个方面汇总形成22条最佳证据,分为评估、启动与实施、监测与管理、治疗原发病、撒离和管理原则。结论成人心搏骤停患者体外心肺复苏急诊救治的最佳证据形成过程科学,可为急诊医护人员开展体外心肺复苏管理实践提供指导,临床应用需结合医疗机构特点和患者具体情况,从而提高急诊体外心肺复苏质量。

Objective To retieve,evaluate and summarize the best evidence for emergency treatment of adult patients with cardiac arrest undergoing extracorporeal cardiopulmonary resuscitation,so as to provide reference for clinical practice.Methods According to the“6S”evidence model,we searched all relevant databases and website,such as UpToDate,BMJ Best Practice,National Guideline Clearinghouse,American Heart Association,SinoMed,CNKI,W anfang Database,Embase,PubMed,Cochrane Library,CINAHL,Joanna Briggs Instiute(JBI)Evidence Based Healtheare Database,from the establishment of the database to July 10,2022.The quality of included literature was evaluated.Results A total of 12 articles were included,including 1 clinical deeision,6 guidelines and 5 expert consensuses.22 pieces of best evidence were summarized from 6 aspects.including assessment,initiation and implementation,monitoring and management,primary disease treatment。evacuation and management principles.Conclusion The best evidence for the emergeney treatment of adult cardiac arrest patients with extracorporeal cardiopulmonary resuscitation is scientific and clinically aplicable,which could provide guidance for emergeney medical stalf.Clinical application should be based on hospital characteristics and patients'specifie conditions,so as to improve the quality of emergency extracorporeal cardiopulmonary resuscitation.