危重症患儿非药物睡眠管理措施的最佳证据总结

Evidence summary of non-pharmacological sleep management measures in critically ill children

目的检索、评价和整合危重症患儿非药物睡眠管理措施的相关证据。方法计算机检索BMJ Best Practice、UpToDate、国际指南协作网、英国国家卫生与临床优化研究所网站、苏格兰校际指南网、加拿大安大略注册护士协会网站、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、美国睡眠医学会网站、国际儿科睡眠协会网站、中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Cochrane Library、PubMed、Web of Science、CINAHL中关于危重症患儿非药物睡眠管理措施的文献,包括临床决策、指南、证据总结、系统评价、专家共识等,检索时限为建库2023年2月。由2名研究人员独立进行文献筛选和质量评价,根据主题进行证据提取、归纳和汇总。结果最终纳入10篇文献,包括指南2篇、专家共识1篇、系统评价4篇、证据总结2篇和临床决策1篇,从睡眠评估、管理原则及教育、噪声管理、光照管理、促进睡眠的措施5个方面汇总28条证据。结论该研究总结了危重症患儿非药物睡眠管理措施的最佳证据。建议医护人员结合临床情境选择并应用证据,以减少危重症患儿夜间觉醒次数、延长睡眠时间、提高睡眠质量。

Objective To retrieve,appraise and integrate the relevant evidence of non-pharmacological sleep management measures in critically ill children.Methods We conducted a systematical search on the topic of non-pharmacological sleep management measures in critically ill children across multiple databases,including BMJ best practice,UpToDate,International Guidelines International Network,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,Registered Nurses’Association of Ontario,Joanna Briggs Institute Library,the American Academy of Sleep Medicine,International Pediatric Sleep Association,CNKI,WanFang database,VIP database,SinoMed,Cochrane Library,PubMed,Web of Science,and CINAHL.The literature retrieval time limit was from the establishment of the database to February 2023.The study design includes clinical practice guideline,evidence summary,clinical decision-making,expert consensus,and systematic review.The evidence was extracted and summarized according to the subject after the independent literature quality evaluation by 2 researchers.Results 10 relevant pieces of literature were identified,including 2 guidelines,1 consensus statement,4 systematic reviews,2 evidence summaries,and 1 top clinical decision.These sources provided a total of 28 pieces of evidence across 5 key themes,including sleep assessment,management principles and education,environmental management and sleep promotion.Conclusion This study summarizes the best available evidence on non-pharmacological sleep management measures in critically ill children.It is recommended that healthcare professionals should consider the clinical context when implementing evidence-based interventions,aiming to reduce nocturnal awakenings,extend sleep duration,and improve sleep quality in critically ill children.