神经重症气管切开患者气道功能康复与管理专家共识(2024)

Expert consensus on rehabilitation and management of airway function for neurocritical patients with tracheotomy(2024)

目的基于循证方法,达成对神经重症气管切开后气道功能康复与管理的专家共识。方法采用德尔菲法形成问题清单和推荐意见,运用GRADE系统评估证据质量和推荐强度,根据RIGHT清单报告专家共识结果。结果在康复医疗情境下,神经重症气管切开患者气道功能的综合康复由康复医生、康复治疗师和护理人员等多学科专家团队完成。针对气道功能的康复、气道功能的管理、拔管前的评估及拔管、拔管后的监测及康复管理4个领域,形成17条共识意见。结论针对康复医疗情境下神经重症气管切开患者气道功能康复与管理的相关问题达成专家共识意见,有助于提升神经重症气管切开患者气道功能康复的质量与安全性。

Objective To create an evidence-based expert consensus on airway function rehabilitation and management post tracheostomy in neurocritical patients.Methods The lists of problems and recommendations were defined using Delphi method,and the evidence quality and recommendation strength were evaluated using GRADE,and the results were reported based on RIGHT.Results The comprehensive rehabilitation of airway function for neurocritical patients with tracheotomy in the setting of clinical rehabilitation would be conducted by a multidisciplinary team,including rehabilitation physicians,rehabilitation therapists,nurses,etc.A total of 17 recommendations were finally formulated on four major issues,including the airway function rehabilitation,airway management,pre-decannulation assessment and decannulation,and the monitoring after decannulation and rehabilitation management.Conclusion The expert consensus on the airway function rehabilitation and the management after tracheostomy in neurocritical patients in the setting of clinical rehabilitation has been created,which may be helpful for the quality and safety of rehabilitation for the airway function in neurocritical patients with tracheostomy.