颅脑损伤人工气道患者吸痰护理操作要点的证据总结

Summary of evidence:sputum suctioning care in traumatic brain injury patients with artificial airways

目的 为颅脑损伤患者的人工气道吸痰护理提供证据依据。方法 应用循证护理方法,文献检索策略根据“6S”金字塔模型,检索数据库国际指南协作网、Cochrane图书馆、PubMed、SinoMed、UpToDate、中国知网、医脉通、万方等。指南采用英国临床指南研究评价系统,其他文献采用澳大利亚JBI循证卫生保健中心的文献评价标准,并采用该中心的证据分级系统进行证据级别评定。结果 最终纳入文献15篇,其中指南1篇,系统评价2篇,证据总结3篇,专家共识1篇,随机对照研究2篇,队列研究2篇,类实验研究4篇。总结出颅脑损伤人工气道患者吸痰护理操作要点,共5个方面22条证据,建议选择密闭式吸痰法,浅层吸痰、按需吸痰,充分做好镇静镇痛管理,做好持续气道湿化管理,为护理人员临床工作提供参考。结论 总结颅脑损伤人工气道吸痰护理操作要点的循证证据,能够为患者制定个性化护理管理,促进患者临床康复,提升临床护理工作质量。

Objective To offer evidence-based recommendations for the management of tracheal suctioning in patients with traumatic brain injury(TBI)requiring artificial airways.Methods Evidence-based nursing methodologies was applied,and the evidence search strategy was based on the'6S'pyramid model,searching databases such as the International Guidelines Collaboration,Cochrane Library,PubMed,SinoMed,UpToDate,China National Knowledge Infrastructure,Medical Pulse,and Wanfang Database.The United Kingdom's Clinical Guidelines Research and Development System was used for guidelines,and the other literature was evaluated according to the Joanna Briggs Institute's(JBI)criteria for assessing evidence in healthcare,and the JBI evidence ranking system was employed to determine the level of evidence.Results Fifteen papers were finally included,including 1 guideline,2 systematic evaluations,3 evidence summaries,1 expert consensus,2 randomized controlled trials,2 cohort studies,and 4 quasi-experimental studies.The essential elements of tracheal suctioning care for patients with TBI requiring artificial airways was summarized,delineating 5 primary aspects supported by 22 pieces of evidence.The recommendations include the utilization of closed suctioning techniques,the implementation of superficial and on-demand suctioning,the management of adequate sedation and analgesia,and the maintenance of continuous airway humidification.These guidelines serve as a reference for clinical practice among nursing professionals.Conclusions Summarizing the evidence-based guidelines for tracheal suctioning care in patients with TBI requiring artificial airways can formulate personalized nursing management for patients,promote patients'clinical recovery,and improve the quality of clinical nursing work.