机械通气患者肠内营养相关性呕吐预防及管理的证据总结

Evidence summary for the prevention and management of enteral nutrition-associated vomitting in patients with mechanical ventilation

目的:总结机械通气患者肠内营养相关性呕吐预防及管理的证据,为临床护理实践提供参考依据。方法:应用循证护理的方法,针对机械通气患者肠内营养相关性呕吐预防及管理提出问题,按照“6S”模型检索国内外相关学会网站及数据库中关于机械通气患者肠内营养相关性呕吐预防及管理的证据。检索时限为建库至2024年6月5日。对文献进行质量评价、证据提取、整理汇总及分类。结果:共纳入16篇文献,其中指南5篇、专家共识4篇、证据总结4篇、系统评价3篇,最终形成了风险评估及危险因素识别、预防与处理、监测与管理3个主题的26条证据。结论:本研究总结了机械通气患者肠内营养相关性呕吐预防及管理的证据,临床工作中医护人员可遵循证据并结合临床情境制定个性化预防及管理方案,促进机械通气患者肠内营养相关性呕吐预防及管理的循证护理实践。

Objective:To summarize the evidence for the prevention and management of enteral nutrition-related vomitting in patients with mechanical ventilation,so as to provide guidance for clinical nursing practice.Methods:Based on the methods of evidence-based nursing,clinical questions about the prevention and management of enteral nutrition-related vomitting in patients with mechanical ventilation were raised.According to the 6S evidence pyramid model,literatures on the prevention and management of enteral nutrition-related vomitting in hospitalized patients were retrieved from relevant websites and databases both at home and abroad from their inception to June 5,2024.Two researchers with evidencebased nursing research background independently evaluated the quality of the literatures and extracted evidence to sort them out and analyze them.Results:A total of 16 articles were included,containing 5 guidelines,4 expert consensus,4 evidence summaries,3 systematic reviews.We summarized 26 pieces of evidence which were then classified into 3 themes,namely,risk assessment and risk factor identification,prevention and treatment,and monitoring and management of enteral nutrition-associated vomitting in patients with mechanical ventilation.Conclusion:This study summarizes the evidence for the prevention and management of enteral nutrition-associated vomitting in mechanically ventilated patients so that nurses can follow the evidence and select personalized prevention and management plans combined with clinical situations to promote evidence-based nursing practice of those patients.