成人危重患者低体温复温管理的证据总结

目的 总结成人危重低体温患者复温管理的相关证据,为临床实践提供指导。方法 根据循证护理方法确立循证问题,根据证据的“6S”模型,从“证据金字塔”上层开始检索国内外有关成人危重患者低体温复温管理的相关证据,证据资源类型包括临床决策、推荐实践、证据总结、指南、专家共识。由2名研究人员独立进行文献质量评价,并对符合质量标准的文献进行证据内容提取。结果 共纳入8篇文献,包括2篇临床决策,1篇推荐意见,3篇证据总结,2篇专家共识。共提取出涉及体温监测（3条证据）、复温目标（2条证据）、复温措施选择（5条证据）、复温风险管理（7条证据）、复温并发症监测（5条证据）的22条证据,证据等级1~5级。结论 本研究从5个维度汇总了成人危重患者低体温复温管理证据,为临床实践提供了理论指导。但本研究汇总的证据来源多为国外研究,建议研究者在使用本次汇总的证据时,要充分评估每条证据在临床的可行性、适宜性、临床意义和有效性,并评估证据在临床应用的障碍与促进因素,以确保证据在临床的顺利应用。

Evidence Summary of Rewarming Management of Hypothermia in Critically Ill Adult Patients

Objective To summarize the best evidence regarding rewarming management in critically ill adult hypothermia patients, so as to provide reference for clinical practice.Methods Evidence-based nursing helped to identify the research problem. According to the "6S" model of evidence, the evidence regarding hypothermia rewarming management of adult critically ill patients was searched from the upper level of "evidence pyramid". Clinical decisions, recommended practices, evidence summary, clinical guidelines and expert consensus were included in this study.Two researchers evaluated the quality of the literature independently and extracted the evidence content of the literature which met the quality standard. Results Eight articles were included in this study, including 2 clinical decisions, 1 recommended opinion, 3 evidence summary and 2 expert consensus. A total of 22 pieces of evidence from 5 dimensions were summarized, including temperature monitoring (3), rewarming goal (2), rewarming measures selection (5), rewarming risk management (7) and rewarming complication monitoring (5). Evidence level ranged from grade 1 to 5. Conclusion We summarized the evidence of hypothermia rewarming management in critically ill adult patients from 5 dimensions, which provides theoretical guidance for clinical practice.However, most of the evidence are extracted from foreign studies. It is suggested that when using the evidence collected in this study, researchers should fully evaluate the feasibility, appropriateness, meaningfulness and effectiveness of each piece of evidence and the obstacles and promoting factors of evidence clinical application should be assessed simultaneously, so as to ensure the successful application of the evidence.