ICU获得性衰弱患者早期活动的最佳证据总结

目的 检索并总结成人患者ICU获得性衰弱早期活动的相关证据,为医护人员对ICU获得性衰弱患者实施早期活动提供循证依据.方法 系统检索2011年1月1日至2021年1月31日国内外循证数据库、指南及协会网站、相关原始文献数据库中有关ICU获得性衰弱成人早期活动的指南、最佳实践信息册、系统评价、证据总结、Meta分析、专家共识、高质量随机对照试验,由2名经过循证培训的研究者独立完成文献质量评价后,对符合质量标准的文献进行证据提取及总结.结果 共纳入13篇文献,其中指南2篇、专家共识2篇、系统评价/Meta分析3篇、随机对照试验6篇.形成最佳证据26条,包括活动前评估、安全标准、活动时间、活动强度、活动阶段、活动内容和注意事项7个方面.结论 ICU获得性衰弱成人患者早期活动安全可行,建议医护人员可以根据ICU获得性衰弱的最佳证据制订个性化干预方案,促进早期活动循证实践,减少ICU获得性衰弱的不良预后.

Best evidence summary of early activities for patients with ICU acquired weakness

Objective To search and summarize the relevant evidence of early activities for adult patients with ICU acquired weakness, so as to provide reference for medical staff conducting early activities for this population. Methods Relevant guidelines, best practices, systematic review, evidence summary, Meta analysis, expert consensus and high quality randomized controlled trials on the early activity of adult with ICU acquired weakness published from January 1, 2011 to January 31, 2021, in evidence summary database, guideline and association website, relevant primary literature database, were systematically searched. Then two evidence-based nursing trained researchers independently evaluated the literature quality, and the evidences were extracted and summarized from the included high quality literature. Results A total of 13 literatures were included, which were consisted of 2 guidelines, 2 expert consensus articles, 3 systematic reviews/meta analysis and 6 randomized controlled trials. Totally 26 best evidences were developed, including pre-activity assessment, safety standards, activity time, activity intensity, activity stage, activity content and precautions. Conclusion Early activities for adult patients with ICU acquired weakness are safe and feasible. It is suggested that medical staff develop personalized intervention plan according to the summarized best evidence, so as to promote evidence-based practice of early activities, and reduce the poor prognosis of ICU acquired weakness.