Evidence-Based Practices for Acute Respiratory Failure and Acute Respiratory Distress Syndrome: A Systematic Review of Reviews.
Evidence-Based Practices for Acute Respiratory Failure and Acute Respiratory Distress Syndrome: A Systematic Review of Reviews.
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DOI：
10.1016/j.chest.2020.06.080
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发表时间：
2020-12
期刊：
影响因子：
9.6
通讯作者：
Sales AE
中科院分区：
文献类型：
--
作者：
Ervin JN;Rentes VC;Dibble ER;Sjoding MW;Iwashyna TJ;Hough CL;Ng Gong M;Sales AE
最近的大流行突出了在复杂的重症监护环境中优化有创机械通气（IMV）使用的重要性。这篇综述映射了与急性呼吸衰竭或ARDS成人患者从插管到解放的连续护理中更好结局相关的循证实践（EBP）。在急性呼吸衰竭/ARDS患者中，推荐使用哪些EPB来缩短IMV持续时间和降低死亡率？我们确定了一组将EBPs与死亡率和/或IMV持续时间联系起来的初始报告。我们对综述进行了回顾，重点是预评价指南、荟萃分析和系统性综述。我们从2016年1月到2019年1月检索了Scopus、CINAHL和PubMed，以寻找尚未纳入当前指南的其他证据。我们最初的搜索产生了61篇包含42个EBP的出版物。我们在数据提取过程中排除了42篇手稿，主要是因为它们与改善患者结局无关。其余19个预先评估的指南、荟萃分析和系统评价符合我们的全部纳入标准，并且涵盖了从插管到解放的IMV护理的连续性。这些包含20个EBP，其中大多数得到中等证据水平的支持。其中，6个EBP侧重于插管和护理升级，如呼吸机管理和同步; 10个EBP减少了与IMV相关的并发症，其中包括自发觉醒和呼吸试验以及早期移动协议; 4个EBP促进了及时拔管和拔管后恢复。本综述描述了在接受IMV治疗急性呼吸衰竭/ARDS的患者中，与呼吸机天数减少和/或死亡率降低相关的EBP。其中许多优先事项在整个护理连续体中相互关联，这表明需要共同促进和评估有效执行，而不是单独执行。
The recent pandemic highlights the essential nature of optimizing the use of invasive mechanical ventilation (IMV) in complex critical care settings. This review of reviews maps evidence-based practices (EBPs) that are associated with better outcomes among adult patients with acute respiratory failure or ARDS on the continuum of care, from intubation to liberation. What EPBs are recommended to reduce the duration of IMV and mortality rate among patients with acute respiratory failure/ARDS? We identified an initial set of reports that links EBPs to mortality rates and/or duration of IMV. We conducted a review of reviews, focusing on preappraised guidelines, meta-analyses, and systematic reviews. We searched Scopus, CINAHL, and PubMed from January 2016 to January 2019 for additional evidence that has not yet been incorporated into current guidelines. Our initial search produced 61 publications that contained 42 EBPs. We excluded 42 manuscripts during the data extraction process, primarily because they were not associated with improved patient outcomes. The remaining 19 preappraised guidelines, meta-analyses, and systematic reviews met our full inclusion criteria and spanned the continuum of IMV care from intubation to liberation. These contained 20 EBPs, a majority of which were supported with moderate levels of evidence. Of these, six EBPs focused on intubation and escalation of care, such as ventilator management and synchrony; ten EBPs reduced complications associated with IMV, which included spontaneous awakening and breathing trials and early mobility protocols; and four EBPs promoted timely extubation and postextubation recovery. This review describes EBPs that are associated with fewer ventilator days and/or lower mortality rates among patients who received IMV for acute respiratory failure/ARDS. Many of these EBPs are connected across the care continuum, which indicates the need to promote and assess effective implementation jointly, rather than individually.
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影响因子：
4
作者：
Smith V;Devane D;Begley CM;Clarke M
通讯作者：
Clarke M
影响因子：
158.5
作者：
Amato, MBP;Barbas, CSV;Carvalho, CRR
通讯作者：
Carvalho, CRR
影响因子：
8.8
作者：
Murray, Michael J.;DeBlock, Heidi;Mehta, Sangeeta
通讯作者：
Mehta, Sangeeta
DOI：
10.1164/rccm.201610-2076st
发表时间：
2017-01-01
影响因子：
24.7
作者：
Schmidt, Gregory A.;Girard, Timothy D.;Truwit, Jonathon D.
通讯作者：
Truwit, Jonathon D.
影响因子：
8.8
作者：
Aggarwal NR;Brower RG;Hager DN;Thompson BT;Netzer G;Shanholtz C;Lagakos A;Checkley W;National Institutes of Health Acute Respiratory Distress Syndrome Network Investigators
通讯作者：
National Institutes of Health Acute Respiratory Distress Syndrome Network Investigators