老年危重症患者ICU后认知障碍管理的最佳证据总结

Summary of the best evidence for the management of post-intensive care syndrome-cognitive impairment in elderly critically ill patients

中文关键词: 老年  危重症患者  ICU后认知障碍  ICU后认知障碍管理  认知功能  证据总结  循证护理学

英文关键词: elderly  critically ill patient  PICS-CI  management of PICS-CI  cognitive function  summary of evidence  evidence-based nursing

中文摘要:

      目的 检索、评价并总结老年危重症患者ICU后认知障碍管理的证据,为ICU医护人员临床预防及干预实践提供依据.方法 系统检索国内外数据库及指南网站中关于老年危重症患者ICU后认知障碍管理的相关文献,检索时限为建库至2024年8月,根据纳入与排除标准筛选文献后,由2名经过循证培训的研究者独立对纳入文献进行质量评价、证据提取和总结.结果 纳入文献12篇,包括临床指南3篇、系统评价6篇以及随机对照试验3篇.汇总出24条最佳证据,涉及ICU后认知障碍症状识别、评估、防治策略.结论 本研究汇总的证据可为老年危重症患者ICU后认知障碍的管理提供参考,ICU医护人员应基于证据,在充分考虑科室人力资源及实际情况,并结合老年患者需求,审慎地将证据应用于临床工作中.

英文摘要:

      Objective To retrieve,evaluate and summarize evidences on the management of post-intensive care syn-drome-cognitive impairment(PICS-CI)in elderly critically ill patients,and provide a basis for clinical prevention and interven-tion practices of ICU medical staff.Methods A systematic search was conducted across domestic and international databases and guideline websites for literature related to the management of PICS-CI in elderly critically ill patients.The search timeframe spanned from the establishment of the databases to August 2024.After screening literature based on inclusion and exclusion cri-teria,two evidence-based trained researchers independently performed quality appraisal,evidence extraction,and summariza-tion of the included literature.Results A total of 12 studies were included,including 3 clinical guidelines,6 systematic re-views,and 3 randomized controlled trials.24 best evidence items were summarized,covering symptom recognition,assess-ment,and prevention and treatment strategies for PICS-CI.Conclusion The evidence summarized in this study can provide a reference for the management of PICS-CI in elderly critically ill patients.ICU medical staffs should,based on the evidence,fully consider the human resources and actual situation of the department,and in combination with the needs of elderly patients,prudently apply these evidences to clinical work.