姑息拔管在重症监护病房和在家里的儿科患者:一个范围审查。

IF 1.3 Q3 PEDIATRICS International Journal of Pediatrics Pub Date : 2023-11-28 eCollection Date: 2023-01-01 DOI:10.1155/2023/6697347
Joana Neto, Hugo Jorge Casimiro, Paulo Reis-Pina
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引用次数: 0

摘要

目的:本范围审查的目的是系统地绘制证据姑息拔管在儿科重症监护病房。方法:检索MEDLINE、EBSCO和Cochrane数据库,检索2018年1月至2022年12月间发表的英文文章。对证据来源的批判性评估是使用乔安娜布里格斯研究所的工具完成的。遵循PRISMA的范围审查准则。结果:纳入6项研究,共366例患者,分别来自美国(n = 4)、巴西(n = 1)和德国(n = 1)。其中3项为高质量研究,2项为中等质量研究,1项为低质量研究。大多数研究为回顾性分析;两种是叙事方法;两个是循证推荐和质量改进项目;一项研究是前瞻性干预。结论:拔管前后症状控制至关重要。检查表(症状管理和家庭支持)和汇报后模板可改善团队沟通和工作人员对拔管后的支持。从医院运送重症监护病人在家提供拔管是可行的。建议为家庭拔管制定一个解决共同规划挑战和资源管理的框架。提供小儿姑息拔管是必要的,因为无效的措施和延长痛苦违反了无害原则。未来对这一课题的研究将为患者、家长和专业人士带来更多好处。
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Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review.

Aim: This scoping review is aimed at systematically mapping the evidence on palliative extubation in the pediatric intensive care unit.

Methods: MEDLINE, EBSCO, and Cochrane databases were searched for articles published between January 2018 and December 2022, in English. Critical appraisal of sources of evidence was done using the Joanna Briggs Institute tools. PRISMA guidelines for scoping reviews were followed.

Results: Six studies were included, with 366 patients, from the USA (n = 4), Brazil (n = 1), and Germany (n = 1). Three were high-quality studies, two were moderate, and one was a low-quality study. Most studies were retrospective analysis; two were narrative approaches; two were evidence-based recommendation and quality improvement project; one study was a prospective intervention.

Conclusion: Symptom control is crucial pre- and postextubation. A checklist (symptom management and family support) and a postdebriefing template improve team communication and staff support postextubation. Critical care transports from the hospital are feasible to provide extubation at home. A framework addressing common planning challenges and resource management is recommended for extubation at home. The provision of pediatric palliative extubation is necessary since futile measures and prolongation of suffering violate the principle of nonmaleficence. Future research on this subject will result in more benefits for patients, parents, and professionals.

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来源期刊
CiteScore
3.90
自引率
0.00%
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0
审稿时长
4 weeks
期刊介绍: International Journal of Pediatrics is a peer-reviewed, open access journal that publishes original researcharticles, review articles, and clinical studies in all areas of pediatric research. The journal accepts submissions presented as an original article, short communication, case report, review article, systematic review, or letter to the editor.
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