身体外生命維持における緩和ケアの結果:体系的なレビュー
Whitney A Kiker1, Anna L Condella2, Astrid Grouls3
1University of Washington, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, WA; Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA.
Journal of pain and symptom management
|August 28, 2025
まとめ
身体外生命維持装置 (ECLS) を施した患者の特別の緩和治療は死亡率に影響しなかった. 他の患者中心的な結果への影響を理解するには,さらなる研究が必要です.
科学分野:
- クリティカル ケア 医療
- 緩和ケア
- 健康 成果 研究
背景:
- 身体外生命維持 (ECLS) の緩和ケアの使用は増加しています.
- ECLSにおける患者と家族を中心としたアウトカムに対する緩和ケアの影響は十分に理解されていません.
研究 の 目的:
- ECLSを受診する患者と家族を中心としたアウトカムとの関連を調査する.
主な方法:
- 複数のデータベース (PubMed,EMBASE,CINAHL,Web of Science,Cochrane) の体系的なレビュー
- 2人の独立した調査者が適用した含有基準.
- 推薦の評価,開発,評価の格付け (GRADE) を用いて評価された証拠の質
主要な成果:
- 21, 417人のECLS患者 (4, 368人が緩和治療を受けた) を対象とした9つの観察研究では,
- すべての結果に対する証拠の確実性は非常に低い.
- 病院での死亡率の有意な差は,緩和医療の診察を受けた患者と診察を受けなかった患者の間で認められませんでした. いくつかの研究では,より多くのケア目標と,より長いECLSの持続期間が,緩和ケアで示されました.
結論:
- ECLSにおける患者と家族を中心としたアウトカムに対する緩和ケアの影響に関する研究は限られている.
- 緩和治療はECLS患者の死亡率に悪影響を及ぼさないようです.
- 緩和ケアがECLS患者に与える役割と影響を明らかにするために,さらなる研究が不可欠です.
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