随机临床试验中的早期动员剂量报告与机械通风患者:一个范围审查
Felipe González-Seguel1,2, Renato Letelier-Bernal2
1School of Physical Therapy, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
Physical therapy
|March 22, 2024
概括
在重症监护室随机临床试验中报告动员剂量通常是不完整的,特别是在运动强度方面. 这种缺乏细节,阻碍了早期动员试验结果的解释.
科学领域:
- 关键护理医学 关键护理医学
- 康复科学 康复科学 康复科学
- 临床试验方法论 临床试验方法论
背景情况:
- 早期动员对于在重症监护室 (ICU) 接受机械呼吸的患者至关重要.
- 调动干预措施的标准化报告,包括剂量,对于可重复性和临床应用至关重要.
- 之前的研究表明,关键护理干预措施的报告质量存在差异.
研究的目的:
- 在涉及机械通风ICU患者的随机临床试验 (RCT) 中对动员剂量报告进行范围审查.
- 评估动员干预报告的完整性,使用关于演习报告模板 (CERT) 的共识.
- 发现报告特定动员剂量组件的缺陷.
主要方法:
- 系统地搜索到2022年12月之前发表的RCT的电子数据库.
- 包括涉及成人患者接受机械通风超过48小时和任何早期动员的试验.
- 数据提取和评估动员剂量报告基于CERT项目对干预和比较组的数据提取和评估.
主要成果:
- 分析了23个涉及2707名患者的RCT,涵盖了各种动员方式.
- 关于CERT项目总体汇总报告率为68%,干预组 (IG) 为86%,比较组 (CG) 为50%.
- 报告的主要缺陷包括运动强度 (IG为4%,CG未报告),个性化 (IG为22%,CG未报告) 和进展,特别是在CG中. 只有35%的IG报告了所有CERT项目,而没有CG报告.
结论:
- 在ICU RCT中报告动员剂量存在重大缺陷,特别是在运动强度和个性化方面.
- 不一致的报告,特别是在对比组中,可能会导致早期动员的元分析结果的变化.
- 未来的研究应该优先考虑详细报告动员剂量,特别是对照组,以加强临床解释和应用.
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