加强手术后康复 (ERAS) 协会对新生儿外科手术期间护理的建议
Mercedes Pilkington1,2, Gregg Nelson2,3, Brandon Pentz4
1Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
这项研究为新生儿重症监护室 (NICU) 接受手术的新生儿制定了16项基于证据的手术后增强恢复 (ERAS) 建议. 这些指导方针旨在改善所有外科手术新生儿的术后护理,无论他们的具体情况如何.
科学领域:
- 新生儿手术 新生儿手术
- 基于证据的医学是基于证据的医学.
- 在外科手术后的护理
背景情况:
- 需要手术的新生儿通常在新生儿重症监护室 (NICU) 进行管理.
- 尽管手术条件不同,但新生儿有共同的术后优先事项.
- 这些共同的优先事项使得整个单位能够制定手术后增强恢复 (ERAS) 建议.
研究的目的:
- 为新生儿进入NICU的新生儿制定基于证据的手术后增强恢复 (ERAS) 准则.
- 制定适用于新生儿各种外科病理的单位范围的建议.
- 为了标准化和改善外科手术新生儿的术后护理.
主要方法:
- 成立了一个多学科的指导方针制定委员会,包括儿科外科医生,麻醉师,新生儿护士,新生儿科医生和ERAS专家.
- 一个经过修改的Delphi技术确定了42个潜在的主题,共识了21个主题领域.
- 系统性文献审查选了5763篇摘要,包括98篇全文文章,制定了11个主题领域的16条建议.
主要成果:
- 开发了16个基于证据的建议,用于新生儿在NICU内进行外科手术周护理.
- 关键的建议领域包括团队沟通,手术前禁食,温度调节,抗生素预防,通风,液体管理,血糖控制,输血门,肠道养和家长支持.
- 由于数据不足,无法就鼻胃管,福利导管和中心线做出建议.
结论:
- 在新生儿重症监护室的新生儿周围手术护理允许制定标准化的ERAS建议,无论手术程序如何.
- 开发的16个ERAS建议旨在在NICU中实施,以造福所有接受手术的新生儿.
- 这些指南旨在通过基于证据的实践优化外科手术新生儿的结果.
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