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上肢外周神经损伤在ARDS患者需要容易定位:一个系统性审查与比例的元分析

Filippo Binda¹, Simone Gambazza², Federica Marelli³

¹Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Healthcare Professions, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Intensive & critical care nursing

|August 10, 2024

概括

一项元分析发现,13%的急性呼吸困扰综合征 (ARDS) 的重症监护病房患者在倾斜定位时出现上肢神经损伤 (PNI). 这强调了需要专门培训和仔细的患者评估,以防止PNI.

科学领域:

关键护理医学关键护理医学
神经学神经学
系统性审查和元分析

背景情况:

躺卧是急性呼吸困扰综合征 (ARDS) 患者在重症监护室 (ICU) 的关键干预措施.
然而,倾斜的位置带有风险,包括潜在的外周神经损伤 (PNI) 到上肢.
在接受倾斜定位的ARDS患者中,这些损伤的患病率需要进行系统的调查.

研究的目的:

为了确定上肢外围神经损伤 (PNI) 在成人ICU患者的患有ARDS的患病率.
通过系统审查和元分析综合现有证据,以提供综合流行率估计.

主要方法:

按照PRISMA和MOOSE指南进行系统审查和元分析.
搜索了四个主要的电子数据库 (PubMed,CINAHL,Cochrane图书馆,EMBASE) 到2024年1月.
使用乔安娜·布里格斯研究所的批判性评估工具评估研究质量,并进行了比例的元分析.

主要成果:

包括8项研究,共511名患者.
上肢PNI的综合流行率为13% (95% CI:5%至29%),具有显著的异质性 (I2 = 84.6%).
部神经病变和部plexopathy是最经常报告的神经损伤.

结论:

在接受倾斜定位治疗的ARDS患者中,很大一部分 (13%) 经历了上肢PNI.
易受定位方法的变化和潜在的选择性报告可能会导致异质性.
强调需要专门培训,标准化方案,以及在ICU后和随访期间对患者进行彻底评估,以减轻神经损伤风险.

关键词:

臂神经病变臂神经病变在 COVID-19 疫情中,重症监护病房的重症监护病房是重症监护病房.周围神经受伤的情况.在俯卧的位置.呼吸困扰综合征是呼吸困扰综合征.

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