后重症监护病房诊所:模型和实施 - - 系统性审查
Sourav Chatterjee1, Swagata Tripathy2,3, Subhasish Nayak1
1Department of Anaesthesiology and Critical Care, AIIMS, Bhubaneswar, India.
Critical care (London, England)
|October 7, 2025
概括
混合后ICU诊所显示出改善低资源环境中的护理的希望. 量身定制的混合模型平衡面对面和远程医疗可以提高后重症监护综合征 (PICS) 患者的随访,尽管存在实施挑战.
科学领域:
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 后重症监护综合征 (PICS) 为幸存者带来了重大的身体,认知和心理挑战.
- 结构化的后续护理,包括ICU后诊所,至关重要,但在低收入和中等收入国家 (LMICs) 欠发达.
研究的目的:
- 系统地审查ICU后的临床模型.
- 确定实施这些诊所的障碍和促进者.
- 评估这些模型在LMICs中的适用性.
主要方法:
- 遵循PRISMA指南的系统审查,注册在PROSPERO.
- 在Medline,Embase和CINAHL搜索了2000年以后发表的关于成人后ICU诊所的研究.
- 包括19项具有不同设计的研究;使用乔安娜·布里格斯研究所检查清单评估偏差风险;由CFIR指导的主题综合.
主要成果:
- 确定了三种模式:基于医院的,混合 (面对面/远程医疗) 和完全远程 (远程医疗/家庭访问).
- 远程医疗/家庭访问模型获得了最高的出席率 (88.7%);混合模型 (59%) 和物理模型 (51.9%) 的比例较低.
- 障碍包括资源限制和运输;促进者包括灵活的日程安排和远程医疗. 混合模型对LMIC有希望,但结果数据有限.
结论:
- 混合后ICU诊所提供了一种可行的方法来改善LMIC随访护理,当适应当地需求时.
- 实施需要解决资金和基础设施障碍,基于对长期患者结果的有限证据.
- 这些研究结果支持在资源有限的环境中制定特定背景的ICU后护理策略.
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