医院获得和呼吸机相关肺炎的临床实践指南:一个范围审查
Diana Manuela Ticona1, Leonardo J Uribe-Cavero2, Lelis G Coronel-Chucos3
1Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, 15001, Peru.; Oficina de Gestión de la Calidad, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, 15001, Peru.
医疗保健相关肺炎 (HAP) 和呼吸机相关肺炎 (VAP) 的临床实践指南在质量和建议方面有所不同. 需要改善基于证据的HAP和VAP患者护理的发展.
科学领域:
- 传染性疾病 传染性疾病
- 临床实践指南 临床实践指南
- 基于证据的医学基于证据的医学.
背景情况:
- 与医疗保健相关的肺炎 (HAP) 和与呼吸机相关的肺炎 (VAP) 存在重大临床挑战.
- 诊断和管理的复杂性导致高患病率和死亡率.
- 现有的临床实践指南 (CPG) 的可靠性需要评估.
研究的目的:
- 总结用于HAP和VAP诊断和管理的CPG的特性和可靠性.
- 评估当前CPG中建议的方法严谨性和一致性.
主要方法:
- 在2015年至2025年2月期间发布或更新的CPG的范围审查.
- 基于系统审查的建议被优先考虑.
- 在多个数据库进行搜索,包括PubMed,Trip数据库和谷歌学者.
- 用于CPG质量评估的AGREE II工具.
主要成果:
- 确定了6个CPG,它们都采用了GRADE方法.
- 只有三个CPG包括结论总结 (SoF) 表;没有一个使用了决定证据 (EtD) 框架.
- 四个CPG获得了≥70%的AGREE-II评分.
- 建议在8个主题中一致,在5个主题中有所不同,在1个主题中有矛盾.
结论:
- 对HAP和VAP的CPG在方法质量和建议方面表现出显著的变化.
- 对SoF表和EtD框架的有限使用阻碍了准则制定中的透明度.
- 加强指南的制定对于支持基于证据的HAP和VAP管理至关重要.
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