神经重症非机械通气患者气管插管拔管的最佳证据总结 [中文引用][英文引用]

目的  汇总神经重症非机械通气患者气管插管拔管的最佳证据，为临床工作提供参考和指导。方法  根据“6S”证据金字塔模型，采用计算机检索 UpToDate，BMJ Best Practice（BMJ），英国国家卫生与临床优化研究所（National Institutefor Health and Care Excellence，NICE），美国国立指南库（National Guideline Clearinghouse，NGC），国际指南协作网（GuidelinesInternational Network，GIN），苏格兰院际指南网（Scottish Intercollegiate Guidelines Network，SIGN），加拿大医学会临床实践指南（Canadian Medical Association：Clinical Practice Guideline，CMA Infobase），新西兰指南协作组（New Zealand Guidelines Group，NZGG），欧洲神经外科学会（European Association of Neurosurgical Societies，EANS），美国神经外科学会（American Association ofNeurological Surgeons，AANS），Cochrane Library，乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心数据库，Campbell，PubMed，Embase，CINAHL，ProQuest，Elsevier，EBSCO，Web of Science，CNKI，万方，维普，SinoMed 和医脉通中关于神经重症非机械通气患者气管插管拔管的文献包括临床决策、指南、系统评价、证据总结、专家共识和随机对照试验。检索时限为建库至 2024 年 3 月 31 日。由两名经过循证护理系统培训的研究者对纳入文献进行质量评价和证据提取。结果  最终纳入文献15 篇，包括临床决策 2 篇、指南 5 篇、系统评价 4 篇、证据总结 2 篇和专家共识 2 篇。汇总出包括拔管前评估、拔管前准备、拔管时操作、拔管后护理 4 个方面共 23 条证据。结论  本研究总结的神经重症非机械通气患者气管插管拔管最佳证据，可为临床实践提供循证依据。

Objective To summarise the best evidence of tracheal intubation and extubation in patients with non-ventilatedneurocritical care so as to provide a reference and guidance for clinical work. Methods The“6S”evidence-based pyramid model was employed to search multiple databases and sources，including UpToDate，BMJ Best Practice（BMJ），National Institute for Health andCare Excellence（NICE），National Guideline Clearinghouse（NGC），Guidelines International Network（GIN），Scottish IntercollegiateGuidelines Network（SIGN），Canadian Medical Association：Clinical Practice Guideline（CMA Infobase），New Zealand GuidelinesGroup（NZGG），European Association of Neurosurgical Societies（EANS），American Association of Neurological Surgeons（AANS），Cochrane Library，Joanna Briggs Institute（JBI），Campbell，PubMed，Embase，CINAHL，ProQuest，Elsevier，EBSCO，Web of Science，CNKI，Wanfang Data，VIP，SinoMed and Yimaitong，from inception of the databases to 31st March，2024 for literature on trachealextubation of the patients in non-ventilated neurocritical care. The retrieved literature included clinical decisions，guidelines，systematicreviews，evidence summaries，expert consensuses，and randomised controlled trials. Two researchers who were trained in evidence-basednursing comprehensively screened the quality of the included literature and extracted the evidences. Results A total of 15 articles wereincluded consisting of 2 clinical decisions，5 guidelines，4 systematic reviews，2 evidence summaries and 2 expert consensuses. Theywere synthesised into 23 evidence-based recommendations across 4 themes：pre-extubation assessment，pre-extubation preparation，extubation procedure and post-extubation care. Conclusion The best evidence on endotracheal intubation and extubation in patientswith non-ventilated neurocritical care summarised in this study provides an evidence-based reference for clinical practice.