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題名:俯臥對加護病房急性呼吸窘迫症候群病人之氧合與合併症成效--系統性回顧暨統合分析
書刊名:護理暨健康照護研究
作者:張惠君簡慧足胡月娟 引用關係
作者(外文):Chang, Hui-chunChien, Hui-tsuHwu, Yueh-juen
出版日期:2014
卷期:10:3
頁次:頁178-189
主題關鍵詞:系統性回顧急性呼吸窘迫症候群俯臥氧合合併症Systematic reviewAcute respiratory distress syndromeProne positioningOxygenationComplications
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 共同引用共同引用:7
  • 點閱點閱:138
背景:急性呼吸窘迫症候群是加護病房常見、致死率高的疾病,俯臥是經濟且安全的照護方式,可以改善病人的氧合,增加吐氣末肺部的容積,改善肺部通氣灌流不平衡。目的:本研究運用系統性回顧,探討俯臥對改善急性呼吸窘迫症候群病人氧合及降低合併症之成效。方法:搜尋PubMed、Cochrane Library、CINAHL(Cumulative Index to Nursing and Allied Health Literature)、eMedline、ProQuest Dissertations and Themes、中文電子學位論文服務(Chinese Electronic Theses & Dissertations Service, CETD)、中文電子期刊服務資料庫(Chinese Electronic Periodical Services, CEPS)、全國博碩士論文資料庫、及臺灣期刊論文等資料庫,以設定的關鍵字進行文獻搜尋,共納入19篇研究,含9篇隨機控制實驗研究及10篇非隨機控制實驗研究。研究品質以Joanna Briggs Institute Standardised Critical Appraisal Tools做評讀,使用RevMan 5.1進行統合分析。結果:俯臥能有效改善氧合(PaO_2/FiO_2;標準平均差71.38,95%信賴區間[52.74,90.03],p<.00001);合併症部份,俯臥不會影響呼吸器相關肺炎(勝算比0.91,95%信賴區間[0.45,1.85],p=.80)與非預期氣管內管脫落(勝算比2.31,95%信賴區間[0.59,9.01],p=.23)的發生率,但會增加壓瘡的發生(勝算比5.67,95%信賴區間[1.24,25.87],p=.03)。結論/實務應用:為急性呼吸窘迫症候群病人執行俯臥能改善其氧合,未來運用於臨床實務中,將每一俯臥執行步驟做好,以維護病人安全,提升護理品質,降低加護病房病人的住院天數及減少醫療費用。
Background: Acute respiratory distress syndrome (ARDS) is a common disease in the intensive care unit with a high rate of mortality. Prone positioning is an economic and safe treatment for patients with this disease. Prone positioning improves oxygenation, increases end expiratory lung volume, improves imbalances in lung ventilation, and changes the thoracic wall mechanics in ARDS patients. Purpose: This article uses systematic review to examine the effects of prone positioning on oxygenation and complications in ARDS patients. Methods: PubMed, Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), eMedline, Chinese Electronic Theses & Dissertations Service (CETD), Chinese Electronic Periodical Services (CEPS), National Digital Library of Theses and Dissertations in Taiwan, and Taiwan Periodical Literature System databasewere searched with predetermined keywords. Nineteen studies, including 9 randomized control trials (RCTs) and 10 non‐randomized control trials (non‐RCTs) that met the inclusion criteria, were included. Standardized critical appraisal tools from the Joanna Briggs Institute (JBI) were used to assess methodological quality. RevMan 5.1 software was used to conduct the meta‐analysis. Results: Prone positioning improved oxygenation, defined as the PaO_2/FiO_2 ratio (mean difference 71.38, 95% CI [52.74, 90.03], p < .00001). With regard to complications, prone positioning did not influence the incidence of ventilator associated pneumonia (odds ratio [OR] 0.91, 95% CI [0.45, 1.85], p = .80) or unplanned extubation (OR = 2.31, 95% CI [0.59, 9.01], p = .23). However, prone positioning did have a significant effect on the incidence of pressure sores (OR = 5.67, 95% CI [1.24, 25.87], p = .03). Conclusions/Implications for Practice: This review supports the use of prone positioning to improve oxygenation in ARDS patients in clinical practice. Careful implementation by nursing staffs of each prone positioning procedure helps maintain patient safety, improve quality of care, decrease length of hospitalization, and reduce medical costs.
期刊論文
1.羅淑芬、張麗蓉、曹文昱(20120800)。重症病人壓瘡問題的預防與照護。護理雜誌,59(4),24-29。new window  延伸查詢new window
2.王伯堅、陳重華、陽光耀(20080000)。急性肺損傷治療的新進展。中華民國重症醫學雜誌,9(2),117-125。  延伸查詢new window
3.汪繼斌、朱綉峰(2010)。液體敷料和聚酯凝膠墊在手術病人壓瘡預防中的應用。海南醫學院學報,16(10),1366-1368。  延伸查詢new window
4.陳惠娟、黃佩瑜、吳惠東(2013)。急性呼吸窘迫症候群醫療資源耗用與相關因子之探討。呼吸治療,12(1),32-40。  延伸查詢new window
5.游群翔、陳炯睿(20120200)。俯臥通氣與急性呼吸窘迫症候群。內科學誌,23(1),1-8。  延伸查詢new window
6.鄒志翔(2007)。急性呼吸窘迫症候群呼吸器治療之進展。北市醫學雜誌,4(9),919−925。  延伸查詢new window
7.Alsaghir, A. H.、Martin, C. M.(2008)。Effect of prone positioning in patients with acute respiratory distress syndrome: A meta-analysis。Critical Care Medicine,36(2),603-609。  new window
8.Bernard, G. R.、Artigas, A.、Brigham, K. L.、Carlet, J.、Falke, K.、Hudson, L.、Spragg, R.(1994)。The American European Consensus Conference on ARDS: Definition, mechanism, relevant outcome, and clinical trial coordination。American Journal of Respiratory and Critical Care Medicine,149(3),818-824。  new window
9.Chan, Ming-Cheng、Hsu, Jeng-Yuan、Liu, Hsiu-Hwa、Lee, Yao-Ling、Pong, Su-Chen、Chang, Li-Yin、Wu, Chieh-Liang(20070900)。Effects of Prone Position on Inflammatory Markers in Patients with ARDS Due to Community-acquired Pneumonia。Journal of the Formosan Medical Association,106(9),708-716。  new window
10.詹明澄、吳杰亮、彭素貞、劉秀華、張麗銀、金湘玲、江自得(20031200)。The Experience of Continuous Prone Position Ventilation in Patients with Severe Community--Acquired Pneumonia in Taichung Veterans General Hospital, Taiwan。胸腔醫學,18(6),486-492。  延伸查詢new window
11.Demory, D.、Michelet, P.、Arnal, J. M.、Donati, S.、Forel, J. M.、Gainnier, M.、Papazian, L.(2007)。High-frequency oscillatory ventilation following prone positioning prevents a further impairment in oxygenation。Critical Care Medicine,35(1),106-111。  new window
12.Ferguson, N. D.(2007)。Inhaled nitric oxide for acute respiratory distress syndrome。British Medical Journal,334(7597),757-758。  new window
13.Fernandez, R.、Trenchs, X.、Klamburg, J.、Castedo, J.、Serrano, J. M.、Lopez, M. J.(2008)。Prone positioning in acute respiratory distress syndrome: A multicenter randomized clinical trial。Intensive Care Medicine,34(8),1487-1491。  new window
14.Gainnier, M.、Michelet, P.、Thirion, X.、Arnal, J. M.、Sainty, J. M.、Papazian, L.(2003)。Prone position and positive end-expiratory pressure in acute respiratory distress syndrome。Critical Care Medicine,31(12),2720-2726。  new window
15.Galiatsou, E.、Kostanti, E.、Svarna, E.、Kitsakos, A.、Koulouras, V.、Efremidis, S. C.、Nakos, G.(2006)。Prone position augments recruitment and prevents alveolar overinflation in acute lung injury。American Journal of Respiratory and Critical Care Medicine,174(2),187-197。  new window
16.Gao, J. L.、Li, X. L.、Zhao, H. Y.、Yan, X. Z.、Ma, Y. J.、Liang, J. T.、Wei, Z. L.(2005)。Role of prone position mechanical ventilation in patients with acute respiratory distress syndrome originating from pulmonary disease and extra-pulmonary disease。Chinese Critical Care Medicine,17(8),487-490。  new window
17.Huang, Y. Z.、Qiu, H. B.、Liu, L.、Yang, Y.、Yan, Y. L.(2004)。How to choose the duration of prone-position ventilation in patients with acute respiratory distress syndrome caused by pulmonary or extrapulmonary diseases?。Chinese Journal of Internal Medicine,43(12),883-887。  new window
18.Kopterides, P.、Siempos, I. I.、Armaganidis, A.(2009)。Prone positioning in hypoxemic respiratory failure: Meta-analysis of randomized controlled trials。Journal of Critical Care,24(1),89-100。  new window
19.Lee, D. L.、Chiang, H. T.、Lin, S. L.、Ger, L. P.、Kun, M. H.、Huang, Y. C. T.(2002)。Prone-position ventilation induces sustained improvement in oxygenation in patients with acute respiratory distress syndrome who have a large shunt。Critical Care Medicine,30(7),1446-1452。  new window
20.Maillet, J. M.、Thierry, S.、Brodaty, D.(2007)。Prone positioning and acute respiratory distress syndrome after cardiac surgery: A feasibility study。Journal of Cardiothoracic and Vascular Anesthesia,22(3),414-417。  new window
21.Mancebo, J.、Fernández, R.、Blanch, L.、Rialp, G.、Gordo, F.、Ferrer, M.、Albert, R. K.(2006)。A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome。American Journal of Respiratory and Critical Care Medicine,173(11),1233-1239。  new window
22.Michelet, P.、Roch, A.、Gainnier, M.、Sainty, J. M.、Auffray, J. P.、Papazian, L.(2005)。Influence of support on intraabdominal pressure, hepatic kinetics of indocyanine green and extravascular lung water during prone positioning in patients with ARDS: A randomized crossover study。Critical Care,9(3),251-257。  new window
23.Miller, R. D.、Fowler, W. S.、Helmholz, H. F.(1956)。Changes of relative volume and ventilation of the two lungs with change to the lateral decubitus position。Journal of Laboratory and Clinical Medicine,47(2),297-304。  new window
24.Mounier, R.、Adrie, C.、Francais, A.、Garrouste-Orgeas, M.、Cheval, C.、Allaouchiche, B.、Ricard, J. D.(2010)。Study of prone positioning to reduce ventilator-associated pneumonia in hypoxaemic patients。European Respiratory Journal,35(4),795-804。  new window
25.Oczenski, W.、Hörmann, C.、Keller, C.、Lorenzl, N.、Kepka, A.、Schwarz, S.、Fitzgerald, R. D.(2005)。Recruitment maneuvers during prone positioning in patients with acute respiratory distress syndrome。Critical Care Medicine,33(1),54-61。  new window
26.Papazian, L.、Gainnier, M.、Marin, V.、Donati, S.、Arnal, J. M.、Demory, D.、Sainty, J. M.(2005)。Comparison of prone positioning and high-frequency oscillatory ventilation in patients with acute respiratory distress syndrome。Critical Care Medicine,33(10),2162-2171。  new window
27.Pelosi, P.、Brazzi, L.、Gattinoni, L.(2002)。Prone position in acute respiratory distress syndrome。European Respiratory Journal,20(4),1017-1028。  new window
28.Pelosi, P.、Croci, M.、Calappi, E.、Cerisara, M.、Mulazzi, D.、Vicardi, P.、Gattinoni, L.(1995)。prone positioning during general anesthesia minimally affects respiratory mechanics while improving functional residual capacity and increasing oxygen tension。Anesthesia and Analgesia,80(5),955-960。  new window
29.Piehl, M. A.、Brown, R. S.(1976)。Use of extreme position changes in acute respiratory failure。Critical Care Medicine,4(1),13-14。  new window
30.Reignier, J.、Lejeune, O.、Renard, B.、Fiancette, M.、Lebert, C.、Bontemps, F.、Martin-Lefevre, L.(2005)。Short-term effects of prone position in chronic obstructive pulmonary disease patients with severe acute hypoxemic and hypercapnic respiratory failure。Intensive Care Medicine,31(8),1128-1131。  new window
31.Rival, G.、Patry, C.、Floret, N.、Navellou, J. C.、Belle, E.、Capellier, G.(2011)。Prone position and recruitment manoeuvre: The combined effect improves oxygenation。Critical Care,15(3),125。  new window
32.Robak, O.、Schellongowski, P.、Bojic, A.、Laczika, K.、Locker, G. J.、Staudinger, T.(2011)。Short-term effects of combining upright and prone positions in patients with ARDS: A prospective randomized study。Critical Care,15(5),230。  new window
33.Samir, E. M.、Hamed, H. M. F.、Elgohary, M. M.(2010)。The effect of different positioning after lung recruitment with CPAP hold maneuver on oxygenation and lung mechanics in acute respiratory distress syndrome。Egyptian Journal of Anaesthesia,26(3),249-259。  new window
34.Voggenreiter, G.、Aufmkolk, M.、Stiletto, R. J.、Baacke, M. G.、Waydhas, C.、Ose, C.、Nast-Kolb, D.(2005)。Prone positioning improves oxygenation in post-traumatic lung injury − A prospective randomized trial。Journal of Trauma- Injury Infection and Critical Care,59(2),333-341。  new window
35.廖如文、洪培菁、張玲華、張秉宜、蕭鵬卿、顧乃平(20080000)。以前瞻性方式探討某醫學中心外科暨神經加護中心呼吸器相關肺炎感染因子。中華民國重症醫學雜誌,9(4),216-227。  延伸查詢new window
36.Augustyn, B.(2007)。Ventilator-associated pneumonia: Risk factors and prevention。Critical Care Nurse,27 (4),32-39。  new window
37.Safdar, N.、Dezfulian, C.、Collard, H. R.、Saint, S.(2005)。Clinical and economic consequences of ventilator-associated pneumonia: A systematic review。Critical Care Medicine,33(10),2184-2193。  new window
38.Rosenthal, R.(1979)。The 'File-Drawer Problem' and Tolerance for Null Results。Psychological Bulletin,86(3),638-641。  new window
39.莊其穆(20110200)。臨床醫師如何閱讀統合分析(Meta-analysis)的論文。臺灣醫界,54(2),18-26。  延伸查詢new window
其他
1.Joanna Briggs Institute(2011)。Module 3 − The appraisal, extraction and pooling of quantitative data,http://www.joannabriggs.edu.au.pdf。  new window
 
 
 
 
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