Abstract:

Objective　To summarize the evidence related to thirst management in ICU adult patients with mechanical ventilation, and to identify the best evidence. Methods　A systematic search was conducted on domestic and foreign databases for relevant literatures on thirst management in ICU adult patients with mechanical ventilation, including guidelines, clinical decisions, systematic reviews, evidence summaries, original studies, recommended practices, and best clinical practice information books. The search period was from the establishment of the databases to June 30, 2023. Two researchers were responsible for evaluating the quality of the included medical literature databases, PubMed, International Guide Library, China Guide Network, and the British National Institute for Health and Care Excellence (NICE) clinical research literatures, and were responsible for extracting evidence consistent with quality standards. Results　Finally, 10 pieces of evidences were included, including 4 systematic reviews, 3 randomized controlled trials (RCTs), 1 expert consensus, and 2 evidence summaries. A total of 16 best evidences were formed from six aspects: influencing factors, evaluation content, evaluation tools, intervention measures, effect evaluation, and personnel management of thirst in ICU adult patients with mechanical ventilation. Conclusions　In terms of clinical application evidences, it is necessary to evaluate the clinical conditions/environment of the hospitals, the positive and negative factors of doctors and nurses in applying evidences, and patients' preferences to carry out targeted evidence selection. In addition, as the best evidence continues to be updated over time, users should also continuously update the evidences and effectively respond to the thirst management issues of adult critically ill patients through scientific nursing methods, thereby promoting the improvement of nursing quality.

Key words:

Intensive care unit, Mechanical ventilation, Thirst,  , Management, Evidence-based nursing, Evidence summary

摘要：

目的　总结重症监护室（ICU）成人机械通气患者口渴管理的相关证据，同时归纳最佳证据。方法　系统检索国内外数据库关于ICU成人机械通气患者口渴管理的相关文献，文献包括指南、临床决策、系统评价、证据总结、原始研究、推荐实践、最佳临床实践信息册。检索时限为建库至2023年6月30日。2名研究人员负责评价纳入医学文献数据库、PubMed、国际指南图书馆、中国指南网、英国国家临床医学研究文献的质量，同时负责与质量标准相符文献的证据提取。结果　最终纳入证据10篇，其中4篇为系统评价，3篇为随机对照试验（RCT），1篇专家共识，2篇证据总结。分别从ICU成人机械通气患者口渴的影响因素、评估内容、评估工具、干预措施、效果评价及人员管理6个方面，形成16条最佳证据。结论　在临床应用证据方面，应对所处医院的临床条件/环境、医护方应用证据的积极因素与消极因素、患者意愿等展开评估，开展有针对性的证据选择。在时间推移下，最佳证据持续更新，应用者还应持续更新证据，通过科学的护理手段有效应对成人危重症患者口渴管理问题，促进护理质量的提升。

关键词:

重症监护室, 机械通气, 口渴, 管理, 循证护理, 证据总结