Objective:To retrieve, evaluate and summarize the best evidence on the use of bedside ultrasound by ICU nurses to assess the lungs of adult critically ill patients, and to provide a reference for clinical practice and the construction of related processes and protocols.Methods:Based on the "6S" pyramid model, a computer-based search was conducted on relevant computer decision support system, guideline networks, professional associations, and domestic and international databases, the search time limit was from the establishment of the database to June 5, 2024. The panel members who had been trained in the evidence-based course evaluated the included literature with corresponding tools, extracted evidence according to the theme.Results:Twenty-five papers were finally included, including 6 guidelines, 8 expert consensus, 2 expert opinion, 3 clinical decision-making, 3 systematic evaluation, and 3 randomized controlled trials. A total of 35 pieces of evidence were formed from 4 aspects, including personnel training, operation specifications, clinical application (including dyspnea screening, intervention implementation, efficacy evaluation, diaphragm function evaluation) and precautions.Conclusions:The best evidence for lung assessment and intervention in adult critically ill patients based on bedside ultrasound can provide a reference for the adjustment and decision-making of nursing measures for adult critically ill patients. In the subsequent process of evidence transformation, attention should be paid to combining clinical practice and the joint cooperation of medical staff.

Objective:To retrieve, evaluate and summarize the best evidence on the use of bedside ultrasound by ICU nurses to assess the lungs of adult critically ill patients, and to provide a reference for clinical practice and the construction of related processes and protocols.Methods:Based on the "6S" pyramid model, a computer-based search was conducted on relevant computer decision support system, guideline networks, professional associations, and domestic and international databases, the search time limit was from the establishment of the database to June 5, 2024. The panel members who had been trained in the evidence-based course evaluated the included literature with corresponding tools, extracted evidence according to the theme.Results:Twenty-five papers were finally included, including 6 guidelines, 8 expert consensus, 2 expert opinion, 3 clinical decision-making, 3 systematic evaluation, and 3 randomized controlled trials. A total of 35 pieces of evidence were formed from 4 aspects, including personnel training, operation specifications, clinical application (including dyspnea screening, intervention implementation, efficacy evaluation, diaphragm function evaluation) and precautions.Conclusions:The best evidence for lung assessment and intervention in adult critically ill patients based on bedside ultrasound can provide a reference for the adjustment and decision-making of nursing measures for adult critically ill patients. In the subsequent process of evidence transformation, attention should be paid to combining clinical practice and the joint cooperation of medical staff.

Objective To analyze the research hotspots in the field of extracorporeal membrane oxygenation (ECMO) patient care at home and abroad in the past 10 years,aiming to provide a reference for related research. Methods Literature related to ECMO nursing collected in CNKI and Web of Science (WOS) databases from January 2013 to July 2023 was searched,journals and key words were visualized by CiteSpace software. Results A total of 192 foreign literatures and 730 Chinese literatures were included. In recent 10 years,the number of papers in the field of ECMO nursing at home and abroad has been on the rise. According to the visual analysis of China's publishing institutions. The visual analysis of key words in the field of nursing showed that the research in the field of ECMO patient care focuses on critical diseases related to the respiratory system and circulatory system. The research focused on acute respiratory distress syndrome (ARDS),coronavirus disease 2019 (COVID-19),prone ventilation,emergency nursing,etc. Conclusions Research hotspots in the field of ECMO patient care in China are changing dynamically with the development of social medicine,but the overall quality of research is low. It is necessary to strengthen the in-depth cooperation between various institutions in the field of ECMO patient care,learn from foreign experience,and promote the quality of ECMO nursing.

Objective To analyze the research hotspots in the field of extracorporeal membrane oxygenation (ECMO) patient care at home and abroad in the past 10 years,aiming to provide a reference for related research. Methods Literature related to ECMO nursing collected in CNKI and Web of Science (WOS) databases from January 2013 to July 2023 was searched,journals and key words were visualized by CiteSpace software. Results A total of 192 foreign literatures and 730 Chinese literatures were included. In recent 10 years,the number of papers in the field of ECMO nursing at home and abroad has been on the rise. According to the visual analysis of China's publishing institutions. The visual analysis of key words in the field of nursing showed that the research in the field of ECMO patient care focuses on critical diseases related to the respiratory system and circulatory system. The research focused on acute respiratory distress syndrome (ARDS),coronavirus disease 2019 (COVID-19),prone ventilation,emergency nursing,etc. Conclusions Research hotspots in the field of ECMO patient care in China are changing dynamically with the development of social medicine,but the overall quality of research is low. It is necessary to strengthen the in-depth cooperation between various institutions in the field of ECMO patient care,learn from foreign experience,and promote the quality of ECMO nursing.

Objective To systematically evaluate the risk factors associated with the occurrence of nosocomial infections(NI)in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods A computerized systematic search was performed aross the Chinese databases including CNKI,Wanfang Database,China Biomedical Literature Database(CBMdisc),and Weipu,as well as the English databases such as PubMed,EMBase,Web of Science,and the Cochrane Library for case-control or cohort studies on the risk factors of hospital-acquired infections in patients undergoing ECMO support from the time of database construction to February 2023.The relevant literatures were screened by two researchers independently.Meta-analysis was performed using RevMan 5.4 software.Results A total of 20 papers,including 2 746 patients and 16 risk factors,were included.Meta-analysis results showed that older age[>50 years:odds ratio(OR)= 2.87,95％ confidence interval(95％ CI)was 1.24-6.63,P = 0.01;>65 years:OR = 1.66,95％ CI was 1.22-2.26,P = 0.001],combined hypertension(OR = 1.48,95％ CI was 1.01-2.15,P = 0.04),combined diabetes mellitus(OR = 1.40,95％ CI was 1.02-1.94,P = 0.04),sequential organ failure assessment(SOFA)was higher(OR = 1.06,95％ CI was 1.02-1.10,P = 0.000 7),the installation of ECMO in the intensive care unit(ICU,OR=1.48,95％ Ciwas 1.11-1.99,P=0.008),ECMO course(OR=1.27,95％ Ciwas 1.05-1.54,P = 0.01),ventilator-assistance for >48 hours(OR = 4.91,95％ CI was 2.40-10.05,P<0.000 1),and tracheotomy(OR = 9.56,95％ CI was 3.60-25.35,P<0.000 01)were identified as ECMO risk factors for hospital-acquired infections in patients.Conclusion Older age,combined hypertension,diabetes mellitus,higher SOFA,ECMO installation site in ICU,ECMO course,ventilator assistance>48 hours,tracheotomy are the risk factors for the occurrence of hospital-acquired infections in patients with ECMO,healthcare professionals should promptly identify the risk factors related to hospital-acquired infections,and take active and effective measures against controllable risk factors,including early intervention to prevent the occurrence of NI in ECMO patients.

Objective:To develop early warning systems for unplanned extubation in critical patients to give the early warning and interference in order to reduce the risks of unexpected drawn tubes and guarantee the security of the patients.Methods:Took the model of risk warning system for unplanned extubation in critical patients as the core, obeyed the guide of the nursing intervention program, based on the information system of patients in ICU and relied on computer science technology to design the architecture for the interface layout, the partitions, the modular structure, the content and the function of the system. This warning system was designed from multiple angels and directions. This research retrospectively analyzed the 18 cases for unplanned extubation from January to December in 2016 using this system to verify its warning effectiveness.Results:The prototype of this warning system included login module, evaluation module, decision module, warning module, directive module and the module for canal fixed scheme. The system automatically determined the level of risk for critical patients to implement the layered pre-warning and screen the high-risk patients. Finally, individual nursing interfering method could be supplied. The detection rate of this warning system was 88.89% after retrospective analysis.Conclusion:The warning system for unplanned extubation patients is an automated, intellectualized and informationalized platform. It can effectively warn the high risk of the extubation patients and evade the risk of canal nursing.