實證醫學競賽組別：( B ) 報告者：洪毓謙醫師.pptVIP

實證醫學競賽組別：( B )報告者：洪毓謙 醫師 PICO 問題類型：□治療； □診斷； □傷害； ?預後 P : patients with ventilator I : head elevation C : supine O : prevent ventilator related pneumonia Database Source 資料庫資源： Pubmed Search Terms 搜尋關鍵字： ventilator ventilator and pneumonia ventilator and pneumonia and position head of bed elevation Search Strategy 搜尋歷程(請描述如何縮小搜尋範圍)： 未限制條件時ventilator and pneumonia 總搜得篇數 = 2382 限制條件：Search ventilator and pneumonia Limits: Meta-Analysis, Randomized Controlled Trial, Middle Aged + Aged: 45+ years, Aged: 65+ years 搜得篇數 = 114 限制條件：Search ventilator and pneumonia and position Limits: Meta-Analysis, Randomized Controlled Trial, Middle Aged + Aged: 45+ years, Aged: 65+ years 搜得篇數 = 8 限制條件： 搜得篇數 = 第一篇 Critically Appraised Article 出處：Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: Prevention journal of critical careVolume 23, Issue 1, Pages 126-137 (March 2008) 研究設計：Purpose To develop evidence-based guidelines for the prevention of VAP.Data Sources MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews and Register of Controlled Trials. Study Selection The authors systematically searched for all relevant randomized, controlled trials and systematic reviews on the topic of prevention of VAP in adults that were published from 1980 to October 1, 2006. Data Extraction Independently and in duplicate, the panel scored the internal validity of each trial. Effect size, confidence intervals, and homogeneity of the results were scored using predefined definitions. Scores for the safety, feasibility, and economic issues were assigned based on consensus of the guideline panel. 研究結果分析(要有數據)：The following statements were used: recommend, consider, do not recommend, and no recommendation due to insufficient or conflicting evidence. 結論：We recommend: head of bed elevation to 45° (when impossible, as near to 45° as possible should be considered). 第二篇 Critically Appraised Article 出處：Reducing the risk o