临床与病理杂志2025，Vol.45Issue(8)：1026-1037,12.DOI:10.11817/j.issn.2095-6959.2025.250377
ICU脓毒症相关性谵妄患者非药物管理的证据总结
Evidence summary on non-pharmacological management of ICU patients with sepsis-associated delirium
摘要
Abstract
Objective:Sepsis is a common condition in intensive care units(ICUs)and its related delirium severely affects patient outcomes.Currently,non-pharmacological interventions are recommended as the first-line management strategy for delirium in septic ICU patients.However,systematic,detailed evidence summaries and practice guidelines tailored for critical-care nurses remain lacking.This study aims to apply an evidence-based approach to identify and synthesize the best evidence for non-pharmacological management of ICU patients with sepsis-associated delirium,thereby providing a reference for developing clinical management protocols and implementing evidence-based practice. Methods:Guided by the"6S"evidence pyramid model,a top-down hierarchical literature search was conducted across BMJ Best Practice,UpToDate,the Joanna Briggs Institute(JBI)Evidence-Based Healthcare Library,the Cochrane Library,international and domestic guideline repositories,intensive-care society websites,and the American Delirium Society website for clinical decision tools,evidence summaries,clinical practice guidelines,and expert consensus statements related to the management of sepsis-associated delirium.Original studies were additionally retrieved from CNKI,SinoMed,PubMed,and Embase,with the search timeframe from database inception to March 27,2025.Literature inclusion and exclusion criteria were developed using the PIPOST(population,intervention,professional,outcome,setting,type of evidence)framework.Non-Chinese or non-English articles,inaccessible full-texts,and duplicate publications were excluded.Two researchers with critical-care experience and evidence-based nursing training independently performed quality appraisal using appropriate methodological assessment tools.Evidence extraction,synthesis,and grading were completed according to the type and quality of each included study. Results:A total of 2 122 publications were initially identified.After removing duplicates and screening titles,abstracts,and full texts,15 studies were included,comprising 1 clinical decision document,3 evidence summaries,5 guidelines,2 expert consensuses,and 4 original studies.The overall methodological quality of the included literature was high.After detailed review,extraction,and categorization,38 pieces of evidence were synthesized under seven key themes:risk identification,screening and assessment,prevention,management,family participation,continuity of care,and quality management.These cover the entire patient trajectory,from risk screening at admission to post-discharge follow-up,providing comprehensive guidance for clinical practice. Conclusion:Critical-care clinicians and nurses should receive structured training in delirium screening and assessment,and develop individualized,multicomponent intervention plans based on hospital and patient characteristics to reduce the incidence and duration of delirium and improve outcomes.This evidence summary enhances the understanding and practice competence of healthcare professionals in non-pharmacological management of ICU patients with sepsis-associated delirium and provides a scientific basis for optimizing patient prognosis.关键词
脓毒症/谵妄/非药物干预/循证护理/证据总结Key words
sepsis/delirium/non-pharmacological intervention/evidence-based nursing/evidence summary引用本文复制引用
汤晶,邹静怡,姜金霞,丁洁,付雪,宗晓佳,许金玲,郑佳妮..ICU脓毒症相关性谵妄患者非药物管理的证据总结[J].临床与病理杂志,2025,45(8):1026-1037,12.基金项目
上海申康医院发展中心医企融合创新支撑技能培训专项(SHDC2023CRS002).This work was supported by the Medical-Enterprise Integration and Innovation Support Skills Training Program of the Shanghai Shenkang Hospital Development Center,China(SHDC2023CRS002). （SHDC2023CRS002）
