重症监护中血浆置换治疗的临床技能：范围综述

IF 1 Q3 NURSING

Enfermeria Intensiva Pub Date : 2025-06-19 DOI:10.1016/j.enfi.2025.500556

Pedro Ramos-Figueiras MSc , Maria Pinto-Marques PhD , Margarida Palma-Goes PhD , Henrique Oliveira PhD

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引用次数: 0

摘要

治疗性血浆置换是一种主要侧重于通过去除与严重病理发展相关的特异性抗体和白蛋白结合毒素来调节免疫系统的手术，它在重症监护病房中使用得更频繁。在这种治疗干预中，护理团队主要使用通过持续透析技术获得的知识和技能。然而，这个过程是复杂和先进的，需要发展特定的技能。目的制定护理干预措施，促进治疗性血浆置换的特定临床技能的发展。方法采用的方法是基于范围审查。使用人口、概念、背景方法来制定审查问题和选择文章。检索科学数据库CINAHL、MEDLINE、COCHRANE、Virtual Health Library及国际采血技术知识专业期刊，纳入标准为“nursing care”、“同行评议文章”，排除标准为“无全文”和“日期小于2017”。此外，还包括最新的治疗性血浆置换国际指南。结果共鉴定出11篇论文，其中基于专家意见和数据库检索的文本证据文章7篇，定量研究4篇；除了与所分析的主题有关的5项准则之外。这反映了发展治疗性血浆分离技术的重要性，分为一般、技术、管理和交流领域。护理干预以临床推理原则为基础，促进循证实践。通过培训证明这些技能的相关性也得到了强调，强调了对高度复杂的治疗干预采取适当方法的结构化方案的必要性。结论治疗性血浆置换在重症监护环境中发挥着至关重要的作用，它涵盖了各种临床情况，需要个性化的方法并仔细考虑患者的具体临床情况。

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Clinical skills in therapeutic plasmapheresis in intensive care: A scoping review

Background

Therapeutic plasmapheresis is a procedure primarily focused on modulating the immune system by removing specific antibodies and albumin-bound toxins implicated in the development of serious pathologies, and it is being used more frequently in intensive care units. In this therapeutic intervention, nursing teams mostly use the knowledge and skills acquired through experience with continuous dialysis techniques. However, the procedure is complex and advanced, requiring the development of specific skills.

Aim

To map the nursing interventions that facilitate the development of specific clinical skills for therapeutic plasmapheresis.

Methodology

The methodology adopted was based on a scoping review. The Population, Concept, Context methodology was used to formulate the review question and to select the articles. The search was carried out in the scientific databases CINAHL, MEDLINE, COCHRANE, Virtual Health Library and international journals specializing in apheresis techniques knowledge, with the inclusion criteria “nursing care”, “peer-reviewed articles” and the exclusion criteria “no full text” and “date less than 2017” applied. In addition, the most recent international guidelines on therapeutic plasmapheresis were included.

Results

A total of 11 articles were identified, of which 7 are textual evidence articles, based on expert opinions and database searches, and 4 are quantitative studies; in addition to 5 guidelines related to the subject under analysis. These reflect the importance of developing skills in therapeutic plasmapheresis, categorized into general, technical, management and communication domains. Nursing interventions are based on the principle of clinical reasoning, promoting evidence-based practice. The relevance of certifying these skills through training is also highlighted, emphasizing the need for structured programs for an adequate approach to highly complex therapeutic interventions.

Conclusion

Therapeutic plasmapheresis plays an essential role in intensive care settings, covering various clinical scenarios, which requires an individualized approach and careful consideration of the person's specific clinical condition.

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来源期刊

Enfermeria Intensiva NURSING-

CiteScore

2.50

自引率

23.10%

发文量

期刊介绍： Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.