Aitken Leanne M, Castillo Maria I, Ullman Amanda, Engström Åsa, Cunningham Kathryn, Rattray Janice
School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia; Intensive Care Unit, Princess Alexandra Hospital, Australia; School of Health Sciences, City University London, UK.
School of Nursing & Midwifery & NHMRC Centre of Research Excellence in Nursing (NCREN), Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia; Intensive Care Unit, Princess Alexandra Hospital, Australia.
Aust Crit Care. 2016 Feb;29(1):5-14; quiz 15. doi: 10.1016/j.aucc.2015.11.004. Epub 2016 Jan 6.
Patients admitted to an intensive care unit (ICU) often experience distressing memories during recovery that have been associated with poor psychological and cognitive outcomes. The aim of this literature review was to synthesise the literature reporting on relationships between elements of ICU treatment and memories after discharge in adult ICU survivors.
Integrative review methods were used to systematically search, select, extract, appraise and summarise current knowledge from the available research and identify gaps in the literature.
The following electronic databases were systematically searched: PubMed, Ovid EMBASE, EBSCOhost CINAHL, PsycINFO and Cochrane Central Register of Controlled Trials. Additional studies were identified through searches of bibliographies. Original quantitative research articles written in English that were published in peer-review journals were included.
Data extracted from studies included authors, study aims, population, sample size and characteristics, methods, ICU treatments, ICU memory definitions, data collection strategies and findings. Study quality assessment was based on elements of the Critical Appraisal Skills Programme using the checklists developed for randomised controlled trials and cohort studies.
Fourteen articles containing data from 13 studies met the inclusion criteria and were included in the final analysis. The relatively limited evidence about the association between elements of ICU treatment and memories after ICU discharge suggest that deep sedation, corticoids and administration of glucose 50% due to hypoglycaemia contribute to the development of delusional memories and amnesia of ICU stay.
The body of literature on the relationship between elements of ICU treatment and memories after ICU discharge is small and at its early stages. Larger studies using rigorous study design are needed in order to evaluate the effects of different elements of ICU treatment on the development of memories of the ICU during recovery.
入住重症监护病房（ICU）的患者在康复期间常常会经历痛苦的记忆，这与不良的心理和认知结果相关。本系统文献综述的目的是综合有关ICU治疗要素与成年ICU幸存者出院后记忆之间关系的文献报道。
采用综合综述方法，系统地检索、选择、提取、评估和总结现有研究中的当前知识，并找出文献中的空白。
系统检索了以下电子数据库：PubMed、Ovid EMBASE、EBSCOhost CINAHL、PsycINFO和Cochrane对照试验中央注册库。通过检索参考文献确定了其他研究。纳入了在同行评审期刊上发表的英文原创定量研究文章。
从研究中提取的数据包括作者、研究目的、人群、样本量和特征、方法、ICU治疗、ICU记忆定义、数据收集策略和研究结果。研究质量评估基于批判性评估技能计划的要素，使用为随机对照试验和队列研究制定的检查表。
14篇包含13项研究数据的文章符合纳入标准，并纳入最终分析。关于ICU治疗要素与ICU出院后记忆之间关联的证据相对有限，这表明深度镇静、皮质类固醇以及因低血糖给予50%葡萄糖会导致妄想性记忆和ICU住院失忆的发生。
关于ICU治疗要素与ICU出院后记忆之间关系的文献数量较少且尚处于早期阶段。需要开展更大规模、采用严谨研究设计的研究，以评估ICU治疗的不同要素对康复期间ICU记忆形成的影响。
