School of Allied Health, Australian Catholic University, Banyo, QLD 4104, Australia; Program for Optimising Outcomes for Mothers and Babies at Risk, Mater Research Institute - The University of Queensland, South Brisbane, QLD 4101, Australia.
School of Allied Health, Australian Catholic University, Banyo, QLD 4104, Australia.
Aust Crit Care. 2021 Nov;34(6):524-529. doi: 10.1016/j.aucc.2021.02.001. Epub 2021 Mar 19.
Endotracheal tube (ETT) suction is among the most common procedures performed in neonatal intensive care units (NICUs). Although necessary, it is associated with significant risks. To mitigate these risks, clinical practice guidelines are developed to provide evidence-based recommendations.
The aim of the study was to appraise the quality of neonatal ETT suction guidelines from all NICUs in Australia and New Zealand.
All level III NICUs in Australia and New Zealand were invited to participate. Three researchers graded the methodological quality of the received guidelines using the AGREE II instrument. Item and domain scores were calculated by scaling as a percentage of the total possible score out of 100%. A threshold score of <50% is considered to be of limited potential use.
Twenty-three (79.31%) clinical practice guidelines were received from 29 invited facilities. The scaled results of the AGREE II domains were as follows: Scope and Purpose, mean = 73%, 95% confidence interval (CI) = 63-83%; Stakeholder Involvement, mean = 23%, 95% CI = 15-31%; Rigour of Development, mean = 17%, 95% CI = 12-21%; Clarity of Presentation, mean = 63%, 95% CI = 56-70%; Applicability, mean = 5%, 95% CI = 20-30%; and Editorial Independence, mean = 50%, 95% CI = 50-50%. Overall assessment indicated low methodological quality (31%; 22-39%), with only five clinical practice guidelines scoring >50%, suggesting that they could be recommended for use with modifications. The remaining 18 could not be recommended for use.
Neonatal ETT suction guidelines are of a low methodological quality. All guidelines poorly incorporated latest evidence in guideline development. This appraisal highlights the need to improve the quality of neonatal ETT suction guidelines to promote optimal patient care.
气管内导管（ETT）吸引是新生儿重症监护病房（NICU）中最常见的操作之一。尽管这是必要的，但它也伴随着显著的风险。为了降低这些风险，制定了临床实践指南，以提供基于证据的建议。
本研究旨在评估澳大利亚和新西兰所有 NICU 的新生儿 ETT 吸引指南的质量。
邀请澳大利亚和新西兰的所有三级 NICU 参与。三位研究人员使用 AGREE II 工具对收到的指南的方法学质量进行了评分。项目和领域得分通过按比例计算得出，满分为 100 分中的 100 分。得分<50%被认为潜在用途有限。
从 29 家受邀机构中收到了 23 份（79.31%）临床实践指南。AGREE II 各领域的评分结果如下：范围和目的，平均=73%，95%置信区间（CI）=63-83%；利益相关者参与，平均=23%，95% CI=15-31%；制定的严谨性，平均=17%，95% CI=12-21%；表述的清晰性，平均=63%，95% CI=56-70%；适用性，平均=5%，95% CI=20-30%；和编辑独立性，平均=50%，95% CI=50-50%。总体评估表明方法学质量较低（31%；22-39%），只有 5 份临床实践指南得分>50%，表明可以在修改后推荐使用。其余 18 份则不能推荐使用。
新生儿 ETT 吸引指南的方法学质量较低。所有指南在指南制定过程中都未能很好地纳入最新证据。这项评估强调需要提高新生儿 ETT 吸引指南的质量，以促进最佳的患者护理。
