Background 

Pulmonary embolism (PE) remains a common and life-threatening event. The use of ultrasound-assisted thrombolysis (USAT) for the delivery of thrombolytic agents to the clot has developed in the last 10 years. A search yielded no evidence-based practice guidelines for the nursing care of the patient with PE during and post USAT treatment and specifically when using the EKOS machine.

Objective 

The objective of this integrative review was to explore the literature and web for any information on the use of USAT for adults with PE both during and post treatment. Our goal was to examine nurse-specific practices to develop appropriate protocols.

Methods 

We conducted a search of PubMed, Web of Science, EBSCOhost, CINAHL, Google Scholar, and Google for any guidelines, observational studies, or experimental studies using USAT for PE in adults. Nurse authors independently reviewed the articles using a standardized data coding form. Information abstracted included sample and setting characteristics, access characteristics, medication, sheath removal, compression, and bleeding events.

Results 

Twenty-two articles, published in 2008–2019, met the eligibility criteria. Most studies were small retrospective studies at single sites. Variation existed on the clinician, the clinical area for placement, the amount and duration of delivery of medication, and where care was provided during the infusion. Few studies noted sheath removal or compression procedures. Fifteen studies reported 1 fatal, 12 major, 4 moderate, and 36 minor bleeding events at the catheter insertion sites.

Conclusion 

There is lack of sufficient information for the development of nursing practice guidelines for this new technology.

中文翻译：

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接受超声辅助溶栓治疗的肺栓塞患者的护理实践：综合评价。

背景 

肺栓塞(PE) 仍然是一种常见且危及生命的事件。在过去的 10 年中，使用超声辅助溶栓 (USAT) 将溶栓剂输送到凝块中得到了发展。一项搜索未发现在 USAT 治疗期间和之后特别是在使用 EKOS 机器时对 PE 患者进行护理的循证实践指南。

目标 

本综合评价的目的是探索文献和网络，以获取有关在治疗期间和治疗后对患有 PE 的成人使用 USAT 的任何信息。我们的目标是检查护士的具体做法，以制定适当的协议。

方法 

我们在 PubMed、Web of Science、EBSCOhost、CINAHL、Google Scholar 和 Google 中搜索了使用 USAT 治疗成人 PE 的任何指南、观察性研究或实验性研究。护士作者使用标准化的数据编码形式独立审查了文章。提取的信息包括样本和设置特征、通路特征、药物、鞘去除、压迫和出血事件。

结果 

2008-2019 年发表的 22 篇文章符合入选标准。大多数研究是单一地点的小型回顾性研究。临床医生、放置的临床区域、给药的数量和持续时间以及在输注期间提供护理的地点存在差异。很少有研究指出鞘膜移除或压缩程序。15 项研究报告了导管插入部位发生 1 起致命、12 起严重、4 起中度和 36 起轻微出血事件。

结论 

缺乏足够的信息来制定这项新技术的护理实践指南。