Objective: 

We aimed to identify which set of components differentiates the ICU diaries that were effective in reducing psychologic symptoms after critical illness.

Data Sources: 

We searched the online databases MEDLINE, OVID, Embase, and EBSCOhost from inception to December 2021.

Study Selection: 

Randomized controlled trials (RCTs) of the ICU diary were included, irrespective of the language, with samples of adult patients (≥ 18 yr old) and/or their relatives hospitalized in an ICU for more than 24 hours. Two qualitative syntheses on patients’ and healthcare providers’ perceptions on the ICU diary were included.

Data Extraction: 

Four findings were extracted from the qualitative synthesis of patients’ perspectives on the ICU diary. From the RCTs, we extracted the components of the ICU diary and whether the patients were ventilated for at least 3 days. We reported the outcome as effective or not, regardless of the psychiatric symptoms and diagnostic tools used for evaluation. We built a matrix in which each column represented a recommendation for an intervention component derived from the qualitative review, and each row represented whether the components of an individual trial’s intervention matched any of the recommendations.

Data Synthesis: 

Eight RCTs were included in the final analysis. The sample of five studies consisted of patients under mechanical ventilation (MV) for at least 3 days. Two were positive trials. Three RCTs included family members, and two of those were positive trials.

CONCLUSIONS: 

For patients under MV for at least 3 days, the ICU diaries that were effective in preventing psychiatric symptoms after critical illness were written by the ICU staff, delivered after hospital discharge, and read with a healthcare professional in order to better understand the diary and the ICU stay. For family members, the presence of photographs was the only characteristic identified a successful ICU diary.

中文翻译：

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使用定性综合探索 ICU 日记随机试验的异质性*

客观的： 

我们的目的是确定哪些组成部分可以区分 ICU 日记，这些日记可以有效减少危重病后的心理症状。

数据源： 

我们搜索了在线数据库 MEDLINE、OVID、Embase 和 EBSCOhost 从创建到 2021 年 12 月。

研究选择： 

ICU 日记的随机对照试验 (RCT) 被纳入，不考虑语言，样本为在 ICU 住院超过 24 小时的成年患者（≥ 18 岁）和/或其亲属。包括关于患者和医疗保健提供者对 ICU 日记的看法的两个定性综合。

数据提取： 

从患者对 ICU 日记的看法的定性综合中提取了四项发现。从随机对照试验中，我们提取了 ICU 日记的组成部分以及患者是否通气至少 3 天。无论用于评估的精神症状和诊断工具如何，我们都将结果报告为有效或无效。我们构建了一个矩阵，其中每一列代表对来自定性审查的干预措施的建议，每一行代表单个试验的干预措施的组成部分是否与任何建议相匹配。

数据综合： 

八项随机对照试验被纳入最终分析。五项研究的样本包括接受机械通气 (MV) 至少 3 天的患者。两个是积极的试验。三项随机对照试验包括家庭成员，其中两项是阳性试验。

结论： 

对于 MV 至少 3 天的患者，由 ICU 工作人员撰写有效预防危重病后精神症状的 ICU 日记，出院后交付，并由医疗保健专业人员阅读，以便更好地理解日记和留ICU。对于家庭成员，照片的存在是识别成功的 ICU 日记的唯一特征。