体外循环下心脏直视术后ICU患者早期上肢运动的最佳证据总结OA

Objective To summarize the best evidence for early upper limb exercise in ICU patients after open-heart surgery with cardiopulmonary bypass(CPB).Methods Following the"6S"evidence framework,we systematically searched domestic and interna-tional databases for guideline,clinical decision,expert consensus,evidence summary,systematic review,and randomized controlled tri-als regarding early upper limb exercise in patients undergoing open-heart surgery with CPB.The retrieval period spanned from the in-ception of databases to July 10,2025.Literature quality assessment and evidence extraction and integration were conducted indepen-dently by two researchers.Results Twenty-three articles were collected,including two guidelines,two clinical decisions,five expert consensus statements,three evidence summaries,five systematic reviews,and six randomized controlled trials.Twenty-five pieces of evidence were summarized across eight aspects:rehabilitation team composition,pre-exercise assessment,conditions and timing for initiation of exercise,types of exercise,exercise intensity/duration/frequency,exercise monitoring,exercise safety,and psychological in-tervention.Conclusion This study systematically summarizes multidimensional and multi-level evidence.Medical staff should apply the evidence while accounting for their departments'current situation and individual patient differences,emphasizing integration of up-per limb exercise with psychological care for precise implementation,thus to improve patient adherence to upper limb exercise and en-hance postoperative outcomes.