For complex searches, it's useful to keep a simple search journal (Google Doc or desktop Note) including a textword search for scoping searches in different databases, notes of databases you searched and a concept table - a grid of subject headings and textwords for different databases.
Try to process results at a consistent level of concentration. Skim preliminary results, noting useful articles and using the database's temporary save feature to set these aside for deeper scrutiny (PubMed Clipboard, Folder or Lists in other databases).
After trying a few scoping searches, analyze the articles set aside. What subject headings or textword phrases are common in the most relevant? Add these to your concept grid for future searching. Use the database's Similar Articles feature to find additional relevant articles that weren't in your initial search and identify the subject headings and textwords in these.
For complicated searches you can save search strategies in the database. As you find additional terms you can edit the search to include these, using the NOT operator to see what new articles are in the results. With most saved searches, you can set up an alert so that newly published articles will come to your attention without your having to repeat the search.
Use citation management software to save results from multiple sources; different databases, webpages, PDFs. More information on the subguide. The software integrates with word processors to format citations inline and in the reference section.