Análisis de concepto del diagnóstico de la ventilación espontánea deteriorada en pacientes críticos
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https://doi.org/10.5294/aqui.2023.23.3.7Palabras clave:
Ventilación pulmonar, falla respiratoria, unidad de cuidados intensivos, enfermería, diagnósticos de enfermeríaResumen
Introducción: en la práctica de enfermería, este concepto fue identificado en estudios que abordan el diagnóstico de la ventilación espontánea deteriorada. La actuación desde enfermería para enfrentar esta indeseada respuesta humana es esencial para el mantenimiento y el control de los signos vitales, el monitoreo cardiovascular, el intercambio de gases y el patrón de respiración, así como para la vigilancia constante de los signos de hipoventilación y ventilación inadecuada. Objetivo: analizar el concepto de ventilación espontánea deteriorada en pacientes críticos en una unidad de cuidado intensivo. Metodología: Este estudio es un análisis de concepto, de acuerdo con el método de Walker y Avant, conducido usando una revisión integrada. Se siguieron todos los pasos referenciales: selección del concepto, determinación de los objetivos y propuestas para el análisis de conceptos, identificación de los posibles usos del concepto, determinar los atributos definitorios, identificación del caso modelo, identificación del caso contrario e identificación de precedentes y consecuencias del concepto. Resultados: se seleccionó una muestra de 38 estudios. Se identificaron como atributos: angustia y fatiga, dificultad respiratoria, taquicardia, inestabilidad hemodinámica, estado mental alterado, gasometría arterial anormal, disnea, ansiedad, agitación, sudoración, hipoxemia e hipercapnia. Antecedentes: sexo; edad; saturación de oxígeno inferior al 90%; enfermedades de los sistemas respiratorio, cardiovascular, neurológico, gastrointestinal, neuromuscular y metabólico; infecciones respiratorias; traumatismos, y venenos, toxinas y sedantes. Consecuencias: aumento del ritmo cardíaco, disminución de la saturación parcial de oxígeno, aumento del uso de los músculos respiratorios, disnea, aumento del índice metabólico e inquietud. Se utilizaron el caso modelo y el caso contrario para ilustrar los atributos, antecedentes y consecuencias. Conclusión: el estudio dirigió el fortalecimiento de la evidencia sobre el fenómeno y demostró una fuerte ocurrencia en pacientes que necesitan asistencia en unidades de cuidados intensivos, quienes requieren, en consecuencia, de cuidados críticos.
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Seganfredo DH, Beltrão BA, Silva VM, Lopes MVO, Castro SMJ, Almeida MA. Analysis of ineffective breathing pattern and impaired spontaneous ventilation of adults with oxygen therapy. Rev. Latino-Am Enfermagem. 2017; 25:e2954. DOI: https://doi.org/10.1590/1518-8345.1950.2954
Herdman TH, Kamitsuru S, Lopes CT. Diagnósticos de enfermagem da NANDA-I: definições e classificação 2021-2023. 12a ed. Porto Alegre: Artmed; 2021. 568 p.
Debone MC, Pedruncci E da SN, Candido M do CP, Marques S, Kusumota L. Nursing diagnosis in older adults with chronic kidney disease on hemodialysis. Rev Bras Enferm. 2017;70(4):800-805. DOI: https://doi.org/10.1590/0034-7167-2017-0117
Canto DF, Almeida MA. Resultados de enfermagem para padrão respiratório ineficaz e ventilação espontânea prejudicada em terapia intensiva. Rev Gaúcha Enferm 2013;34(4):137-45. DOI: https://doi.org/10.1590/S1983-14472013000400018
Walker L, Avant KC. Strategies for theory construction in nursing. Boston: Pearson. 2019. 272 p.
Hopia H, Latvala E, Liimatainen L. Reviewing the methodology of an integrative review. Scand J Caring Sci. 2016;30(4):662-9. DOI: https://doi.org/10.1111/scs.12327
Perkins GD, Mistry D, Gates S, et al. Effect of protocolized weaning with early extubation to noninvasive ventilation vs invasive weaning on time to liberation from mechanical ventilation among patients with respiratory failure. JAMA. 2018;320(18):1881-8. DOI: https://doi.org/10.1001/jama.2018.13763
Diaz-Abad M, Brown JE. Use of volume-targeted non-invasive bilevel positive airway pressure ventilation in a patient with amyotrophic lateral sclerosis. J Bras Pneumol. 2014;40(4):443-7. DOI: https://doi.org/10.1590/S1806-37132014000400013
Antonio ACP, Teixeira C, Castro PS, et al. Behavior of lung ultrasound findings during spontaneous breathing trial. Rev Bras Ter Intensiva. 2017;29(3):279-86. DOI: https://doi.org/10.5935/0103-507X.20170038
Girault C, Bubenheim M, Abroug F, et al. Noninvasive ventilation and weaning in patients with chronic hypercapnic respiratory failure. Am J Respir Crit Care Med. 2011;184(6):672-9. DOI: https://doi.org/10.1164/rccm.201101-0035OC
Ferreira JC, Diniz-Silva F, Moriya HT, Alencar AM, Amato MBP, Carvalho CRR. Neurally Adjusted Ventilatory Assist (NAVA) or Pressure Support Ventilation (PSV) during spontaneous breathing trials in critically ill patients: a crossover trial. BMC Pulm Med. 2017;17(1):139. DOI: https://doi.org/10.1186/s12890-017-0484-5
Hennus MP, Vught AJ van, Brabander M, Brus F, Jansen NJ, Bont LJ. Mechanical ventilation drives inflammation in severe viral bronchiolitis. PLoS ONE. 2013;8(12):e83035. DOI: https://doi.org/10.1371/journal.pone.0083035
Teixeira SN, Osaku EF, Lima de Macedo Costa CR, et al. Comparison of proportional assist ventilation plus, T-Tube ventilation, and pressure support ventilation as spontaneous breathing trials for extubation: a randomized study. Respir Care. 2015;60(11):1527-35. DOI: https://doi.org/10.4187/respcare.03915
Figueroa-casas JB, Montoya R, Arzabala A, Connery SM. Comparison between automatic tube compensation and continuous positive airway pressure during spontaneous breathing trials. Respir Care. 2010;55(5):549-54. Available from: https://rc.rcjournal.com/content/respcare/55/5/549.full.pdf
Raurich JM, Rialp G, Ibáñez J, Campillo C, Ayestarán I, Blanco C. Hypercapnia test as a predictor of success in spontaneous breathing trial sand extubation. Respir Care. 2008; 53(8):1012-8. Available from: https://rc.rcjournal.com/content/respcare/53/8/1012.full.pdf
Mokhlesi B, Tulaimat A, Gluckman TJ, Wang Y, Evans AT, Corbridge TC. Predicting extubation failure after successful completion of a spontaneous breathing trial. Respir Care. 2007; 52(12):1710-7. Available from: https://rc.rcjournal.com/content/respcare/52/12/1710.full.pdf
Gnanapandithan K, Agarwal R, Aggarwal AN, Gupta D. Weaning by gradual pressure support (PS) reduction without an initial spontaneous breathing trial (SBT) versus PS-supported SBT: A pilot study. Rev Por Pneumologia. 2011;17(6):244-52. DOI: https://doi.org/10.1016/j.rppneu.2011.06.015
Putensen C, Zech S, Wrigge H, Zinserling J, Stüber F, Von Spiegel T, et al. Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury. Am J Respir Crit Care Med. 2001;164(1):43-9. DOI: https://doi.org/10.1164/ajrccm.164.1.2001078
Ely EW, Baker AM, Dunagan DP, et al. Effect on the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med. 1996;335(25):1864-9. DOI: https://doi.org/10.1056/NEJM199612193352502
Delisle S, Francoeur M, Albert M, Ouellet P, Bellemare P, Arsenault P. Preliminary evaluation of a new index to predict the outcome of a spontaneous breathing trial. Respir Care. 2011; 56(10):1500-5. DOI: https://doi.org/10.4187/respcare.00768
Andrade LZC, Chaves DBR, Silva VM da, Beltrão BA, Lopes MV de O. Diagnósticos de enfermagem respiratórios para crianças com infecção respiratória aguda. Acta Paul Enferm. 2012;25(5):713-20. DOI: https://doi.org/10.1590/S0103-21002012000500011
Campbell ML. Ensuring breathing comfort at the end of life: The integral role of the critical care nurse. Am J Crit Care. 2018;27(4):264-9. DOI: https://doi.org/10.4037/ajcc2018420
Storm DS, Baumgartner RG. Achieving self-care in the ventilator-dependent patient: a critical analysis of a case study. Int J Nurs Stud. 1987;24(2):95-106. DOI: https://doi.org/10.1016/0020-7489(87)90052-6
Sørensen D, Frederiksen K, Groefte T, Lomborg K. Nurse-patient collaboration: a grounded theory study of patients with chronic obstructive pulmonary disease on non-invasive ventilation. Int J Nurs Stud. 2013; 50(1):26-33. DOI: https://doi.org/10.1016/j.ijnurstu.2012.08.013
Sørensen D, Frederiksen K, Grøfte T, Lomborg K. Practical wisdom: a qualitative study of the care and management of non-invasive ventilation patients by experienced intensive care nurses. Intensive Crit Care Nurs. 2013 Jun;29(3):174-8. DOI: https://doi.org/10.1016/j.iccn.2012.10.001
Manfredini GMSG, Machado RG, Mantovani R. Prone position in acute respiratory distress syndrome: nursing care. Journal of Nursing UFPE. 2013;7(8):5588-97. DOI: https://doi.org/10.1097/DCC.0000000000000393
Pertab D. Principles of mechanical ventilation--a critical review. Br J Nurs. 2009;18(15):915-8. DOI: https://doi.org/10.12968/bjon.2009.18.15.43560
Yücel ŞÇ, Eşer I, Güler EK, Khorshid L. Nursing diagnoses in patients having mechanical ventilation support in a respiratory intensive care unit in Turkey. Int J Nurs Pract. 2011;17(5):502-8. DOI: https://doi.org/10.1111/j.1440-172X.2011.01959.x
Pattison N, Watson J. Ventilatory weaning: a case study of protracted weaning. Nurs Crit Care. 2009;14(2):75-85. DOI: https://doi.org/10.1111/j.1478-5153.2008.00322.x
Cools F, Offringa M. Neuromuscular paralysis for newborn infants receiving mechanical ventilation. Cochrane Database Syst Rev. 2000;(4):CD002773. DOI: https://doi.org/10.1002/14651858.CD002773
Greenough A, Dimitriou G, Prendergast M, Milner AD. Synchronized mechanical ventilation for respiratory support in newborn infants. Cochrane Database Syst Rev. 2008;23(1):CD000456. DOI: https://doi.org/10.1002/14651858.CD000456.pub3
Prado PR, Bettencourt ARC, Lopes JL. Fatores preditores do diagnóstico de enfermagem padrão respiratório ineficaz em pacientes de uma unidade de terapia intensiva. Rev LatAm Enfermagem. 2019;27:e3153. DOI: https://doi.org/10.1590/1518-8345.2902.3153
Hsu JC, Chen YF, Chung WS, Tan TH, Chen T, Chiang JY. Clinical verification of a clinical decision support system for ventilator weaning. Biomed Eng Online. 2013;12 Suppl 1(Suppl 1):S4. DOI: https://doi.org/10.1186/1475-925X-12-S1-S4
Kauppi W, Herlitz J, Magnusson C, Palmér L, Axelsson C. Characteristics and outcomes of patients with dyspnoea as the main symptom, assessed by prehospital emergency nurses- a retrospective observational study. BMC Emerg Med. 2020;20(1):67. DOI: https://doi.org/10.1186/s12873-020-00363-6
Jellington MO, Overgaard D, Sørensen EE. Manoeuvring along the edge of breathlessness: an ethnographic case study of two nurses. BMC Nurs. 2016;15:27. DOI: https://doi.org/10.1186/s12912-016-0148-4
Tonnelier JM, Prat G, Le Gal G, Gut-Gobert C, Renault A, Boles JM, et al. Impact of a nurses’ protocol-directed weaning procedure on outcomes in patients undergoing mechanical ventilation for longer than 48 hours: a prospective cohort study with a matched historical control group. Crit Care. 2005; 9(2):R83-9. DOI: https://doi.org/10.1186/cc3030
Li W, An X, Fu M, Li C. Emergency treatment and nursing of children with severe pneumonia complicated by heart failure and respiratory failure: 10 case reports. Exp Ther Med. 2016; 12(4):2145-9. DOI: https://doi.org/10.3892/etm.2016.3558
Yang L, Jiang Q, Guan H, Bo H. Nursing care in anti-N-methyl-d-aspartate receptor encephalitis. Medicine. 2019;98(46):e17856. DOI: https://doi.org/10.1097/MD.0000000000017856
Vitacca M, Paneroni M, Peroni R, Barbano L, Dodaj V, Piaggi G, et al. Effects of a multidisciplinary care program on disability, autonomy, and nursing needs in subjects recovering from acute respiratory failure in a chronic ventilator facility. Respir Care. 2014;59(12):1863-71. DOI: https://doi.org/10.4187/respcare.03030
Rose L, Gerdtz MF. Review of non-invasive ventilation in the emergency department: clinical considerations and management priorities. J Clin Nurs. 2009; 18(23):3216-24. DOI: https://doi.org/10.1111/j.1365-2702.2008.02766.x
Belveyre T, Auchet T, Levy B. Spontaneous breathing during extracorporeal membrane oxygenation treatment of sickle cell disease acute chest syndrome. Respir Med Case Rep. 2019;28:100924. DOI: https://doi.org/10.1016/j.rmcr.2019.100924
Mohammed H, Abdelatief DA. Easy blood gas analysis: implications for nursing. Egyptian J Diseases Chest and Tuberculosis. 2016;65(1):369-76. https://doi.org/10.1016/j.ejcdt.2015.11.009
Liang YR, Yang MC, Wu YK, Tzeng IS, Wu PY, Huang SY, et al. Transitional percentage of minute volume as a novel predictor of weaning from mechanical ventilation in patients with chronic respiratory failure. Asian Nurs Res. 2020;14(1):30-5. DOI: https://doi.org/10.1016/j.anr.2020.01.002
Hernández-Hernández G, Reynoso-García JG. Cuidado de enfermería posto peración de Tromboend arterectomia Pulmonar Bilateral. Estudio de caso fundamentado en los principios de Henderson. Enferm. univ. 2019;16(3):322-34. DOI: https://doi.org/10.22201/eneo.23958421e.2019.3.710
Walton J. Safe sedation practice for surgeons. Surgery. 2019;37(12):712-4. DOI: https://doi.org/10.1016/j.mpsur.2019.10.004
Phua J, Weng L, Ling L, Egi M, Lim CM, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020; 8(5):506-17. DOI: https://doi.org/10.1016/S2213-2600(20)30161-2
Antonucci LAO, Savino MJP. Paciente com ventilação espontânea prejudicada: uma revisão integrativa das intervenções de enfermagem no uso da respiração artificial. Rev Saúde Com. 2014;10(1):96-108. Disponível em: https://periodicos2.uesb.br/index.php/rsc/article/view/289
Moorhead S, Johnson M, Mass ML, Swanson E. Classificação dos resultados de enfermagem. 5 ed. Rio de Janeiro: Elsevier, 2016.
Bulechek GM, Butcher HK, Dochterman JM, Wagner CM. Classificação das intervenções de enfermagem. 6 ed. Rio de Janeiro: Elsevier, 2016. 640 p.
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