The recommended care for critical patients with nursing diagnosis impaired gas exchange - Systematic Literature Review

Ana Carolina de Oliveira Jeronymo, Isabel Cruz


The nursing diagnosis impaired gas exchange is very common in intensive care units, and its resolution is used some nursing interventions, among them listen lungs and aspire airways. Objective: This research aimed to investigate what is the most efficient and current knowledge in making decisions about the care of the patient with this diagnosis. Method: Was used as a methodology to systematic review of the literature, using of scientific articles, as full text, published between 2009-2014, contained in LILACS and MEDLINE databases. Results: According to scientific evidence, endotracheal aspiration can be defined as an essential component of bronchial hygiene and mechanical. The main recommendations for suction are flights via: just suck when necessary; using a suction catheter with a diameter equal to less than half the tube diameter; should use the lowest possible vacuum pressure; should not remain more than 15 seconds performing the aspiration; should avoid washing with saline solution; should provide a hyperoxygenation process before aspiration; and lastly, it should be aseptic technique. Comparing the open and closed suction systems, there is little scientific evidence that supports the superiority of one system over the other. The aspiration procedure is associated with the complications and risks, for example, bleeding, infection, atelectasis and hypoxemia. Conclusion: It can be concluded that the suction of the airways is a procedure of extreme relevance for the critical patient with the nursing diagnosis impaired gas exchange. In addition, the use of scientific evidence for the qualification of the nursing team in conducting airway aspiration provides a safe care practice, full, efficient and humane to highly complex the client.


Pulmonar Gas Exchange; Suction; Nursing diagnosis; Intensive Care.

Full Text:



Pascoal LM, Sousa VEC, Montoril MH, et al. Indicadores de troca de gases prejudicada em pacientes com doenças cardiovasculares segundo a NOC. Rev. Rene. [internet] 2009 [cited 2014 Jul 07]; 10(4):96-102. Available from:

Ministério da Saúde (Brasil). Caderno de Informações de Saúde. Brasília: Ministério da Saúde; 2010. [cited 2014 Sept 05]. Available from:

Secretaria Executiva do Ministério da Saúde (Brasil). Caderno de Informações de Saúde. Informações Gerais. São Paulo: Ministério da Saúde; 2006. [cited 2014 Jun 19]. Available from:

Aquino RD, Fonseca SM, Lourenço EPL, et al. Mapeamento dos diagnósticos de enfermagem em uma unidade de pneumologia. Acta Paul Enferm [internet]. 2011 [cited 2014 Aug 26]; 24(2):192-8. Available from:

North American Nursing Diagnosis Association (United States os America) . Diagnósticos de enfermagem da NANDA: definições e classificações 2007-2008. Porto Alegre: Artmed; 2008.

The Journal of the American Medical Association. Classificação das evidências. 2000. Available from:

Rocha DH, Sousa VEC, Pascoal LM, et al. Troca de gases prejudicada em pacientes com angina instável. Esc Anna Nery Rev Enferm. [internet] 2009 [cited 2014 Aug 10 ]; 13(3):471-76. Available from:

Paganin A, Souza EN, Azzolin K, et al. Intervenções de enfermagem implementadas de acordo com os diagnósticos mais prevalentes em intensivismo: estudo transversal. Online Braz J Nurs [internet]. 2010 [cited 2014 Aug 21]; 9(3): 1-10. Available from:

Gamboa FEA, Àlvarez JCD, Suarez CO. Propuesta de cuidado de enfermería al paciente con enfermedad pulmonar obstructiva crónica según la taxonomía NANDA, NIC, NOC. Av.Enferm [internet]. 2013 [cited 2014 Jul 10]; 31(2): 116-37. Available from:

Dalri MCB, Rossi LA, Zacarelicyrillo MZ, et al. Validacion del diagnostico deterioro del intercambio gaseoso en adultos en atencion de emergencia. Ciencia y Enfermeria. 2009. [cited 2014 Aug 10]; 14(1): 63-72. Available from:

Pedersen CM, Rosendahl-Nielsen M, Hjermind J, et al. Endotracheal suctioning of the adult intubated patient – what is the evidence? Intensive and Critical Care Nursing [internet]. 2009 [cited 2014 Jul 14]; (25): 21-30. Available from: file:///C:/Users/Qbex/Downloads/Artikel%20Svb.%20(3).pdf

Seyyed MM, Pishgou’ei AH, Zareian A, et al. Effect of open and closed endotrache al suction systems on heart rhythm and arterial blood oxygen level in intensive care unit patients. Iranian Journal of Critical Care Nursing [internet]. 2010 [cited 2014 Aug 02]; 2(4); 133-7. Available from:

Maggiore, SM, Volpe C. Endotracheal suctioning in hypoxemic patients. Réanimation [internet]. 2011 [cited 2014 Aug 25]; (20):12-8. Disponível em:

Irajpour A, Abbasinia M, Hoseini A, et al. Effects of shallow and deep endotracheal tube suctioning on cardiovascular indices in patients in intensive care units. Iran J Nursing Midwifery Res. [internet] 2014 [cited 2014 Aug 28]; 19(4): 366–70. Available from:


Share |