Lung injury associated with mechanical ventilator: systematic literature review for a clinical protocol

Abstract

Mechanical ventilation (MV) applies a positive pressure during the inspiratory phase, reversing the respiratory physiology, which may cause several complications, such as the biotrauma, the atelectrauma and the volutrauma. The reduction of these complications is essential for the maintenance of adequate oxygenation and ventilation in patients on ventilation support, reducing the deleterious hemodynamic effects and ensuring patient safety. This study aimed to evaluate the knowledge of nurses working in the intensive care unit on mechanical ventilation, check if the errors during the assistance to the patient in mechanical ventilation are related with the staff dimensioning of the nursing team and describe the strategies for the prevention of lung injuries associated with mechanical ventilation. This is a descriptive and exploratory study, based on literature review, covering the period from 2 April 2015 to 02 November 2015, through the setting of the Biblioteca Virtual de Saúde (BVS). Twenty articles were selected, which have suffered systematic analysis. A clinical protocol has been proposed, covering the 13 strategies listed in the studies analyzed as relevant to the prevention of lung injury associated with mechanical ventilation in order to ensure patient safety. It was concluded that nursing care is the main focus of the studies and that there is the need to improve nursing care in intensive care units, to increase the quality of care and reduce the risk of complications related to the use of ventilatory prosthesis. It is also concluded that the scientific research in this area needs to be intensified for the effective improvement of the care and recognition of the importance of nurses in mechanical ventilation.