Nursing evidence-based practice guidelines for acid base imbalance in ICU - Systematic Literature Review

Débora Moraes Reis da Silva, Isabel CF da Cruz

Abstract


Acid-base disorders are conditions commonly found in Intensive Care Unit patients and occur as an attempt by the body to keep the pH within normal parameters in order to preserve cellular functions. These alterations impair the normal regulation of metabolic and enzymatic processes in the body, with high risk for multiple organ dysfunction and death. Objective: To review the nursing guidelines based on evidence that will help the intensive nurse in the identification and treatment of acid-base disorders, within 7 days. Methodology: This is an integrative review of the literature, according to the PICOT methodology, whose data collection was conducted in the period from 2012 to 2019, in the LILACS, Scielo, BDENF and PubMed databases. Results: The results reveal 10 publications that were grouped into three categories of analysis: Interpretation of gasometric tests, Care during blood collection for gasometry, Nursing assistance in the treatment of acid-base imbalance. Conclusion: During the patient's hospitalization period, several variables can influence the acid-base balance and the knowledge about blood collection and the adequate interpretation of the gasometric data become necessary for holistic care. It is up to the nurse professional to associate the clinic with the changes in laboratory value that occur with the imbalance and to evaluate the treatment options, maintaining active participation with the multiprofessional team for the reestablishment of blood homeostasis.

Keywords


Acid-Base Imbalance; Intensive Care Units; Blood Gas Analysis; Nursing Care

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References


Rajendran B, Mallampati SRR, Jha SJJ. Acid based disorders in intensive care unit: a hospital-based study. Int J Adv Med [Internet]. 2019 [cited 2020 Out 12];6(1): 1-4. Available from: https://www.ijmedicine.com/index.php/ijam/article/view/1485

Shreewastav RK, Jaishi KP, Pandey MR, Singh GP, Singh AG. Study of acid-base disorders and biochenical findings of patients in a tertiary care hospital: a descriptive cross-sectional study. J Nepal Med Assoc [Internet]. 2019 Dec [cited 2020 Out 12];57(220): 432-436. Available from: https://pubmed.ncbi.nlm.nih.gov/32335656/

Al-Jaghbeer M, Kellum JA. Acid-base disturbances in intensive care patients: etiology, pathophysiology and treatment. Nephrol Dial Transplant [Internet]. 2015 Jul [cited 2020 Out 22];30(7): 1104-1111. Available from: https://academic.oup.com/ndt/article/30/7/1104/2324819

Pinto JMA, Saracini KC, Lima LCA, Souza LP, Lima MG, Algeri EDBO. Gasometria arterial: aplicações e implicações para a enfermagem. Rev Amazônia Science & Health [Internet]. 2017 Jun [cited 2020 Out 22];5(2):33-39.Available from: http://ojs.unirg.edu.br/index.php/2/article/view/1117

Hamilton PK, Morgan NA, Connolly GM, Maxwell AP. Understanding acid-base disorders. Ulster Med J [Internet] 2017 Jan [cited 2020 Out 23];86(3):161-166. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849971/

Camelo SHH. Competência profissional do enfermeiro para atuar em Unidades de Terapia Intensiva: uma revisão integrativa. Rev Latino-Am Enferm [Internet] 2012 Fev [cited 2020 Out 25];20(1):1-9. Available from:https://www.scielo.br/scielo.php?pid=S0104-11692012000100025&script=sci_abstract&tlng=pt

Sousa LMM, Marques-Vieira CMA, Severino SSP, Antunes AV. A metodologia de revisão integrativa da literatura em enfermagem. Rev Investigação Enferm [Internet] 2017 Nov [cited 2020 Out 25];17-26. Available from: https://www.researchgate.net/publication/321319742_Metodologia_de_Revisao_Integrativa_da_Literatura_em_Enfermagem

Souza MT, Silva MD, Carvalho R. Revisão integrativa: o que é e como fazer. Einstein [Internet].2010 [cited 2020 Out 25]; 8(1): 102-106. Available from: https://www.scielo.br/scielo.php?pid=S1679-45082010000100102&script=sci_arttext&tlng=pt

Riva, JJ, Malik KMP, Burnie SJ, Endicott AR, Busse JW. What is your research question? Na introduction to the PICOT format for clinicians. J Can Chiropr Assoc [Internet]. 2012 [cited 2020 Out 25]; 56(3): 167-71. Available from: https://pubmed.ncbi.nlm.nih.gov/22997465/

Oxford Centre for Evidence-Based Medicine. Níveis de evidencia científica segundo a Classificação de Oxford Centre for Evidence-Based Medicine [Internet]. 2001 [cited 2020 Nov 12]. Available from: https://portalarquivos2.saude.gov.br/images/pdf/2014/janeiro/28/tabela-nivel-evidencia.pdf

Soler VM, Sampaio R, Gomes MR. Gasometria arterial – Evidências para o cuidado de enfermagem. CuidArte Enferm [Internet]. 2012 Jul/dez [cited 2020 Nov 15];6(2):78-85. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1027861

Pompey J, Abraham-Settles B. Clarifying the confusion of arterial blood gas analysis: Is it compensation or combination?. Am J Nurs [Internet]. 2019 March [cited 2020 Nov 17]; 119(3):52-56. Available from: https://pubmed.ncbi.nlm.nih.gov/30801317/

Masco NA. Acid-base homeostasis: Overview for infusion nurses. J Infus Nurs [Internet]. 2016 Sept/oct [cited 2020 Nov 12];39(5):288-295. Available from: https://pubmed.ncbi.nlm.nih.gov/27598068/

Parry A, Higginson R. How to manage na arterial cateter. Nurs Standard [Internet]. 2016 March [cited 2020 Nov 15];30(29):36-9. Available from: https://journals.rcni.com/nursing-standard/how-to-manage-an-arterial-catheter-ns.30.29.36.s45

Lian JX. Using ABGs to optimize mechanical ventilation: three case studies illustrate how arterial blood gas analyses can guide appropriate ventilator strategy. Dimens Crit Care Nurs [Internet]. 2013 [cited 2020 nov 16];32(4): 204-209. Available from: https://europepmc.org/article/med/23759918

Christensen M, Chen F. Advanced arterial blood gas analysis in septic shock: A Singaporean nursing case review. Intens Crit Care Nurs [Internet]. 2013 Aug [cited 2020 Nov 16];29: 70-77. Available from: https://www.sciencedirect.com/science/article/abs/pii/S096433971200078X

Ellis MF. Use of bicarbonate in patients with metabolic acidosis. Crit Care Nurs [Internet]. 2015 [cited 2020 Nov 17]; 35(5): 73-75. Available from: https://pubmed.ncbi.nlm.nih.gov/26427978/

Barker ME. 0,9% Saline induced hyperchloremic acidosis. J Trauma Nurs [Internet]. 2015 Mar-Apr [cited 2020 Nov 17];22(2):111-116. Available from: https://pubmed.ncbi.nlm.nih.gov/25768968/

Gooch MD. Identifying acid-base and electroylyte imbalances. Nurse Pract [Internet] 2015 Aug [cited 2020 Nov 17];40(8):37-42. Available from: https://journals.lww.com/tnpj/Abstract/2015/08000/Identifying_acid_base_and_electrolyte_imbalances.9.aspx




URN: http://www.jsncare.uff.br/index.php/jsncareurn:nbn:de:1983-4152jsncare.v13i1.33469



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