Evidence-Based Nursing Practice About Impaired Ventilatory Weaning - Systematized Literature Review

Giselda Pacheco Silva, Isabel Cruz

Abstract


Mechanical ventilation is necessary to reverse respiratory disorders and has the negative effect of physical deconditioning as a result of the need for sedation and restriction of movement. Weaning is considered difficult when the patient meets the criteria to leave ventilatory support and has one or more failures in attempts at extubation, or when, after starting weaning, it is impossible to complete the withdrawal process. Objective: to show what specialized literature is about nursing interventions with patients weaning from mechanical ventilation. Methods: it is an integrative literature review with the following question: What is the specialized literature about nursing interventions with patients weaning from mechanical ventilation? Results: 10 full articles were used found in the database of Latin American and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE) and the EMBASE biomedical database, based on the time frame between the years 2012 to 2019 with articles in the Portuguese language. Discussion: ventilatory weaning is defined as the abrupt or gradual withdrawal of ventilatory support and contributes at least 40% of the overall MV period. Even so, several factors contribute to the failure of weaning and return to MV, such as retention of secretions, atelectasis, pulmonary congestion, myocardial ischemia, laryngeal edema and bronchoaspiration. Conclusion: Throughout the research, there was a shortage regarding the care of nursing professionals with patients on Mechanical Ventilation with indication for Ventilatory Weaning, since what is in vogue is only to identify care in certain groups.

Keywords


Nursing, Artificial Respiration, Extubation, Respirator Weaning, Intensive Care Units

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References


Matos CA, Meneses JB, Bucoski SCM, Mora CTR, Fréz AR, Daniel CR. Existe diferença na mobilização precoce entre os pacientes clínicos e cirúrgicos ventilados mecanicamente em UTI? Fisioter Pesqui [Internet]. 2016 June [cited 2020 Set 13]; 23(2):124-128. Available from: https://www.scielo.br/pdf/fp/v23n2/2316-9117-fp-23-02-00124.pdf

DOI: 10.1590/1809-2950/13965623022016

Muzaffar SN, Gurjar M, Baronia AK, Azim A, Mishra P, Poddar B, et al. Preditores, padrão de desmame e desfecho em longo prazo de pacientes com ventilação mecânica prolongada em unidade de terapia intensiva no norte da Índia. Rev bras ter intensiva [Internet]. 2017 Mar [cited 2020 Set 13];29(1):23-33. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2017000100023&lng=en DOI: http://dx.doi.org/10.5935/0103-507x.20170005

Adam CT, Vieira CT, Aguiar SC, Bündchen D, Vieira DSR. Protocolos para desmame da ventilação mecânica não invasiva: uma revisão sistemática. Fisioter Pesqui [Internet]. 2017 Dec [cited 2020 Set 13];24(4):453-460. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1809-29502017000400453&lng=en DOI:https://doi.org/10.1590/1809-2950/17542224042017

Ortega ICM, Valdivieso AMH, Lopez JFA, Villanueva MÁM, Lopez LHA. Avaliação dos índices de desmame com base na atividade do diafragma em pacientes submetidos à ventilação mecânica após cirurgia cardiovascular. Um estudo piloto. Rev Bras Ter Intensiva [Internet]. 2017 June [cited 2020 Set 13];29(2):213-221. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2017000200213&lng=en DOI: https://doi.org/10.5935/0103-507x.20170030

Silva LCR, Tonelli IS, Oliveira RCC, Lemos PL, Matos SS, Chianca TCM. Clinical study of Dysfunctional Ventilatory Weaning Response in critically ill patients. Rev Lat-Am Enferm [Internet]. 2020 [cited 2020 Set 13];28: e3334.Available from:https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-11692020000100384&tlng=en

Nascimento MS, Rebello CM, Vale LAPA, Santos E, Prado C. Spontaneous breathing test in the prediction of extubation failure in the pediatric population. Einstein [Internet]. 2017 [cited 2020 Set 13];15(2):162-166. Available from: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082017000200162

Piotto RF, Maia LN, Machado MN, Orrico SP. Efeitos da aplicação de protocolo de desmame de ventilação mecânica em Unidade Coronária: estudo randomizado. Rev Bras Cir Cardiovasc [Internet]. 2011 [cited 2020 Set 13];26(2): 213-221. Available from:https://www.scielo.br/scielo.php?pid=S0102-76382011000200011&script=sci_abstract&tlng=pt

Dexheimer Neto FL, Vesz PS, Cremonese RV, Leães CGS, Raupp ACT, Rodrigues CS, et al. Out-of-bed extubation: a feasibility study. Rev Bras Ter Intensiva [Internet]. 2014 [cited 2020 Set 13];26(3): 263-8. Available from: https://www.scielo.br/scielo.php?pid=S0103-507X2014000300263&script=sci_arttext&tlng=en

Rolim JFC, Moraes NHL, Uchôa Junior JR. Variáveis hemodinâmicas, hemogasométricas e respiratórias em pacientes cardiopatas submetidos ao teste de respiração espontânea. Fisioter mov [Internet]. 2011 Dec [cited 2020 Nov 05]; 24(4):673-682. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-51502011000400011&lng=en. Doi: https://doi.org/10.1590/S0103-51502011000400011.

Nozawa E, Feltrim MIZ, Hernandes NA, Preisig A, Malbouisson LMS, Auler Júnior JOC. Efeitos da posição sentada na força de músculos respiratórios durante o desmame de pacientes sob ventilação mecânica prolongada no pós-operatório de cirurgia cardiovascular. Fisioter. Pesqui. [Internet]. 2011 June [cited 2020 Nov 05]; 18(2):171-175. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1809-29502011000200012&lng=en. Doi:https://doi.org/10.1590/S1809-29502011000200012.




URN: http://www.jsncare.uff.br/index.php/jsncareurn:nbn:de:1983-4152jsncare.v13i1.33799



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