Impact of nursing care on lung functional residual capacity in acute respiratory distress syndrome patients.
Nurs Crit Care
; 27(5): 652-657, 2022 09.
Article
em En
| MEDLINE
| ID: mdl-33860610
BACKGROUND: The respiratory consequences of daily nursing care interventions in patients with acute respiratory distress syndrome (ARDS) are not clearly established. AIMS AND OBJECTIVES: The main objective of this study was to assess the feasibility of alveolar collapse analysis by the measurement of lung impedance distribution technique during nursing care in patients with ARDS. DESIGN: Prospective observational pilot physiologic study in a surgical intensive care unit of a tertiary care hospital including adult intubated patients with moderate-to-severe ARDS. METHODS: Each patient was monitored for 12 hours using a chest impedance device. Daily care interventions studied were as follows: endotracheal suctioning, mouth care, bed-bathing, and blood sampling. The primary endpoint was the variation in end-expiratory lung impedance (reflecting functional residual capacity) before and 1, 5, 15, and 30 minutes after nursing care interventions. Data are presented as median (interquartile-range). RESULTS: One hundred and eight events were collected in 18 patients. Endotracheal suctioning (n = 42), mouth care (n = 26), and bed-bathing (n = 23) induced a significant decrease in lung impedance after care: endotracheal suctioning (-40.0 [-53.8; -28.6]% at 1 minute [P < .001], -10.4 [-27.9; 1.8]% at 30 minutes [P = .03]; mouth care -17.9 [-45.4; -14.6]% at 1 minute [P < .001], -10.4 [-21.3; 3.4]% at 30 minutes [P = .01]; bed-bathing -40.2 [-53.5; -14.3]% at 1 minute [P < .001], -10.6 [-36.4; 1.6]% at 30 minutes [P = .01]). Blood sampling (n = 17) did not induce significant changes in lung impedance. CONCLUSIONS: The lung impedance distribution technique during nursing care appears feasible in the majority of patients with ARDS. Some daily nursing care in ARDS patients (including bed-bathing and mouth care) resulted in a prolonged decrease in lung functional residual capacity and therefore could be associated with pulmonary de-recruitment. RELEVANCE TO CLINICAL PRACTICE: A caregiver who has to assess the functional residual capacity of these patients should probably be informed of the schedules of the nursing care interventions.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Síndrome do Desconforto Respiratório
/
Respiração com Pressão Positiva
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Nurs Crit Care
Assunto da revista:
ENFERMAGEM
/
TERAPIA INTENSIVA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França