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
ABSTRACT
BACKGROUND:
The respiratory consequences of daily nursing care interventions in patients with acute respiratory distress syndrome (ARDS) are not clearly established. AIMS ANDOBJECTIVES:
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
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Base de dados:
MEDLINE
Assunto principal:
Síndrome do Desconforto Respiratório
/
Respiração com Pressão Positiva
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article