Cuidados de enfermería en la CAP neonatal / Nursing care in the use of neonatal continuous positive airway pressure

RESUMEN

La ventilación no invasiva neonatal, y principalmente la CPAP (Continuous Positive Airway Pressure), se ha convertido en una herramienta esencial en el manejo de la patología respiratoria y de soporte vital del recién nacido. Su uso se ha generalizado en la mayoría de los hospitales de nuestro medio. La administración de corticoides prenatales, del surfactante pulmonar y la CPAP son los pilares básicos que han contribuido a disminuir la mortalidad neonatal en los últimos años. La enfermería supone el pilar fundamental del éxito de la ventilación no invasiva. Para ello se debe conocer su manejo, sus características principales, los cuidados adecuados, las complicaciones y problemas técnicos. Pocos trabajos publicados se centran en los cuidados de enfermería a pesar de ser la base de su correcta aplicación. En este artículo se revisan la literatura, los cuidados básicos de enfermería y los protocolos de actuación, basados en la evidencia disponible y en la experiencia de las autoras (AU)

ABSTRACT

Noninvasive neonatal ventilation, and principally the method of CPAP neonatal Continuous Positive Airway Pressure (CPAP), has become an essential tool in the management of respiratory pathology and a vital support for the newborn. Its use has become a common procedure in the majority of our hospitals. Actually, it is the treatment of choice for neonatal respiratory distress syndrome, as much for full-term newborns as for premature babies. This is an alternative technique to invasive ventilation and one that aims to diminish the occurrence of bronchopulmonary dysplasia and other associated complications. The administering of prenatal steroids, pulmonary surfactants, and CPAC are the fundamental pillars that have contributed to the decrease in neonatal mortality in the last few years. We rely on a variety of devices to administer CPAP. Nursing care is the fundamental pillar of success in noninvasive ventilation. For this reason, it is essential to know how to carry it out, its principle characteristics, the proper care, as well as the most frequent complications and technical problems that can arise. Few published works concentrate on the nursing care and work, despite the fact that this is the base of its correct application. This article will briefly review the latest published data, go over the basic nursing care, underlining the necessity to establish protocols based on the available evidence and the experience acquired in recent years (AU)