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Nurse's Role and Responsibility In Mechanical Ventilation and Weaning and Its Methods

Year 2020, Issue: 3, 380 - 383, 01.09.2020

Abstract

Weaning from mechanical ventilation can be defined as the process of abruptly or gradually withdrawing ventilatory support and removing the intubation tube extubation . In this process, the respiratory load is shifted from the ventilator to the patient’s respiratory system. Practical knowledge of experienced nurses in mechanical ventilation and skills in the weaning process steps are required. Monitoring the nurses Or A close monitoring from the nurses ? and a correct orientation about the changes allow early detection of any problems by preventing delayed weaning. In this study, the methods used in the transition of the ventilatation from the mechanical ventilator to the control of the patient in addition to common nursing practices in different methods of mechanical ventilation are discussed

References

  • Öz H, Köksal MG. İnvaziv Mekanik Ventilasyon. Türkiye Klinikleri J Int Med Sci 2006; 2:89-96.
  • Koyuncu A, Yava A, Kürklüoğlu M, Güler A, Demirkılıç U. Mekanik Ventilasyondan Ayırma ve Hemşirelik. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2011;19:671-81. [CrossRef]
  • Dankers M, Grosu H, Jean R, Cruz RB, Fidellaga A, Han Q, et al. Nurse- Driven, Protocol-Directed Weaning From Mechanical Ventilation Improves Clinical Outcomes and is Well Accepted By Intensive Care Unit Physicians. J Crit Care. 2013;28:433–41. [CrossRef]
  • Crocker C. Weaning From Ventilation-Current State of the Science and Art. Nurs Crit Care 2009;14:185-90. [CrossRef]
  • Lavelle C, Dowling M. The Factors which Influence Nurses When Weaning Patients from Mechanical Ventilation: Findings From a Qualitative Study. Intensive Crit Care Nurs 2011;27:244-52. [CrossRef]
  • Tonnelier JM, Prat G, Gal LG, Gobert CG, Renault A, Boles JM, et all. Impact of a Nurses’ Protocol-Directed Weaning Procedure on Outcomes in Patients Under Going Mechanical Ventilation for Longer Than 48 Hours: a Prospective Cohort Study with a Matched Historical Control Group. Critical Care 2005;9:83-9. [CrossRef]
  • Irajpour A, Khodaee M, Yazdannik A, Abbasi S. Developing a Readiness Assessment Tool for Weaning Patients Under Mechanical Ventilation. Iran J Nurs Midwifery Res 2014; 19: 273–8.
  • Selek Ç, Özcan EP, Orhun G, Şentürk E, Akıncı İÖ, Çakar N. Mekanik Ventilasyondan Weaning Sürecinde T-parçası ile Otomatik Tüp Kompansasyonu (OTK) Yöntemlerinin Karşılaştırılması. Turk J Anaesth Reanim. 2014; 42: 91-5. [CrossRef]
  • Yorgancı K, Topeli İskit A. (Çev). Mekanik Ventilasyonun Sonlandırılması. Ankara, Türkiye: Palme Yayıncılık; 2009. p. 511-27.
  • Gelsthorpe T, Crocker C. A Study Exploring Factors Which Influence the Decisionto Commence Nurse-Led Weaning. Nurs Crit Care 2004;9:213-21.
  • Arnal JM. Clinical Practice Guidelines for Weaning Critically ill Adult Patients from Mechanical Ventilation. 2017. https://www. hamilton-medical.com/pt/News/Newsletter-articles/Article~2017- 04-03~Clinical-practice-guidelines-for-weaning-critically-ill-adult- patients-from-mechanical-ventilation~178b221a-8be7-44b5-a39a- 47af0f1aacf7~.html Erişim: 26.08.2019.
  • Geiseler J, Kelbel C. Weaning From Mechanical Ventilation. Weaning Categories and Weaning Concepts. Med Klin IntensivMed Notfmed 2016; 111:208-14. [CrossRef]
  • Taylor F. A Comparative Study Examining the Decision Making Processes of Medicaland Nursing Staff in Weaning Patients From Mechanical Ventilation. Intensive Crit Care Nurs 2006; 22:253-63. [CrossRef]
  • Karcz M, Vitkus A, Papadakos PJ, Schwaiberger D, Lachmann B. State of‐the‐Art Mechanical Ventilation. J Cardiothoracic and Vasc Anesth 2012; 26: 486‐506. [CrossRef]
  • Korkmaz FD, İlçe AÖ. Mekanik Ventilatörden Ayırmada Hemşirenin Rolü. Turkiye Klinikleri J Nurs Sci 2009;1:81-7.
  • Macintyre NR. Respiratory Mechanics in the Patient who is Weaning from the Ventilator. Respir Care 2005; 50:275-86.
  • White AC. Long‐Term Mechanical Ventilation. Management Strategies. Respir Care. 2012; 57:889–97. [CrossRef]
  • Schmidt GA, Girard TD, Kress JP, Morris PE, Ouellette DR, Alhazzani W, et al. Official Executive Summary of an American Thoracic Society/ American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults. Am J Respir Crit Care Med. 2017; 195:115-9. [CrossRef]
  • Karakoç E. Temel Mekanik Ventilasyon Modları ve Ayarlamalar. Yoğun Bakım Derg 2007; 7:317-21.
  • Ghodrati M, Pournajafian A, Khatibi A, Niakan M, Hemadi MH, Zamani MM. Comparing the Effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation (SIMV) on Respiratory Parameters in Neurosurgical ICU Patients. Anesth Pain Med. 2016; 6:e40368. [CrossRef]
  • Jaber S, Petrof JB, Jung B, Chanques G, Berthet JB, Rabuel C, et all. Rapidly Progressive Diaphragmatic Weakness and Injury during Mechanical Ventilation in Humans. Am J Respir Crit Care Med 2011;183:364-71. [CrossRef]
  • Black JM, Hawks JH. Medical-Surgical Nursing: Clinical Management for Positive Outcomes, 8th ed, Philadelphia, Saunders Elsevier; 2009.p. 1880-6.
  • Girard TD, Alhazzani W, Kress JP, Ouellette DR, Schmidt GA, Truwit JD, et al. An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically III Adults. Rehabilitation Protocols, Ventilator Liberation Protocols, and Cuff Leak Tests. Am J Respir Crit Care Med. 2017;195:120-33. [CrossRef]
  • Pattison N, Watso J. Ventilatory Weaning: A Case Study of Protracted Weaning. British Association of Critical Care Nurses. 2009; 14:75-85. [CrossRef]
  • Tabaeian SM, Yazdannik A, Abbasi S. Compliance with the Standards for Prevention of Ventilator-Associated Pneumonia by Nurses in the Intensive Care Units. Iran J Nurs Midwifery Res. 2017;22:31–6. [CrossRef]
  • Perren A, Brochard L. Managing The Apparent and Hidden Difficulties of Weaning From Mechanical Ventilation. Intensive Care Med. 2013;39:1885–95. [CrossRef]

Mekanik Ventilasyon Ayırma Yöntemleri ve Hemşirenin Rolü

Year 2020, Issue: 3, 380 - 383, 01.09.2020

Abstract

Mekanik ventilatörden ayırma, solunum desteğiyle mekanik ventilatöre bağlanan hastanın destekten ve entübasyon tüpünden ayrılmasını içeren süreçtir. Bu süreçte, solunum yükü ventilatörden hastaya geçer. Mekanik ventilatörden ayırma işlemi aşamalarında ileri hemşirelik bilgisi ve uygulaması gereklidir. Hemşirenin solunum fonksiyonlarındaki değişimleri izlemesi ve doğru yönlendirmesi mekanik ventilatörden ayırmanın gecikmesini engelleyerek sorunların erken dönemde saptanmasını sağlar. Bu derlemede, solunum işinin ventilatörden bireyin kontrolüne geçişinin sağlanması sürecinde kullanılan yöntemler ve uygulanan farklı yöntemlerdeki ortak hemşirelik uygulamaları ele alınmıştır

References

  • Öz H, Köksal MG. İnvaziv Mekanik Ventilasyon. Türkiye Klinikleri J Int Med Sci 2006; 2:89-96.
  • Koyuncu A, Yava A, Kürklüoğlu M, Güler A, Demirkılıç U. Mekanik Ventilasyondan Ayırma ve Hemşirelik. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2011;19:671-81. [CrossRef]
  • Dankers M, Grosu H, Jean R, Cruz RB, Fidellaga A, Han Q, et al. Nurse- Driven, Protocol-Directed Weaning From Mechanical Ventilation Improves Clinical Outcomes and is Well Accepted By Intensive Care Unit Physicians. J Crit Care. 2013;28:433–41. [CrossRef]
  • Crocker C. Weaning From Ventilation-Current State of the Science and Art. Nurs Crit Care 2009;14:185-90. [CrossRef]
  • Lavelle C, Dowling M. The Factors which Influence Nurses When Weaning Patients from Mechanical Ventilation: Findings From a Qualitative Study. Intensive Crit Care Nurs 2011;27:244-52. [CrossRef]
  • Tonnelier JM, Prat G, Gal LG, Gobert CG, Renault A, Boles JM, et all. Impact of a Nurses’ Protocol-Directed Weaning Procedure on Outcomes in Patients Under Going Mechanical Ventilation for Longer Than 48 Hours: a Prospective Cohort Study with a Matched Historical Control Group. Critical Care 2005;9:83-9. [CrossRef]
  • Irajpour A, Khodaee M, Yazdannik A, Abbasi S. Developing a Readiness Assessment Tool for Weaning Patients Under Mechanical Ventilation. Iran J Nurs Midwifery Res 2014; 19: 273–8.
  • Selek Ç, Özcan EP, Orhun G, Şentürk E, Akıncı İÖ, Çakar N. Mekanik Ventilasyondan Weaning Sürecinde T-parçası ile Otomatik Tüp Kompansasyonu (OTK) Yöntemlerinin Karşılaştırılması. Turk J Anaesth Reanim. 2014; 42: 91-5. [CrossRef]
  • Yorgancı K, Topeli İskit A. (Çev). Mekanik Ventilasyonun Sonlandırılması. Ankara, Türkiye: Palme Yayıncılık; 2009. p. 511-27.
  • Gelsthorpe T, Crocker C. A Study Exploring Factors Which Influence the Decisionto Commence Nurse-Led Weaning. Nurs Crit Care 2004;9:213-21.
  • Arnal JM. Clinical Practice Guidelines for Weaning Critically ill Adult Patients from Mechanical Ventilation. 2017. https://www. hamilton-medical.com/pt/News/Newsletter-articles/Article~2017- 04-03~Clinical-practice-guidelines-for-weaning-critically-ill-adult- patients-from-mechanical-ventilation~178b221a-8be7-44b5-a39a- 47af0f1aacf7~.html Erişim: 26.08.2019.
  • Geiseler J, Kelbel C. Weaning From Mechanical Ventilation. Weaning Categories and Weaning Concepts. Med Klin IntensivMed Notfmed 2016; 111:208-14. [CrossRef]
  • Taylor F. A Comparative Study Examining the Decision Making Processes of Medicaland Nursing Staff in Weaning Patients From Mechanical Ventilation. Intensive Crit Care Nurs 2006; 22:253-63. [CrossRef]
  • Karcz M, Vitkus A, Papadakos PJ, Schwaiberger D, Lachmann B. State of‐the‐Art Mechanical Ventilation. J Cardiothoracic and Vasc Anesth 2012; 26: 486‐506. [CrossRef]
  • Korkmaz FD, İlçe AÖ. Mekanik Ventilatörden Ayırmada Hemşirenin Rolü. Turkiye Klinikleri J Nurs Sci 2009;1:81-7.
  • Macintyre NR. Respiratory Mechanics in the Patient who is Weaning from the Ventilator. Respir Care 2005; 50:275-86.
  • White AC. Long‐Term Mechanical Ventilation. Management Strategies. Respir Care. 2012; 57:889–97. [CrossRef]
  • Schmidt GA, Girard TD, Kress JP, Morris PE, Ouellette DR, Alhazzani W, et al. Official Executive Summary of an American Thoracic Society/ American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults. Am J Respir Crit Care Med. 2017; 195:115-9. [CrossRef]
  • Karakoç E. Temel Mekanik Ventilasyon Modları ve Ayarlamalar. Yoğun Bakım Derg 2007; 7:317-21.
  • Ghodrati M, Pournajafian A, Khatibi A, Niakan M, Hemadi MH, Zamani MM. Comparing the Effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation (SIMV) on Respiratory Parameters in Neurosurgical ICU Patients. Anesth Pain Med. 2016; 6:e40368. [CrossRef]
  • Jaber S, Petrof JB, Jung B, Chanques G, Berthet JB, Rabuel C, et all. Rapidly Progressive Diaphragmatic Weakness and Injury during Mechanical Ventilation in Humans. Am J Respir Crit Care Med 2011;183:364-71. [CrossRef]
  • Black JM, Hawks JH. Medical-Surgical Nursing: Clinical Management for Positive Outcomes, 8th ed, Philadelphia, Saunders Elsevier; 2009.p. 1880-6.
  • Girard TD, Alhazzani W, Kress JP, Ouellette DR, Schmidt GA, Truwit JD, et al. An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically III Adults. Rehabilitation Protocols, Ventilator Liberation Protocols, and Cuff Leak Tests. Am J Respir Crit Care Med. 2017;195:120-33. [CrossRef]
  • Pattison N, Watso J. Ventilatory Weaning: A Case Study of Protracted Weaning. British Association of Critical Care Nurses. 2009; 14:75-85. [CrossRef]
  • Tabaeian SM, Yazdannik A, Abbasi S. Compliance with the Standards for Prevention of Ventilator-Associated Pneumonia by Nurses in the Intensive Care Units. Iran J Nurs Midwifery Res. 2017;22:31–6. [CrossRef]
  • Perren A, Brochard L. Managing The Apparent and Hidden Difficulties of Weaning From Mechanical Ventilation. Intensive Care Med. 2013;39:1885–95. [CrossRef]
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

Canan Kaş Güner

Sevinç Kutlutürkan

Publication Date September 1, 2020
Published in Issue Year 2020Issue: 3

Cite

EndNote Güner CK, Kutlutürkan S (September 1, 2020) Mekanik Ventilasyon Ayırma Yöntemleri ve Hemşirenin Rolü. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 3 380–383.