Síndrome do desconforto respiratório agudo: intervenções do enfermeiro no cuidado ao paciente na posição prona em terapia intensiva

Abstract

PORTO, M. M. N. Nursing interventions in the management of prone positioning in the care of critically ill patients in the intensive care unit: an integrative review. 2012. 73 fl. Dissertation (monograph) - School of Nursing, Federal University of Minas Gerais, Belo Horizonte, 2012. It is an integrative review aimed to analyze the interventions indicated for nurses in the management of prone positioning in the care of critically ill patients with Acute Respiratory Distress Syndrome in the Intensive Care Unit. We searched for studies in the databases SciELO, LILACS, MEDLINE with the following descriptors: adult respiratory distress syndrome, Intensive Care Unit, prone, Adult Respiratory Distress Syndrome, Intensive Care Units, Prone Position in Portuguese, English and Spanish, from 1997 to 2012. How to design the ten selected papers dealing with meta-analysis studies, controlled clinical trial almost random, non-randomized quasi-experimental study and report cases related to levels of evidence I, III, IV and V as the Classification proposed by Stetler et al. (1998). It can be argued that the study identified interventions to the use of the prone position on nursing care of critically ill patients. In this integrative review is evident the importance of the role of nurses in the prone position, whether in management, prevention of complications of this procedure, in assessing the needs of each patient and the availability of suitable equipment and devices. It is essential that nurses become more involved in research or resultos research and / or conduct studies that respond to the problems experienced in daily life, as well as seek implementation strategies of the available evidence in clinical practice that will result in the consolidation of Evidence-Based Practice. This work does not exhaust, and nor, answers all questions regarding the influence of patient mobilization in lung mechanics underwent pronation, but it shows that this mobilization may or may not be therapeutic. It also demonstrates that more studies about this topic are needed in order to view nursing care under the clinical point of view, creating evidence to base it in critical care, prescribed individually, depending on the patient's clinical, in the presence or absence protocols. We conclude that to do so, avoiding adverse events from the mobilization of critical patient, no longer held, simply, a position change and realized, with awareness and scientificity, a mobilization therapy.