The recommended care for critical patients with nursing diagnosis impaired gas exchange - Systematic Literature Review

Abstract

The nursing diagnosis impaired gas exchange is very common in intensive care units, and its resolution is used some nursing interventions, among them listen lungs and aspire airways. Objective: This research aimed to investigate what is the most efficient and current knowledge in making decisions about the care of the patient with this diagnosis. Method: Was used as a methodology to systematic review of the literature, using of scientific articles, as full text, published between 2009-2014, contained in LILACS and MEDLINE databases. Results: According to scientific evidence, endotracheal aspiration can be defined as an essential component of bronchial hygiene and mechanical. The main recommendations for suction are flights via: just suck when necessary; using a suction catheter with a diameter equal to less than half the tube diameter; should use the lowest possible vacuum pressure; should not remain more than 15 seconds performing the aspiration; should avoid washing with saline solution; should provide a hyperoxygenation process before aspiration; and lastly, it should be aseptic technique. Comparing the open and closed suction systems, there is little scientific evidence that supports the superiority of one system over the other. The aspiration procedure is associated with the complications and risks, for example, bleeding, infection, atelectasis and hypoxemia. Conclusion: It can be concluded that the suction of the airways is a procedure of extreme relevance for the critical patient with the nursing diagnosis impaired gas exchange. In addition, the use of scientific evidence for the qualification of the nursing team in conducting airway aspiration provides a safe care practice, full, efficient and humane to highly complex the client.