Impact of nursing care on lung functional residual capacity in acute respiratory distress syndrome patients

Abstract

Background: The respiratory consequences of daily nursing care interventions in patients with acute respiratory distress syndrome (ARDS) are not clearly established. Aims and objectives: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

Spotlight on the first joint BACCN/IACCN conference

“…Guner and Kutluturkan's randomized controlled trial adds to the growing body of evidence about the optimum angle of the head of bed elevation that is safe and effective in the prevention of ventilator-associated pneumonia, 9 while Burey et al investigated the feasibility of alveolar collapse analysis by measuring lung impedance distribution by nurses caring for patients with acute respiratory distress syndrome. 10 The other papers in this issue focus on pain intensity during treatment and care procedures 11 and after discharge from ICU 12 ; enteral nutrition practices by ICU nurses 13 ; medication administration through enteral feeding tubes 14 ; the development of an oral care frequency assessment scale 15 ; and ICU nurses' knowledge and practice regarding maintaining arterial catheter patency. 16 The authors of these papers employed various quantitative and qualitative methodologies, varying from randomized controlled trials and prospective observational studies to cross-sectional studies and survey design, and from document analysis and retrospective service evaluation to narrative inquiry.…”

“…Respiratory care also features prominently in this issue. Guner and Kutluturkan's randomized controlled trial adds to the growing body of evidence about the optimum angle of the head of bed elevation that is safe and effective in the prevention of ventilator‐associated pneumonia, 9 while Burey et al investigated the feasibility of alveolar collapse analysis by measuring lung impedance distribution by nurses caring for patients with acute respiratory distress syndrome 10 …”