Nonpharmacological Interventions to Manage Common Symptoms in Patients Receiving Mechanical Ventilation

Abstract

Patients receiving mechanical ventilation can experience symptoms such as pain, anxiety, agitation, and lack of sleep while in the intensive care unit, all of which can affect healing. Nonpharmacological complementary therapies can be used as adjuncts to sedatives and analgesics. By incorporating appropriate use of complementary therapies in conjunction with mainstream medical therapies, nurses can decrease patients’ anxiety, promote sleep, and promote a healing environment to improve outcomes. Minimizing noise and providing access to natural light help promote a healing environment. Methods to promote sleep include relaxation techniques such as progressive muscle relaxation and massage and communication with patients’ and their families to determine the patients’ normal sleep patterns. Complementary therapies to relieve anxiety and agitation include music intervention, imagery, presence, and animal-assisted therapy.

Introduction to Complementary, Alternative, and Traditional Therapies

“…Such therapies can ameliorate the adverse experience of critical illness in countless ways: improved sleep; decreased anxiety and discomfort; lowered heart rate, respiratory rate, and blood pressure; decreased levels of stress hormones; immune system stimulation; normalized intestinal motility; and reduced need for analgesics and sedatives. 35,36 In patients with life-threatening illness for whom conventional care may have been unsuccessful or escalation of care may be deemed too risky or no longer beneficial, CAM therapies may be considered to enhance the patients' comfort. 37 The goal of CAM therapies is not to replace modern medicine, as the term might suggest.…”

Sleep Disturbances and Critical Illness

“…These include massage, foot rubs, relaxation techniques, reading, acupuncture, mobilization and optimizing comfort [9,11,18,25,27]. Massage may activate the parasympathetic nervous system, which results in a decrease in heart rate, blood pressure, respiratory rate and stress.…”

Achieving Quality Patient-Ventilator Management: Advancing Evidence-Based Nursing Care

“…Although only a limited selection of complementary therapies are addressed in an article by Tracy and Chlan,3 there is great opportunity for research that tests these adjunctive interventions for their influence on common symptoms experienced by patients The current AACN research priorities are summarized into 5 broad priority areas to guide future research activities and initiatives.…”

“…Three articles [1][2][3] presented as a series in the June 2011 issue of Critical Care Nurse address selected aspects of caring for patients receiving mechanical ventilatory support based on the authors' expertise and include an overview of mechanical ventilatory support, 1 promoting effective communication with patients receiving mechanical ventilation, 2 A lthough most of the technical aspects of managing the mechanical ventilator are the responsibility of respiratory care practitioners, nurses are responsible for the holistic care of patients, including management of common symptoms and responses to mechanical ventilatory support. To care for patients effectively, nurses must be comfortable and confident in their knowledge of basic principles of mechanical ventilatory support This article presents suggestions for nurses to gain skill, competence, and comfort in caring for critically ill patients receiving mechanical ventilatory support, with a specific focus on education strategies and building communication skills with these challenging nonverbal patients.…”

“…3 The overall purpose of that series of articles was to empower and educate nurses with respect to caring for patients receiving mechanical ventilatory support. In addition to specific implications for nursing practice and research contained in each of the articles, we offer as a summary to the series additional suggestions to promote patientcentered care with an emphasis on implications for evidence-based nursing practice and implications for nursing research.…”