Non-Invasive Ventilation in People With Acute Lung Edema

The objective of this study is to identify the health gains obtained with the use of non-invasive ventilation in patients with acute lung edema. A narrative review of the literature was carried out with bibliographic research carried out in the CINAHL, MEDLINE, and COCHRANE databases, in May 2019, with defined inclusion criteria and descriptors. This review highlighted a set of conclusive studies on the place of operation as the first line, as well as the contribution to the reduction of mortality, the need for endotracheal intubation, and a reduction in hospital stay. These results can contribute to the improvement of healthcare, practices, and patient satisfaction.

Early Weaning of the Person Undergoing Invasive Mechanical Ventilation

The use of invasive mechanical ventilatory support has been increasingly used in the treatment of respiratory insufficiency, since it replaces the respiratory work while reversing the pathological processes that led to its necessity, allowing the recovery of respiratory function. The critical patient's ventilatory weaning requires a rigorous assessment by qualified professionals to reduce complications and the eventual need for (re) intubation, referring to the design and implementation of rehabilitation nursing programs. The nurse specialist in rehabilitation nursing intervenes in an early, autonomous, and differentiated way, avoiding complications and incapacities, promoting effective ventilatory weaning. This integrative review of the literature made evident the gains obtained in the critical patient undergoing invasive mechanical ventilation and included in an early rehabilitation program, revealing significant impact for both the patient and the hospital institution.

Non-Invasive Ventilation

The objective of this chapter is to analyze articles on the adaptation of the elderly to NIV. The methodology is integrative literature review, using the PICO methodology. After analyzing the content covered, the authors found that there are common factors regarding the adaptation of elderly users to NIV. COPD users are the main users of NIV. This technique promotes an improvement in the quality of life. The introduction of NIV in the user's daily life requires behavioral and lifestyle changes involving health professionals, the user, and caregivers. The choice of the type of ventilator and interfaces is important, in issues such as late assessment of the user's condition and the influence of external factors in adapting to NIV, such as the use of drugs. The adaptation of the elderly user to NIV is influenced by socio-demographic, pathological, anatomical, and associated factors.

Inhalotherapy in Noninvasive Ventilation

The use of non-invasive ventilation (NIV) has markedly increased over the last decades, and NIV has now become an important alternative to invasive ventilation and has gained popularity particularly as treatment option for patients with obstructive sleep apnea, chronic obstructive pulmonary disease (COPD), and acute respiratory failure. The most prominent forms of NIV are noninvasive positive pressure ventilation (NPPV) and the recently introduced high-flow nasal cannula (HFNC) therapy. Many patients who received NIV may also benefit from the administration of pharmaceutical aerosols, typically bronchodilators, which are best delivered without interrupting respiratory support. For example, nowadays, the use of NIV is considered the standard of care for some forms of acute respiratory failure such as COPD exacerbation and acute cardiogenic pulmonary edema. Patients with COPD exacerbation also benefit from inhaled bronchodilator therapy.

Outpatient Oxygen Therapy, Illness Experience, and Mental Health

This chapter is a literary review based on the experience of patients with ambulatory oxygen therapy treatment that analysed the way in which this treatment influences patients from an occupational point of view. The relationship of these pathologies and treatments with mental health, especially with depression, anxiety, and stress, is also addressed, with an interest in the treatment of possible functional limitations from the intervention of the discipline of occupational therapy. Oxygen therapy allows patients to continue in their performance contexts, although it can generate new limitations and deficiencies derived from episodes of anxiety and mood disorders, causing greater occupational disfunction. A function-dysfunction process that can be approached from occupational therapy with the aim of minimizing the impact both physical and psychological, enhancing the autonomy and independence of these patients.

Ambulatory Oxygen Therapy From Narrative-Based Medicine

Oxygen therapy consists on administering oxygen at a higher concentration than that found in the air in order to treat problems due to respiratory failure. When the oxygen therapy treatment is not necessary to administer in the hospital, within a hospital admission, it can be prescribed for the patient to receive at home, referred to as continuous home oxygen therapy. This type of therapy has great advantages for patients and their families because it allows them to stay together longer. But there are also important difficulties to be taken into account that have to do with the handling of the devices that are used for the administration of oxygen, as well as the compliance or not of the time prescribed by the health professional.

Noninvasive Ventilation in the Elderly Patient With COPD

The objective of this chapter is to identify the latest evidence on the elderly critical patient with chronic obstructive pulmonary disease. Nine articles were analysed. The effectiveness of NIV has been demonstrated in cases of elderly critically ill patients with acute COPD. Evidence has been shown to decrease hospital stay and mortality, although long-term survival has been shown to be short. The prediction of NIV failure is multifactorial, including very old age, comorbidities, low analytical values of albumin, simplified severity index II, pH < 7.3 of arterial blood, PaCO2 (Carbon Dioxide Pressure) < 45 mmHg, CAT (COPD Assessment Test) elevated, Glasgow Coma Scale < 11, and APACHE II (Acute Physiology and Chronic Health Evaluation) 29. NIV has demonstrated efficacy in elderly patients in situations of acute COPD.

Person in Need of Airway Cleaning and Use of Mechanical Insufflator-Exsufflator

Clearing of the airways in patients undergoing invasive mechanical ventilation (IMV) or non-invasive mechanical ventilation (NIMV) is a fundamental intervention that should be performed regularly, not only to avoid accumulation of secretions, but also to prevent the accumulation of secretions. One of the most relevant interventions in this type of patients is the use of the mechanical insufflator-exsufflator (MI-E), commonly known as cough assist. On the other hand, respiratory functional reeducation (RFR) involves a set of non-invasive procedures that allow the secretion to be released. The efficacy of the RFR associated with the use of MI-E presents gains resulting from this conjugation, namely when the person does not cooperate, when he/she shows a decrease in muscle strength or fails to present an effective cough. The integrative review of the literature has made evident the gains that exist for the person in intensive care, using MI-E associated with airway clearance, ventilation performance, airway permeability, decreased complications, and rate mortality.

Non-Invasive Ventilation in Alveolar Obesity-Hypoventilation Syndrome

Obesity is the main risk factor for several sleep breathing disorders, including obstructive sleep apnea syndrome (OSAS), either alone or associated with chronic obstructive pulmonary disease (COPD), and alveolar obesity-hypoventilation syndrome (AOHS). In several of these conditions, the indicated treatment includes the use of non-invasive ventilation during sleep, such as the use of continuous positive airway pressure (continuous positive airway pressure or CPAP) and two-level pressure (BIPAP, bi-level positive airway pressure). In this chapter, a brief review is made of what the most recent studies say regarding the treatment of SOHA with non-invasive ventilation (NIV), comparing different ventilation modes and/or treatments.

Rehabilitation Nursing Care for the Person in the Context of Non-Invasive Ventilation

Non-invasive ventilation is, nowadays, a well received, successful therapeutic strategy for the treatment of different varieties of respiratory failure. Associated to respiratory rehabilitation and exercise training, NVI brings numerous advantages to the person, namely in the control of symptoms, in the quality of life, in the reduction of the perception of dyspnea, in the increase of the tolerance to the activity, and in the decrease in the use of health services. The intervention of the specialist nurse in rehabilitation nursing is essential in order to maximize health gains. However, the bibliography that supports these gains with the intervention of the EEER needs greater investment in the research area.