Best Practices to Prevent Complications in Non-Invasive Ventilation

Yıl 2025, Sayı: 7, 20 - 35, 28.02.2025

Celina Maria Peixoto Ladeira , Luis Paiva , Hélène Ferreira Malta

https://doi.org/10.26650/CURARE.2025.1575611

Öz

Objective: Non-invasive ventilation (NIV) refers to the delivery of positive pressure ventilation without using invasive methods. To develop a best practices protocol to standardise nursing interventions for preventing complications associated with the interface and air pressure/flow and to optimise NIV.

Methods: A non-probability snowball, convenience or intentional study was carried out using the Delphi technique. Online questionnaires in two rounds were applied to 24 nurses who were experts in the field under study, selected according to previously defined criteria.

Results: The expert panel reached a consensus on 67 nursing interventions to prevent two types of NIV complications: those associated with the interface (facial pain or discomfort, noise, skin lesions on the nasal bridge and face, carbon dioxide rebreathing, claustrophobia, and patient-ventilator asynchrony) and those associated with air pressure/flow (air leaks; nasal and oral dryness/congestion, conjunctivitis; aerophagia and abdominal distension).

Conclusion: A validated protocol for patients undergoing NIV can support decision-making, provide a set of evidence-based interventions and promote the quality and standardisation of nursing care practices to improve the effectiveness and, consequently, the success of NIV.

Anahtar Kelimeler

Non-invasive ventilation , nursing care , prevention

Kaynakça

• 1 Costa JC, Machado JN, Costa J, Fortuna J, Gama J, Rodrigues C. Ventilaçao nao invasiva: Experiencia de um serviço de medicina interna. Medicina Interna. 2018;25(l):18-22. https://doi.Org/10.24950/rspmi/original/78/1/2018 google scholar
• 2 Seyfi S, Amri P, Mouodi S. New modalities for non-invasive positive pressure ventilation: A review article. Caspian Journal of Internal Medicine. 2019;10(1):1-6. https://doi.org/10.22088/cjim.10.1.1 google scholar
• 3 Gregoretti C, Pisani L, Cortegiani A, Ranieri VM. Noninvasive ventilation in critically Ill patients. Critical Care Clinics. 2015;31(3):435-457. https://doi.org/10. 1016/j.ccc.2015.03.002 google scholar
• 4 Reis C, Leite T, Fonseca C, Santos V. Ganhos de Reabilitaçao respiratöria em pessoas com insuficiencia respiratöria submetidas a ventilaçao nao-invasiva :Revisao sistemâtica da literatura. Journal of Aging & Innovation. 2019;8(1):4-13. http://www.journalofagingandinnovation.org/wp-content/uploads/1JAIV8E1.pdf google scholar
• 5 Lazovic B, Dmitrovic R, Simonovic I, Esquinas AM, Mina B, Zack S. Unusual complications of non-invasive mechanical ventilation (NIV) and high-flow nasal cannula (HF-NC): A systematic review. Tuberkuloz ve Toraks. 2022;70(2):197-202. https://doi.org/10.5578/tt.20229810 google scholar
• 6 Rolle A, Jong A, Vidal E, Molinari N, Azoulay E, Jaber S. Cardiac arrest and complications during non-invasive ventilation: A systematic review and meta-analysis with meta-re-gression. Intensive Care Medicine. 2022;48(11):1513-1524. https://doi.org/10.1007/s00134-022-06821-y google scholar
• 7 Pereira RD, Alvim NA. Delphi technique in dialogue with nurses on acupuncture as a proposed nursing intervention. Escola Anna Nery - Revista de Enfermagem. 2015;19(1):174-180. https://doi.org/10.5935/1414-8145.20150024 google scholar
• 8 Marques JBV, Freitas D. Metodo Delphi : Caracterizaçao e potencialidades na pesquisa em educaçao. Pro-Posiçöes. 2018;29(2).389-415. https://doi.org/10.1590/1980-6248-2015-0140 google scholar 9 Valdes MG, Marın MS. Empleo del metodo Delphi en investigaciones sobre salud publicadas en revistas cientîflcas cubanas. Revista Cubana de Informaciön En Ciencias de La Salud. 2013 ;24(2):133-144. https://doi.org.10.36512/rcics.v24i2.414 google scholar
• 10 Gomes GC. Ferramenta web de suporte ao estudo delphi [Master’s dissertation, Instituto Superior Tecnico da Universidade de Lisboa]. Repositörio Institucional do Instituto Superior Tecnico da Universidade de Lisboa, Engenharia Informâtica e de Computadores, 2017. https://fenix.tecnico.ulisboa.pt/departamentos/dei/ dissertacao/1691203502342760 google scholar
• 11 Melo RP, Moreira RP, Fontenele FC, Aguiar ASC, de Joventino ES, Carvalho EC de, Criterios de seleçao de experts para estudos de validaçao de fenömenos de enfermagem TT - Criteria for selection of experts for validation studies of nursing phenomena. Revista RENE. 2011;12(2):424-431. http://www.revistarene. ufc.br/revista/index.php/revista/article/download/174/83 google scholar
• 12 Passos J, Sequeira C, Fernandes L. Desenvolvimento de um catâlogo CIPE: Necessidades do idoso em enfermagem de saüde mental e psiquiatria. Portuguese Journal of Mental Health Nursing. 2013;(10):15-23. https://doi.org/ 10.19131/rpesm.0049 google scholar
• 13 Chalmers J, Armour M. The delphi technique. In P. Liamputtong (Ed.). Handbook of Research Methods in Health Social Sciences. 2019; pp.715-735. Springer. https://doi.org/10.1007/978-981-10-5251-4_99 google scholar
• 14 Malta HF. Enfermeiros da Viatura Medica de Emergencia e Reanimaçao: Que competencias? [Master’s dissertation, Escola Superior de Enfermagem de Coimbra]. Escola Superior de Enfermagem de Coimbra 2016. google scholar
• 15 Scarparo AF, Laus AM, Azevedo AL, Freitas MR, Gabriel CS, Chaves LD. Reflexöes sobre o uso da tecnica Delphi em pesquisas na enfermagem. Revista Rene. 2012;13(1):242-251. https://pdfs.sema nticscholar.org/f4eb/593021eeaa3665cf3a2a5db9f281fb391cb8.pdf google scholar
• 16 Wright JT, Giovinazzo R.A. Delphi: uma ferramenta de apoio ao planejamento prospectivo. Caderno de Pesquisa Em Administraçao. 2000;l(l2):54-65. https://pt.scribd.com/document/257810335/Wright-Giovinazzo-2000-Delphi-Uma-Ferramenta-de-Apoio-Ao-Planejamento-Prospectivo google scholar
• 17 Scapolo F, Miles I. Eliciting experts’ knowledge: A comparison of two methods. Technological Forecasting and Social Change. 2006;73(6):679-704. https://doi. org/10.1016/j.techfore.2006.03.001 google scholar
• 18 Rodrigues CC, Dias RB, Junior AC. Construçao de consenso Delphi das competencias otorrinolaringolögicas preconizadas ao egresso de medicina. Revista Brasileira de Educaçao Medica. 2021;45(3):1-9. https://doi.org/10.1590/ 1981-5271v45.3-20210024 google scholar
• 19 Ordem dos Enfermeiros [OE] (2019). Regulamento das Competencias Comuns do Enfermeiro Especialista. Regulamento n° 140/2019, de 6 de fevereiro. Lisboa: Diârio da Repüblica, 2019. n° 26-Serie II. https://www.ordemenfermeir os.pt/media/10778/0474404750.pdf google scholar
• 20 Cunha PT. Percursos de prâtica perita de enfermeiros a trabalhar numa unidade de cuidados intensivos [Master’s dissertation, Instituto Politecnico de Viana do Castelo]. Repositörio Institucional do Instituto Politecnico de Viana do Castelo, 2017. http://repositorio.ipvc.pt/handle/20.500.11960/1887 google scholar
• 21 Criner GJ, Gayen S, Zantah M, Dominguez Castillo E, Naranjo M, Lashari B, Pourshahid S, Gangemi A. Clinical review of non-invasive ventilation. The European Respiratory Journal. (2024;64(5):2400396. https://doi.org/10.1183/ 13993003.00396-2024 google scholar
• 22 Silva NS, Baptista CSD, Melo EMOP, Tavares JPA. Ventilaçao nao invasiva em pessoas internadas em serviços de medicina: Estudo retrospetivo. Revista De Enfermagem Referencia. 2024;6(3):1-9. https://doi.org/10.12707/RVI23.95.32475 google scholar
• 23 Joint Commission International. Joint Commission International Accreditation Standards for Hospitals (6th ed.). 2017. https://www.jointcommissioninternatio nal.org/assets/3/7/JCI_Standards_Only_6th_Ed_Hospital.pdf google scholar
• 24 Sales CB, Bernardes A, Gabriel CS, Brito MF, Moura AA, Zanetti B. Protocolos operacionais padrao na prâtica profissional da enfermagem: Utilizaçâo, fragilidades e potencialidades. Revista Brasileira de Enfermagem. 2018;71(1):138-146. https://doi.org.10.1590/0034-7167-2016-0621 google scholar