Intensive and Critical Care Nursing
Volume 23, Issue 1 , Pages 4-14 , February 2007

Nursing care of the mechanically ventilated patient: What does the evidence say? Part one

  • Bronwyn A. Couchman

      Affiliations

    • Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Butterfield St., Brisbane, Qld 4029, Australia
    • Tel.: +61 7 3636 8534; fax: +61 7 3636 1557.
    • ,
  • Sharon M. Wetzig

      Affiliations

    • Intensive Care Unit, Princess Alexandra Hospital, Ipswich Rd., Brisbane, Qld 4102, Australia
    • Tel.: +61 7 3240 6268.
    • ,
  • Fiona M. Coyer

      Affiliations

    • Queensland University of Technology, Victoria Park Rd., Brisbane, Qld 4059, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 7 3864 3895; fax: +61 7 3863 3814.
    • ,
  • Margaret K. Wheeler

      Affiliations

    • Queensland University of Technology, Victoria Park Rd., Brisbane, Qld 4059, Australia
    • Tel.: +61 7 3864 9757; fax: +61 7 3864 3814.

,Accepted 8 August 2006.

References 

  1. ACCCN . Position statement on intensive care nursing staffing. Australian College of Critical Care Nurses; 2005;Available: www.acccn.com.au
  2. Adams K. Hemodynamic assessment: the physiologic basis for turning data into clinical information. AACN Clin Issues. 2004;15(4):534–546
  3. Aneman A, Eisenhofer G, Fandriks L, Olbe L, Dalenback J, Nitescu P, et al. Splanchnic circulation and regional sympathetic outflow during peroperative PEEP ventilation in humans. Br J Anaesth. 1999;82(6):838–842
  4. Blackwood B. Normal saline instillation with endotracheal suctioning: primum non nocere (first do no harm). J Adv Nurs. 1999;29(4):928–934
  5. Bowman A, Greiner J, Doerschug K, Little S, Bombei C, Comried L. Implementation of an evidence-based feeding protocol and aspiration risk reduction algorithm. Crit Care Nurs Q. 2005;28(4):324–333
  6. Boyle M, Green M. Pressure sores in intensive care: defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools. Aust Crit Care. 2001;14(1):24–30
  7. Cannesson M, Besnard C, Durand P, Bohe J, Jacques D. Relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and arterial pulse pressure in ventilated patients. Crit Care. 2005;9(5):R562–R568
  8. Capovilla J, VanCouwenberghe C, Miller WA. Noninvasive blood gas monitoring. Crit Care Nurs Q. 2000;23(2):79–86
  9. Crimlisk JT, Horn MH, Wilson DJ, Marino B. Artificial airways: a survey of cuff management practices. Heart Lung. 1996;25(3):225–235
  10. Crunden E, Boyce C, Woodman H, Bray B. An evaluation of the impact of the ventilator care bundle. Nurs Crit Care. 2005;10(5):242–246
  11. Day T, Farnell S, Wilson-Barnett J. Suctioning: a review of current research recommendations. Intensive Crit Care Nurs. 2002;18:79–89
  12. De Jonghe B, Sharshar T, Hopkinsonb N, Outina H. Paresis following mechanical ventilation. Curr Opin Crit Care. 2004;10:47–52
  13. DeBoer S, Seaver M, Arndt K. Verification of endotracheal tube placement: a comparison of confirmation techniques and devices. J Emergency Nurs. 2003;29(5):444–450
  14. Dellinger P, Carlet J, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving sepsis campaign guidelines for management of severe sepsis and septic shock. Intensive Care Med. 2004;30(4):536–555
  15. Demir F, Dramali A. Requirement for 100% oxygen before and after closed suction. J Adv Nurs. 2005;51(3):254–351
  16. Dodek P, Keenan S, Cook D, Heyland D, Jacka M, Hand L, et al. Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia. Ann Internal Med. 2004;141(4):305–313
  17. Donald KJ, Robertson VJ, Tsebelis K. Setting safe and effective suction pressure: the effect of using a manometer in the suction circuit. Intensive Care Med. 2000;26:15–19
  18. Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogue S, Ferrer M. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised controlled trial. Lancet. 1999;354:1851–1858
  19. Ely W, Truman B, Shintani A, Thomason J. Monitoring sedation status over time in ICU patients: reliability and validity. JAMA. 2003;289(22):2971–2983
  20. Fischer J, Mathieson C. History of the Glasgow Coma Scale: implications for practice. Crit Care Nurs Q. 2001;23(4):52–58
  21. Flancbaum L, Choban P, Sambucco S, Verducci J, Burge J. Comparison of indirect calorimetry, the Fick method, and prediction equations in estimating the energy requirements of critically ill patients. Am J Clin Nutr. 1999;69(3):461–466
  22. Frakes MA. Measuring end-tidal carbon dioxide: clinical applications and usefulness. Crit Care Nurs. 2001;21(5):23–37
  23. Fowler R, Berensen M. Blood conservation in the intensive care unit. Crit Care Med. 2003;31(12):S715–S720
  24. Gaini S, Koldkjaer O, Pedersen C, Pedersen S. Procalcitonin, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein. Crit Care. 2006;10(2):
  25. Gardner A, Hughes D, Cook R, Henson R, Osborne S, Gardner G. Best practice in stabilisation of oral endotracheal tubes: a systematic review. Aust Crit Care. 2005;18(4):158–165
  26. Grap MJ, Munro CL. Preventing ventilator-associated pneumonia: evidence-based care. Crit Care Nurse Clin N Am. 2004;16:349–358
  27. Grmec S. Comparison of three different methods to confirm tracheal tube placement in emergency intubation. Intensive Care Med. 2002;28:701–704
  28. Heffner J. A wake-up call in the intensive care unit. New Engl J Med. 2000;342(20):1520–1522
  29. Hillman K, Bishop G. Clinical intensive care and acute medicine. 2nd ed.. Cambridge: Cambridge University Press; 2004;
  30. Hogarth D, Hall J. Management of sedation in mechanically ventilated patients. Curr Opin Crit Care 10(1):40–6, in press.
  31. Institute for Healthcare Improvement. Implement the ventilator bundle. http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/Changes/ImplementtheVentilatorCareBundle.htm; [retrieved 3rd July 2006].
  32. Jaber S, Pigeot J, Bodil R, Maggiore S, Harf A, Isabey D, et al. Long-term effects of different humidification systems on endotracheal tube patency. Anaesthesiology. 2004;100:782–788
  33. Jensen LA, Onyskiw JE, Prasad NGN. Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults. Heart Lung. 1998;27(6):387–408
  34. Jubran A, Tobin MJ. Monitoring during mechanical ventilation. Clin Chest Med. 1996;17(3):453–473
  35. Kelly M, Gillies D, Lockwood C, Todd D. Heated humidification versus heat and moisture exchangers for ventilated adults and children (protocol). Cochrane Database Syst Rev 2004(1). Art. No.: CD004711. doi:10.1002/14651858.CD0004711.
  36. Knapp S, Kofler J, Stoiser B, Thalhammer F, Burgmann H, Posch M, et al. The assessment of four different methods to verify tracheal tube placement in the critical care setting. Anesth Analg. 1999;88:766–770
  37. Kollef MH. The prevention of ventilator-associated pneumonia. New Engl J Med. 1999;340(8):627–634
  38. Krishnan J, Parce P, Martinez A, Diette G, Brower R. Caloric intake in medical ICU patients: consistency of care with guidelines and relationship to clinical outcomes. Chest. 2003;124(1):297–305
  39. LeBlanc J, Dasta J, Kane-Gill S. Role of the bispectral index in sedation monitoring in ICU. Ann Pharmacother. 2006;40(3):490–500
  40. Leblanc M, Kellum J, Gibney R, Lieberthal W, Tumlin J, Mehta R. Risk factors for acute renal failure: inherent and modifiable risks. Curr Opin Crit Care. 2005;11(6):533–536
  41. Lindgren A, Ames N. Caring for patients on mechanical ventilation: what research indicates is best practice. AJN. 2005;105(5):50–61
  42. Lorente L, Lecuona M, Martin MM, Garcia C, Mora ML, Sierra A. Ventilator-associated pneumonia using a closed versus an open tracheal suction system. Crit Care Med. 2005;33(1):115–119
  43. Martin S, Wilson M. Monitoring gaseous exchange: implications for nursing care. Aust Crit Care. 2002;15(1):8–13
  44. McClave S, DeMeo M, DeLegge M, DiSario J, Heyland D, Maloney J. North American summit on aspiration in the critically ill patient: consensus statement. J Parenteral Enteral Nutr. 2002;26(6):S80–S85
  45. McGrath A, Cox C. Cardiac and circulatory assessment in intensive care units. Intens Crit Care Nurs. 1998;998(14):283–287
  46. In:  Nettina SM editors. Lippincott manual of nursing practice. 8th ed.. Philadelphia: Lippincott, Williams and Wilkins; 2006;
  47. Oh H, Seo W. A meta-analysis of the effects of various interventions in preventing endotracheal suction-induced hypoxaemia. J Clin Nurs. 2003;12:912–924
  48. Pinsky M. Cardiovascular issues in respiratory care. Chest. 2005;128(5):592S–597S
  49. Provonost PJ, Berenholtz SM, Ngo K, McDowell M, Holzmueller C, Haraden C, et al. Developing and pilot testing quality indicators in the intensive care unit. J Crit Care. 2003;18(3):145–155
  50. Resar R, Pronovost P, Haraden C, Simmonds T, Rainey T, Nolan T. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. Joint Commission J Qual Patient Saf. 2005;31(5):243–248
  51. Riker R, Fraser G. Monitoring sedation, agitation, analgesia, neuromuscular blockade, and delirium in adult ICU patients. Semin Respir Crit Care Med. 2001;22(2):189–198
  52. Rhodes A, Bennet E. Early goal directed therapy: an evidence based review. Crit Care Med. 2004;32(11):S448–S450
  53. Robb J. Physiological changes occurring with positive pressure ventilation: part one. 1997;13:293–307
  54. Sabol V. Nutrition assessment of the critically ill adult. AACN Clin Issues. 2004;15(4):595–606
  55. Safdar N, Dezfulian C, Collard H, Saint S. Clinical and economic consequences of ventilator associated pneumonia: a systematic review. Crit Care Med. 2005;33(10):2184–2193
  56. Schoonhoven L, Halboom J, Bousema M, Algra A, Grobbee D, Grypdonck M, et al. Prospective cohort study of routine use of risk assessment scales for prediction of pressure ulcers. Br Med J. 2002;326(7381):165
  57. Soubani AO. Noninvasive monitoring of oxygen and carbon dioxide. Am J Emergency Med. 2001;19(2):141–146
  58. St John RE, Malen JF. Contemporary issues in adult tracheostomy management. Crit Care Nurs Clin N Am. 2004;16:413–430
  59. Subirana M, Sola I, Garcia JM, Laffaire E, Benito S. Closed tracheal suctions systems versus ope tracheal systems for mechanically ventilated adult patients (protocol). Cochrane Database Syst Rev 2003(3). Art. No.: CD004581. doi:10.1002/14651858.CD0004581.
  60. Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R. Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. Morbid Mortal Weekly Rep 2004;53(RR–3):1–38. Available from http://www.cdc.gov/mmwr/PDF/RR/RR5303.pdf.
  61. van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters P, Weekers F. Intensive insulin therapy in the medical ICU. New Engl J Med. 2006;354(5):449–463
  62. Vyas D, Inweregbu K, Pittard A. Measure of tracheal tube cuff pressure in critical care. Anaesthesia. 2002;57:275–277
  63. Winters A, Munro N. Assessment of the mechanically ventilated patient: an advanced practice approach. AACN Clin Issues. 2004;15(4):525–533
  64. Wolverton C, Hobbs L, Beeson T, Benjamin M, Campbell K, Forbes C, et al. Nosocomial pressure ulcer rates in critical care: performance improvement project. J Nurs Care Qual. 2005;20(1):56–62
  65. Wynne R, Botti M, Paratz J. Preoxygenation for tracheal sunctioning in ventilated adults (protocol). Cochrane Database Syst Rev 2004(4). Art. No.: CD005142. doi:10.1002/14651858.CD005142.
  66. Yang J. Prevention and treatment of deep vein thrombosis and pulmonary embolism in critically ill patients. Crit Care Nurs Q. 2005;28(1):72–79
  67. Yeh S, Lee L, Ho T, Chiang M, Lin L. Implications of nursing care in the occurrence and consequences of unplanned extubation in adult intensive care units. Int J Nurs Stud. 2004;41(3):255–262
  68. Zeitoun SS, Leite De Barros ALB, Diccini S. A prospective, randomised study of ventilator-associated pneumonia in patients using a closed vs. open suction system. J Clin Nurs. 2003;12:484–489
  69. Zink W, Noll J, Rauch H, Bauer H, Desimone R, Martin E, et al. Continuous assessment of right ventricular ejection fraction: new pulmonary artery catheter versus transesophageal echocardiography. Anaesthesia. 2004;59:1126–1132

PII: S0964-3397(06)00099-1

doi: 10.1016/j.iccn.2006.08.005

Intensive and Critical Care Nursing
Volume 23, Issue 1 , Pages 4-14 , February 2007

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