Supportive Care of Patients on Mechanical Ventilation

被引:7
作者
Urner, Martin [1 ,2 ]
Ferreyro, Bruno L. [1 ,2 ]
Doufle, Ghislaine [1 ,3 ]
Mehta, Sangeeta [1 ,4 ,5 ]
机构
[1] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada
[2] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[3] Univ Toronto, Dept Anesthesia, Toronto, ON, Canada
[4] Sinai Hlth Syst, Dept Med, Toronto, ON, Canada
[5] Univ Toronto, Toronto, ON, Canada
关键词
intensive care unit; critical illness; sedation; pain; analgesia; delirium; agitation; caregivers; family members; early mobilization; CRITICALLY-ILL PATIENTS; INTENSIVE-CARE; FAMILY PARTICIPATION; SEDATION PROTOCOL; SHORT-TERM; DELIRIUM; UNIT; SLEEP; MIDAZOLAM; AGITATION;
D O I
10.4187/respcare.06651
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The paradigm of supportive care of patients who are critically ill has changed significantly over the past 20 years. Patients on mechanical ventilation are no longer heavily sedated; the goal is a comfortable patient who can interact with health-care professionals and with their family members. Systematic. regular assessment of the patient for pain, anxiety, and sleep deprivation allows early recognition of these distressing symptoms. Appropriate treatment of patients' symptoms should be based on a multi-modal pharmaadogic and non-pharmacologic approach. Early mobilization and avoidance of physical restraint are additional patient-centered goals. The presence of family members during daily rounds and at the bedside can reduce the distress of the patient and enhance communication with the health-care team. All of these changes have created new challenges and opportunities for the multidisciplinary health-care team. This review aimed to describe the main components of evidence-based supportive care of patients on mechanical ventilation, beyond the specific settings of the ventilator.
引用
收藏
页码:1567 / 1574
页数:8
相关论文
共 79 条
  • [1] DELIRIUM MONITORING AND PATIENT OUTCOMES IN A GENERAL INTENSIVE CARE UNIT
    Andrews, Lois
    Silva, Susan G.
    Kaplan, Susan
    Zimbro, Kathie
    [J]. AMERICAN JOURNAL OF CRITICAL CARE, 2015, 24 (01) : 48 - 56
  • [2] [Anonymous], COCHRANE DATABASE SY
  • [3] [Anonymous], SURVEY ANESTHESIOLOG
  • [4] [Anonymous], MELATONIN PROMOTION
  • [5] Arumugam Suresh, 2017, J Emerg Trauma Shock, V10, P37, DOI 10.4103/0974-2700.199520
  • [6] Family participation in care to the critically ill:: opinions of families and staff
    Azoulay, É
    Pochard, F
    Chevret, S
    Arich, C
    Brivet, F
    Brun, F
    Charles, PE
    Desmettre, T
    Dubois, D
    Galliot, R
    Garrouste-Orgeas, M
    Goldgran-Toledano, D
    Herbecq, P
    Joly, LM
    Jourdain, M
    Kaidomar, M
    Lepape, A
    Letellier, N
    Marie, O
    Page, B
    Parrot, A
    Rodie-Talbere, PA
    Sermet, A
    Tenaillon, A
    Thuong, M
    Tulasne, P
    Le Gall, JR
    Schlemmer, B
    [J]. INTENSIVE CARE MEDICINE, 2003, 29 (09) : 1498 - 1504
  • [7] Early activity is feasible and safe in respiratory failure patients
    Bailey, Polly
    Thomsen, George E.
    Spuhler, Vicki J.
    Blair, Robert
    Jewkes, James
    Bezdjian, Louise
    Veale, Kristy
    Rodriquez, Larissa
    Hopkins, Ramona O.
    [J]. CRITICAL CARE MEDICINE, 2007, 35 (01) : 139 - 145
  • [8] Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit
    Barr, Juliana
    Fraser, Gilles L.
    Puntillo, Kathleen
    Ely, E. Wesley
    Gelinas, Celine
    Dasta, Joseph F.
    Davidson, Judy E.
    Devlin, John W.
    Kress, John P.
    Davidson, Judy E.
    Devlin, John W.
    Kress, John P.
    Joffe, Aaron M.
    Coursin, Douglas B.
    Herr, Daniel L.
    Tung, Avery
    Robinson, Bryce R. H.
    Fontaine, Dorrie K.
    Ramsay, Michael A.
    Riker, Richard R.
    Sessler, Curtis N.
    Pun, Brenda
    Skrobik, Yoanna
    Jaeschke, Roman
    [J]. CRITICAL CARE MEDICINE, 2013, 41 (01) : 263 - 306
  • [9] Benbenbishty Julie, 2010, Intensive Crit Care Nurs, V26, P241, DOI 10.1016/j.iccn.2010.08.003
  • [10] Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review
    Berger, Zackary
    Flickinger, Tabor E.
    Pfoh, Elizabeth
    Martinez, Kathryn A.
    Dy, Sydney M.
    [J]. BMJ QUALITY & SAFETY, 2014, 23 (07) : 548 - 555