中华护理杂志 ›› 2023, Vol. 58 ›› Issue (7): 881-884.DOI: 10.3761/j.issn.0254-1769.2023.07.017
收稿日期:
2022-10-20
出版日期:
2023-04-10
发布日期:
2023-04-11
通讯作者:
高岚,E-mail:1329695978@qq.com作者简介:
王宇娇:女,硕士,主管护师,副护士长,E-mail:wangyujiao1989@jlu.edu.cn
基金资助:
WANG Yujiao(), GAO Lan(), MU Jingjing, ZHAO Xiaosu
Received:
2022-10-20
Online:
2023-04-10
Published:
2023-04-11
摘要:
清醒俯卧位通气是在意识清醒患者中使用的一种辅助体位通气方式。清醒俯卧位通气能够显著改善急性呼吸窘迫综合征患者的氧合指数,降低气管插管率、病死率等。该文介绍了清醒俯卧位通气的定义、适应证、禁忌证、启动与终止时机、重点监测内容、并发症的预防与处理,并对应用过程中存在的护理难点进行总结并提出建议,以期为清醒俯卧位通气患者的护理提供参考依据,改善患者临床结局。
王宇娇, 高岚, 牟静静, 赵晓甦. 清醒俯卧位通气在急性呼吸窘迫综合征患者中的应用进展[J]. 中华护理杂志, 2023, 58(7): 881-884.
WANG Yujiao, GAO Lan, MU Jingjing, ZHAO Xiaosu. Application progress of awake self-prone positioning ventilation in patients with acute respiratory distress syndrome[J]. Chinese Journal of Nursing, 2023, 58(7): 881-884.
[1] | Chad T, Sampson C. Prone positioning in conscious patients on medical wards:a review of the evidence and its relevance to patients with COVID-19 infection[J]. Clin Med (Lond), 2020, 20(4):e97-e103. |
[2] |
ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome:the Berlin definition[J]. JAMA, 2012, 307(23):2526-2533.
DOI PMID |
[3] |
Guérin C, Reignier J, Richard JC, et al. Prone positioning in severe acute respiratory distress syndrome[J]. N Engl J Med, 2013, 368(23):2159-2168.
DOI URL |
[4] |
Fan E, Del Sorbo L, Goligher EC, et al. An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline:mechanical ventilation in adult patients with acute respiratory distress syndrome[J]. Am J Respir Crit Care Med, 2017, 195(9):1253-1263.
DOI URL |
[5] | Douglas WW, Rehder K, Beynen FM, et al. Improved oxygenation in patients with acute respiratory failure:the prone position[J]. Am Rev Respir Dis, 1977, 115(4):559-566. |
[6] |
Ding L, Wang L, Ma WH, et al. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS:a multi-center prospective cohort study[J]. Crit Care, 2020, 24(1):28.
DOI |
[7] |
Elharrar X, Trigui Y, Dols AM, et al. Use of prone positioning in nonintubated patients with COVID-19 and hypoxemic acute respiratory failure[J]. JAMA, 2020, 323(22):2336-2338.
DOI PMID |
[8] |
Sodhi K, Chanchalani G. Awake proning:current evidence and practical considerations[J]. Indian J Crit Care Med, 2020, 24(12):1236-1241.
DOI URL |
[9] | Intensive Care Society. ICS guidance for prone positioning of the conscious COVID patient[EB/OL]. [2022-10-20]. http://www.ics.ac.uk/ICS/COVID-19/COVID-19_Guidance/ICS/Guidelines And Stan-dards/COVID19_Guidance.aspx?hkey=fff229b8-28da-43f6-a0d6-f2d50b5fcf68. |
[10] | National Institutes of Health, COVID-19 Treatment Guidelines Panel. Coronavirus disease 2019(COVID-19) treatment guidelines[EB/OL].(2021-04-21) [2022-10-20]. http://www.ncbi.nlm.nih.gov/books/NBK570371/pdf/Bookshelf_NBK570371.pdf. |
[11] | 国家卫生健康委员会. 新型冠状病毒肺炎诊疗方案(试行第九版)[J]. 中国医药, 2022, 17(4):481-487. |
General Office of National Health Commission. Diagnosis and treatment protocol for coronavirus disease-19(9th trial edition)[J]. China Med, 2022, 17(4):481-487. | |
[12] |
Jiang LG, LeBaron J, Bodnar D, et al. Conscious proning:an introduction of a proning protocol for nonintubated,awake,hypoxic emergency department COVID-19 patients[J]. Acad Emerg Med, 2020, 27(7):566-569.
DOI PMID |
[13] | Montanaro J. Using in situ simulation to develop a prone positioning protocol for patients with ARDS[J]. Crit Care Nurs, 2020:e1-e13. |
[14] | Andrea B, Adriano B. Prone positioning in severe acute hypoxemic respiratory failure in the emergency ward[J]. Emerg Care J, 2018, 14(1):22-23. |
[15] | Winearls S, Swingwood EL, Hardaker CL, et al. Early conscious prone positioning in patients with COVID-19 receiving continuous positive airway pressure:a retrospective analysis[J]. BMJ Open Respir Res, 2020, 7(1):e000711. |
[16] |
Telias I, Katira BH, Brochard L. Is the prone position helpful during spontaneous breathing in patients with COVID-19?[J]. JAMA, 2020, 323(22):2265-2267.
DOI PMID |
[17] | Allicock KA, Coyne D, Garton AN, et al. Awake self-prone positioning:implementation during the COVID-19 pandemic[J]. Crit Care Nurs, 2021, 41(5):23-33. |
[18] | Taboada M, Baluja A, Santos LD, et al. Effectiveness of dex-medetomidine combined with high flow nasal oxygen and long periods of awake prone positioning in moderate or severe COVID-19 pneumonia[J]. J Clin Anesth, 2021, 72:110261. |
[19] |
Scaravilli V, Grasselli G, Castagna L, et al. Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure:a retrospective study[J]. J Crit Care, 2015, 30(6):1390-1394.
DOI PMID |
[20] |
Flynn Makic MB. Prone position of patients with COVID-19 and acute respiratory distress syndrome[J]. J Perianesth Nurs, 2020, 35(4):437-438.
DOI PMID |
[21] |
Mammen S, Yousuf B, Shamsah M. Transdermal fentanyl patch:an approach to enhance tolerance of conscious proning in COVID-19 patients[J]. J Opioid Manag, 2020, 16(4):237-238.
DOI URL |
[22] |
Bellani G, Laffey JG, Pham T, et al. Epidemiology,patterns of care,and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries[J]. JAMA, 2016, 315(8):788-800.
DOI URL |
[23] |
Barker J, Koeckerling D, West R. A need for prone position CPR guidance for intubated and non-intubated patients during the COVID-19 pandemic[J]. Resuscitation, 2020, 151:135-136.
DOI PMID |
[24] | Taras J, Everett T. Rapid cycle deliberate practice in medical education-a systematic review[J]. Cureus, 2017, 9(4):e1180. |
[25] |
Carsetti A, Damia PA, Marini B, et al. Prolonged prone position ventilation for SARS-CoV-2 patients is feasible and effective[J]. Crit Care, 2020, 24(1):225.
DOI |
[26] | Solverson K, Weatherald J, Parhar KKS. Tolerability and safety of awake prone positioning COVID-19 patients with severe hypoxemic respiratory failure[J]. J Can D’anesthesie, 2021, 68(1):64-70. |
[27] | Froelich S, Mandonnet E, Julla JB, et al. Towards individuali-sed and optimalised positioning of non-ventilated COVID-19 patients:putting the affected parts of the lung(s) on top?[J]. Diabet Metab, 2021, 47(2):101167. |
[28] |
蒋燕, 陆叶, 蒋旭琴, 等. 成人急性呼吸窘迫综合征患者俯卧位通气管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(15):1878-1885.
DOI |
Jiang Y, Lu Y, Jiang XQ, et al. Best evidence summary for prone ventilation management in adults with acute respiratory distress syndrome[J]. Chin J Nurs, 2022, 57(15):1878-1885.
DOI |
|
[29] | Slessarev M, Cheng J, Ondrejicka M, et al. Patient self-proning with high-flow nasal cannula improves oxygenation in COVID-19 pneumonia[J]. J Can D’anesthesie, 2020, 67(9):1288-1290. |
[30] |
Behrens S, Kozeniecki M, Knapp N, et al. Nutrition support during prone positioning:an old technique reawakened by COVID-19[J]. Nutr Clin Pract, 2021, 36(1):105-109.
DOI PMID |
[31] | 汪晖, 曾铁英, 吴欣娟, 等. 重型危重型新型冠状病毒肺炎患者整体护理专家共识[J]. 中华护理杂志, 2020, 55(3):337-342. |
Wang H, Zeng TY, Wu XJ, et al. Holistic care for patients with severe coronavirus disease 2019:an expert consensus[J]. Chin J Nurs, 2020, 55(3):337-342. | |
[32] | Bruni A, Garofalo E, Grande L, et al. Nursing issues in enteral nutrition during prone position in critically ill patients:a systematic review of the literature[J]. Intensive Crit Care Nurs, 2020, 60:102899. |
[33] |
侯锦, 李奇, 李尊柱, 等. 俯卧位通气患者肠内营养安全性和有效性的Meta分析[J]. 中华护理杂志, 2022, 57(17):2149-2155.
DOI |
Hou J, Li Q, Li ZZ, et al. Efficacy and safety of enteral nutrition in patients with prone position ventilation:a Meta-analysis[J]. Chin J Nurs, 2022, 57(17):2149-2155. | |
[34] |
Reignier J, Dimet J, Martin-Lefevre L, et al. Before-after study of a standardized ICU protocol for early enteral feeding in patients turned in the prone position[J]. Clin Nutr, 2010, 29(2):210-216.
DOI PMID |
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