Akutna dihalna odpoved pri otrocih in vloga medicinske sestre pri izvajanju aspiracije - pregled literature : diplomsko delo

Dolenec, Renata (author), Bizjak, Martina (mentor), Kamenšek, Tina (comentor), Thaler, Darja (reviewer)

Uvod: Akutna dihalna odpoved je življenjsko ogrožajoče stanje pri otrocih. Opredeljena je kot nezmožnost zagotavljanja telesu kisik in odstranjevanje ogljikovega dioksida iz telesa s hitrostjo, ki ustreza presnovnim zahtevam organizma. Motnja se lahko pojavi zaradi nepravilnega delovanja dihalnega centra, oslabljenega delovanja dihalnih mišic ter oslabljene ventilacije in perfuzije pljuč. Dihalno odpoved delimo na hipoksemično, kjer je primarni vzrok za hipoksijo bolezensko stanje pljučnih mešičkov, in hiperkapnično, kjer je vzrok odpoved dihalne črpalke, ki ne more več zadostno izmenjevati plinov. Namen: Namen diplomskega dela je predstaviti posebnosti respiratornega sistema otroka, opisati značilnosti akutne dihalne odpovedi, predstaviti načine mehanske ventilacije in vlogo medicinske sestre pri čiščenju dihalnih poti. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda raziskovanja s sistematičnim pregledom in analizo strokovne in znanstvene literature. Literaturo smo iskali v podatkovnih bazah MEDLINE/PubMed, ScienceDirect, Google učenjak in brskalnikov PubMed in DiKUL. Vključeni so članki, napisani v slovenskem in angleškem jeziku. Vsi uporabljeni članki so bili dostopni v celoti. Prav tako smo ročno iskali znanstveno literaturo v knjižnicah Zdravstvene in Medicinske fakultete. Literaturo smo iskali od maja do julija 2020. Rezultati: Mehanska ventilacija rešuje življenje otrok, saj zmanjša dihalno delo in olajša dihanje otroka. Otroka lahko mehansko predihavamo na invazivni ali neinvazivni način. V primerjavi z neinvazivno je pri invazivni obliki mehanske ventilacije potrebna umetna dihalna pot. Glede na sposobnost otrokovega aktivnega dihanja dihalno podporo delimo na popolno ali delno. Kadar ti načini ne zadoščajo otrokovim potrebam, se zdravniki lahko odločijo za vzpostavitev zunaj telesnega krvnega obtoka ali za visokofrekvenčno oscilacijsko predihavanje. Otroci z dihalno odpovedjo pogosto potrebujejo aspiracije. Naloga medicinske sestre je, da skrbi za prehodnost dihalnih poti. Aspiracijo lahko izvaja skozi nos ali usta ter skozi endotrahealni tubus ali kanilo. Razprava in zaključek: Mehanska ventilacija je ključna za zdravljenje dihalne odpovedi. Otrok na mehanski ventilaciji se obravnava v enoti intenzivne terapije, kjer medicinska sestra stalno spremlja otrokove vitalne znake in otrokovo obnašanje. Medicinska sestra mora imeti specifična znanja, dobro mora poznati fiziologijo zdravega otroka, saj šele tako lahko prepozna patološke spremembe. Prav tako pa mora čim več vedeti o delovanju ventilatorja, oblikah in načinih mehanske ventilacije, osnovnih nastavitvah dihalnega cikla, vzrokih sprožitve alarmov ter vplivih mehanskega predihavanja na fiziologijo otroka in posledičnih zapletih.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, otrok, akutna dihalna odpoved, mehanska ventilacija, zdravstvena nega, aspiracija
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [R. Dolenec]
• Year: 2021
• Number of pages: 31 str.
• PID: 20.500.12556/RUL-124779
• UDC: 616-083
• COBISS.SI-ID: 52035587
• Publication date in RUL: 17.02.2021

DOLENEC, Renata, 2021, Akutna dihalna odpoved pri otrocih in vloga medicinske sestre pri izvajanju aspiracije - pregled literature : diplomsko delo [online]. Bachelor’s thesis. Ljubljana : R. Dolenec. [Accessed 1 April 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=124779

Secondary language

• Language: English
• Title: Acute respiratory failure in children and the role of the nurse in performing aspiration - literature review : diploma work

Abstract

Introduction: Acute respiratory failure is a life-threatening condition in children. It is defined as the inability to provide oxygen to the body and to remove carbon dioxide from the body at the rate that corresponds to metabolic requirements of an organism. The disorder may occur due to failure of the respiratory centre, impairment of respiratory muscles as well as impaired ventilation and pulmonary perfusion. There are two types of respiratory failure: hypoxemic, where the primary reason for hypoxia lies in the air sac impairment, and hypercapnic, which is the result of respiratory pump failure, unable to adequately exchange gases. Purpose: The aim of the paper is to present the particularities of a child's respiratory system, describe the characteristics of acute respiratory failure and outline different mechanical ventilation methods and the role of a nurse in performing aspiration. Methods: In the paper, a descriptive research method was used, along with a systematic review and analysis of academic and scientific literature. The literature was found in the MEDLINE, PubMed, ScienceDirect and Google Scholar databases as well as the PubMed and DiKUL search engines. The articles included in the research are written in Slovene and English, and they could be accessed in entirety. Scientific literature was also obtained by searching in the library of the Faculty of Health Sciences and the Faculty of Medicine from May to July 2020. Results: Mechanical ventilation saves children's lives as it reduces a child's breathing efforts and alleviates their breathing. A child can undergo two types of mechanical ventilations: invasive and non-invasive. Compared to the non-invasive mechanical ventilation, invasive mechanical ventilation requires an artificial respiratory tract. Based on a child's active breathing capability, breathing support can be full or partial. When these methods do not answer a child's needs, doctors may opt to establish extracorporeal circulation or to carry out high-frequency oscillatory ventilation. Children with breathing failure often require aspirations. The role of a nurse is to ensure airflow patency. Aspiration can be performed through the nose or mouth and through endotracheal tubes or a cannula. Discussion and conclusion: Mechanical ventilation is essential in treating respiratory failure. A child undergoing mechanical ventilation is treated in the intensive care unit, where a nurse constantly monitors their vital signs and behaviour. A nurse must possess specific knowledge and be well-familiar with a healthy child's physiology to identify pathological changes. They must also be familiar with the ventilator's functioning, types and methods of mechanical ventilation, basic phases of a respiratory cycle, reasons to sound the alarm and the impacts of mechanical ventilation on a child's physiology and possible complications.

• Keywords: diploma theses, nursing care, child, acute respiratory failure, mechanical ventilation, health care, aspiration