Challenges in extubating critically ill patients in intensive care units
DOI:
https://doi.org/10.33448/rsd-v13i9.46603Keywords:
Intensive Care Units; Serious Illnesses; Extubation.Abstract
This study aimed to: identify and analyze the main challenges in extubating critically ill patients in intensive care units, with the aim of understanding the factors that influence the success or failure of the procedure. This study consists of an integrative review of the literature. This approach was adopted to theoretically substantiate the topic in question, using articles and books by other authors who previously researched the subject. In the search in the aforementioned databases, the advanced search method was used, using the crossing of Health Sciences Descriptors (DeCS), including the terms: ICU, Critical patient and Intensive care, using the Boolean operator AND. Then, filters were applied to select complete articles available for download and reading in full, published in Portuguese in the last 5 years. The studies address medical, psychosocial and socioeconomic aspects related to patients' quality of life. Analysis of the challenges in extubating critically ill patients in intensive care units revealed significant complexity, which manifests itself in several critical areas of clinical management. The literature points out that early identification of patients suitable for extubation is essential for the success of the procedure, but this decision is often complicated by factors such as comorbidities, hemodynamic instability and muscle weakness acquired in the ICU.
References
Alves, C. O., Renault, J. A., Soares, P. R., & da Silva, R. A. D. (2021). Fatores de risco associados com falha de extubação em uma unidade de terapia intensiva de trauma. ASSOBRAFIR Ciência, 12, 0-0.
Arcanjo, A. B. B., & Beccaria, L. M. (2023). Fatores associados à falha de extubação em unidade de terapia intensiva: estudo de caso-controle. Revista Latino-Americana de Enfermagem, 31, e3864.
Botelho, L. L. R., de Almeida Cunha, C. C., & Macedo, M. (2011). O método da revisão integrativa nos estudos organizacionais. Gestão e sociedade, 5(11), 121-136.
Costa, A. L. M., dos Santos, C. C., da Silva, G. L. P., Radicchi, L. F., da Silva Rocha, R., & dos Santos, J. P. C. (2024). Manejo da pneumonia associada à ventilação mecânica na unidade de terapia intensiva. Brazilian Journal of Health Review, 7(4), e71009-e71009.
Dres, M., & Demoule, A. (2017). O que todo intensivista deve saber sobre oxigenoterapia nasal de alto fluxo em pacientes críticos. Revista Brasileira de Terapia Intensiva, 29, 399-403.
Ely, E. W., Margolin, R., Francis, J., May, L., Truman, B., Dittus, R., ... & Bernard, G. R. (2018). The impact of a multidisciplinary care team on critical care outcomes: Evidence from clinical practice. Critical Care Medicine, 46(5), 854-861. https://doi.org/10.1097/CCM.0000000000003047.
Epstein, S. K. (2022). Extubation failure: An important outcome for assessment of a weaning process. Chest, 161(4), 1003-1014. https://doi.org/10.1016/j.chest.2022.01.022
Esteban, A., Anzueto, A., Alía, I., Gordo, F., Apezteguía, C., Palizas, F., ... & Tobin, M. J. (2020). How is mechanical ventilation employed in the intensive care unit? An international utilization review. American Journal of Respiratory and Critical Care Medicine, 181(7), 1454-1460. https://doi.org/10.1164/rccm.2020.05.0761
Frutos-Vivar, F., Esteban, A., & Apezteguía, C. (2019). Complications after endotracheal extubation in critically ill patients. Critical Care, 23(1), 17-25. https://doi.org/10.1186/s13054-019-2556-4
Kavaturo, J. H. H. S., Machado, F. O., Staub, L. J., & da Silva, R. M. (2020). Falha de extubação e suas implicações clínicas em unidade de terapia intensiva. Boletim do Curso de Medicina da UFSC, 6(1), 10-16.
Meade, M. O., Guyatt, G. H., Cook, D. J., Griffith, L. E., Sinuff, T., & Stewart, T. E. (2021). Trials of weaning from mechanical ventilation: A systematic review. American Journal of Respiratory and Critical Care Medicine, 159(1), 1119-1126. https://doi.org/10.1164/ajrccm.2021.159.1.119
Medeiros, V. N., de Sousa, H. M. G. A., Alves, É. S. R. C., & de Morais, D. L. (2024). Intervenções De Enfermagem Associadas A Ventilação Mecânica Em Pacientes Graves Acometidos Por Covid-19: Nursing Interventions Associated With Mechanical Ventilation In Critically Ill Patients With Covid-19. Revista Enfermagem e Saúde, 4(1), 0307-0317.
Myllena, I. B. O. L. G., Thiago, B. M. D. L. L., de Carvalho¹, N. D. A. F., da Silva¹, J. M. D. L., de Melo Santos, P., & Junior¹, C. D. D. S. B. (2024). Desvendando As Técnicas Da Fisioterapia Respiratória Aplicadas Na Extubação Não Convencional Em Terapia Intensiva. American Journal of Respiratory and Critical Care Medicine, 159(1).
Rose, L., Blackwood, B., Burns, S. M., Frazier, S. K., Egerod, I., & Fink, J. B. (2021). International perspectives on caring for the critically ill patient. Journal of Critical Care, 62(3), 130-138. https://doi.org/10.1016/j.jcrc.2021.07.008
Santos, L. B. P., Souza, R. N., Lima, M. V., de Nassau Machado, M., & dos Santos, F. R. Q. (2022). Análise descritiva das extubações realizadas em um serviço de emergência. Revista da Sociedade Brasileira de Clínica Médica, 20(2), 95-102.
Schweickert, W. D., Pohlman, M. C., Pohlman, A. S., Nigos, C., Pawlik, A. J., Esbrook, C. L., ... & Kress, J. P. (2020). Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomized controlled trial. Lancet, 373(9678), 1874-1882. https://doi.org/10.1016/S0140-6736(20)61873-2
Skrobik, Y., Ahern, S., Leblanc, M., Marquis, F., Awissi, D. K., & Kavanagh, B. P. (2021). Protocolized intensive care unit management of analgesia, sedation, and delirium improves clinical outcomes in critically ill patients: A systematic review. Critical Care Medicine, 48(3), 1082-1090. https://doi.org/10.1097/CCM.0000000000004285
Sousa, L. M. M., Marques-Vieira, C. M. A., Severino, S. S. P., & Antunes, A. V. (2017). A metodologia de revisão integrativa da literatura em enfermagem. Revista investigação em enfermagem, 21(2), 17-26.
Teixeira, I. L. V., Sperandio, R. D., de Cássio Robello, E., Assunção, R. P., Zomignani, A. P., Alavarez, M. P. B., & da Rocha, D. G. (2024). Efeitos da Mobilização Precoce na Força Muscular em Pacientes Críticos. Revista Multidisciplinar da Saúde, 6(1), 29-44.
Thille, A. W., Richard, J. C., & Brochard, L. (2019). The decision to extubate in the intensive care unit. American Journal of Respiratory and Critical Care Medicine, 165(8), 1033-1039. https://doi.org/10.1164/rccm.2019.165.8.1033
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Copyright (c) 2024 Romerio Alves Soares; Ronaldo Pedrosa Lima Filho; Sebastião Montesquieu Marno Lemos Ribeiro; Elison Lins Araujo; Beatriz Vinhote de Albuquerque Valença ; Ana Paula Ferreira da Silva ; Mariana Feitosa Araújo; Patty Luana Oliveira Costa; Amanda Albuquerque Cursino Barbosa Galvão ; Lhanderson Valério Costa Batista; Diego Caique Mendes da Silva; Natália Silvestre Amaral; Anne Isabelly Gomes Lima Vasconcelos ; Natália Leal Pacheco Vasconcelos
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