Analysis of ineffective breathing pattern and impaired spontaneous ventilation of adults with oxygen therapy.
Deborah Hein Seganfredo, Beatriz Amorim Beltrão, Viviane Martins da Silva and 3 others
PMID 29211196WHAT IT FOUND
In adult ICU patients on oxygen therapy, signs used for two breathing nursing diagnoses did not separate into two distinct conditions.
They fit better as one ventilation problem with severity levels, but oxygen therapy may have masked some signs.
Key findings
01The signs did not support two separate nursing diagnoses; models treating them as one ventilation diagnosis fit better.
02Decreased inspiratory and expiratory pressure were recorded in all 128 patients on non-invasive ventilation and all 175 patients on invasive ventilation.
03Fifteen signs showed good diagnostic accuracy in at least one support group, and 14 signs showed low discrimination in at least one group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All patients were already receiving oxygen therapy, which may have reduced or hidden the signs. The study was done in one adult ICU in a Brazilian tertiary hospital, so it may not apply to other settings. Patients with neurological or muscular disease, neuromuscular blockers, or moderate to profound sedation were excluded. The models for the two diagnoses did not fit well, and many signs had low discrimination. The pressure signs were assigned by specialist consensus as present with positive-pressure support and absent with spontaneous ventilation, which may have shaped the results.
The easy way to misread this
Do not conclude that ineffective breathing pattern and impaired spontaneous ventilation are proven separate diagnoses. The models did not fit well, many signs had low discrimination, and all patients were already receiving oxygen therapy, which may have hidden signs.