A efetividade do decúbito ventral na Acute Respiratory Distress Syndrome: revisão sistemática

Background: prone Position is a well-established evidence-based clinical practice in patients with Acute Respiratory Distress Syndrome undergoing invasive mechanical ventilation. Little evidence in non-intubated patients is known. Due to the increasing rate of acute respiratory distress syndrome, the need to know the effectiveness in non-intubated patients has emerged. Objective: to know the effectiveness of prone position in the treatment of acute respiratory distress syndrome in non-intubated adults. Methodology: Systematic reviews based on the manual of Joanna Briggs Institute and carried out using PICO strategy. Research conducted in August 2021 in the access platforms Web of Science, PubMed, and EBSCO Host. Selection was done after elimination of duplicates, title reading, reading of abstracts, and full texts according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram Results: 741 results were identified, and seven were included in the review. Conclusion: Early prone position is advantageous in non-intubated patients with mild and moderate acute respiratory distress syndrome. A risk intervention in non-intubated patients with Severe Acute Respiratory Distress Syndrome. Mortality/survival, physiological/clinical, adverse events/effects and functioning outcomes were identified as predictors of success/failure of prone position.Marco contextual: posición prona es una práctica clínica, basada en evidencia, conocida en pacientes con Síndrome de Dificultad Respiratoria Aguda con ventilación mecánica invasiva. Hay poca evidencia en pacientes no entubados. La creciente tasa de síndrome de distrés respiratorio agudo originó la necesidad de desarrollar esfuerzos para conocer su efectividad en pacientes no intubados. Objetivo: conocer la efectividad del decúbito prono en el tratamiento del síndrome de distrés respiratorio agudo en adultos no intubados. Metodología: revisión sistemática basadas en el manual del Instituto Joanna Briggs y mediante la estrategia PICO. La búsqueda ocurrió en agosto 2021 en las plataformas de acceso Web of Science, PubMed y EBSCO Host. Selección realizada por previa eliminación de duplicados, lectura de títulos, resúmenes y textos completos de acuerdo con el diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados: se identificaron 741 resultados, siete incluyeron la revisión. Conclusión: la posición prona temprana demostró ser ventajosa en pacientes no intubados con Síndrome de Dificultad Respiratoria Aguda leve y moderado. Intervención riesgosa en pacientes no intubados con Síndrome de Dificultad Respiratoria Aguda grave. Indicadores de mortalidad/supervivencia, fisiológicos/clínicos, de eventos/efectos adversos e indicadores funcionales, fueron identificados como predictores de éxito/fracaso de la posición prono.Enquadramento: o decúbito ventral é uma prática clínica baseada na evidência que se encontra bem estabelecida em pacientes com Acute Respiratory Distress Syndrome submetidos a ventilação mecânica invasiva. Porém, existe parca evidência em pacientes não intubados. Face ao aumento da taxa de Acute Respiratory Distress Syndrome, emergiu a necessidade de conhecer a sua eficácia em pacientes não intubados. Objetivo: conhecer a efetividade do decúbito ventral no tratamento da Acute Respiratory Distress Syndrome em adultos não intubados. Metodologia: revisão sistemática fundamentada no manual de Joanna Briggs Institute, com recurso à estratégia PICO. Pesquisa realizada em agosto de 2021, nas plataformas de acesso Web of Science, PubMed e EBSCO Host. Seleção realizada após eliminação de duplicados, leitura do título, de resumos e textos integrais de acordo com o diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados: identificaram-se 741 resultados, sendo sete os incluídos na revisão. Conclusão: O decúbito ventral precoce revelou-se vantajoso em pacientes não intubados com Acute Respiratory Distress Syndrome ligeira e moderada. É uma intervenção de risco em pacientes não intubados com Acute Respiratory Distress Syndrome grave. Foram identificados indicadores de mortalidade/ sobrevida, fisiológicos/ clínicos, de eventos/ efeitos adversos e indicadores funcionais como preditores de sucesso/ insucesso do decúbito ventral

Clinical Supervision Programs for Critical Care Nurses: Scoping Review Protocol

Aim: 1) To map clinical supervision programs for the integration of nurses in critical care. Background: The global shortage of nurses, considered one of the priority areas of intervention by the World Health Organization, has exposed increased difficulties in recruiting and retaining nurses during the COVID-19 pandemic. Clinical Supervision in Nursing, as a systematized and structured process for the development of clinical practice in different contexts, seems to contribute to outcomes, in continuous training and in the course of nurses professional experience. Inclusion criteria: articles written in Portuguese, English and Spanish; quantitative, qualitative and mixed type studies and secondary studies, which answer the research question; text and opinion documents and studies found in secondary bibliographic references and published between 2012 and 2022. Articles without full text, outside the scope of the starting question, and whose context is pediatric and neonatal critical care will be excluded. Methods: This scoping review protocol was defined based on the methodological proposal presented by the Joanna Briggs Institute, considering the PCC strategy (population, concept and context) and starting from the question: what are the characteristics of clinical supervision programmes for the integration of nurses in critical care? The search will be carried out in the search engines PubMed/medline, EBSCOhost, Google Scholar, Web of Science, SCOPUS, LILACS, with all associated databases. The analyzed data will be presented in a diagrammatic, tabular and narrative form