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Eficácia das medidas não farmacológicas no alívio da dispneia na pessoa em situação critica
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| 5.98 MB | Adobe PDF |
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Abstract(s)
Introdução | A dispneia é um sintoma prevalente e debilitante em pessoas em situação crítica, frequentemente associado a condições respiratórias, cardíacas e sistémicas. Embora as intervenções farmacológicas sejam amplamente utilizadas, estratégias não farmacológicas têm ganhado atenção como alternativas eficazes para o alívio da dispneia. Esta scoping review explora as evidências disponíveis sobre a eficácia dessas medidas para fornecer uma base sólida à prática clínica e futuras pesquisas.
Objetivos | A presente scoping review tem como propósito identificar e mapear intervenções não farmacológicas utilizadas no tratamento da dispneia em pessoa em situação critica. Por sua vez, tal permitirá avaliar a eficácia dessas intervenções na redução da intensidade da dispneia e identificar lacunas na literatura e propor áreas para futuras investigações.
Metodologia | A scoping review foi conduzida seguindo o modelo do Joanna Briggs Institute (JBI) e as diretrizes do PRISMA. A pesquisa foi realizada na base de publicações científicas PubMed®, CINAHL® e Cochrane®, utilizando a conjugação dos seguintes termos: dyspnea, non pharmacological measures e critical patients. Estudos em inglês e publicados nos últimos 10 anos foram incluídos. Os dados foram extraídos e sintetizados qualitativamente.
Resultados | As intervenções mais estudadas no tratamento da dispneia em pessoas em situação critica incluem: i) técnicas de respiração controlada (como respiração diafragmática e com lábios semicerrados); ii) suporte ventilatório não invasivo (ventilação não invasiva ou alto fluxo); iii) intervenções de posicionamento (como posição semi-fowler); iv) uso de ventilação dirigida à redução da ansiedade (incluindo técnicas de mindfulness); e v) estímulos sensoriais (ar frio direcionado ao rosto ou ventilação dirigida). Os resultados demonstraram que estas intervenções reduzem frequentemente a percepção de dispneia, melhoram a oxigenação e diminuem a ansiedade associada ao desconforto respiratório provocado pela dispneia.
Conclusão | As medidas não-farmacológicas oferecem uma abordagem eficaz e complementar no tratamento da dispneia em pessoa em situação critica, especialmente quando combinadas com intervenções farmacológicas. No entanto, a heterogeneidade dos estudos destaca a necessidade de investigações adicionais com metodologias mais robustas para fortalecer a evidência e orientar a prática clínica.
Abstract Introduction | Dyspnea is a prevalent and debilitating symptom in people in critical condition, often associated with respiratory, cardiac and systemic conditions. Although pharmacological interventions are widely used, non-pharmacological strategies have gained attention as effective alternatives for relieving dyspnea. This scoping review explores the available evidence on the effectiveness of these measures to provide a solid foundation for clinical practice and future research. Objectives | The purpose of this scoping review is to identify and map non-pharmacological interventions used to treat dyspnea in critically ill patients. In turn, this will allow us to assess the effectiveness of these interventions in reducing the intensity of dyspnea and identify gaps in the literature and propose areas for future investigation. Methodology | The scoping review was conducted following the Joanna Briggs Institute (JBI) model and PRISMA-ScR guidelines. The search was carried out in the scientific publications database PubMed®, CINAHL® e Cochrane® using the combination of the following terms: dyspnea, non pharmacological measures and critical patients. Studies in English and published in the last 10 years were included. Data were extracted and synthesized qualitatively. Results | The most studied interventions in the treatment of dyspnea in critically ill patients include: i) controlled breathing techniques (such as diaphragmatic breathing and with half-closed lips); ii) non-invasive ventilatory support (non-invasive ventilation or high flow); iii) positioning interventions (such as semi-fowler position); iv) use of ventilation aimed at reducing anxiety (including mindfulness techniques); and v) sensory stimuli (cold air directed to the face or targeted ventilation). The results demonstrated that these interventions often reduce the perception of dyspnea, improve oxygenation and reduce anxiety associated with respiratory distress caused by dyspnea. Conclusion | Non-pharmacological measures offer an effective and complementary approach in the management of dyspnea in critically ill patients, especially when combined with pharmacological interventions. However, the heterogeneity of studies highlights the need for additional investigations with more robust methodologies to strengthen the evidence and guide clinical practice.
Abstract Introduction | Dyspnea is a prevalent and debilitating symptom in people in critical condition, often associated with respiratory, cardiac and systemic conditions. Although pharmacological interventions are widely used, non-pharmacological strategies have gained attention as effective alternatives for relieving dyspnea. This scoping review explores the available evidence on the effectiveness of these measures to provide a solid foundation for clinical practice and future research. Objectives | The purpose of this scoping review is to identify and map non-pharmacological interventions used to treat dyspnea in critically ill patients. In turn, this will allow us to assess the effectiveness of these interventions in reducing the intensity of dyspnea and identify gaps in the literature and propose areas for future investigation. Methodology | The scoping review was conducted following the Joanna Briggs Institute (JBI) model and PRISMA-ScR guidelines. The search was carried out in the scientific publications database PubMed®, CINAHL® e Cochrane® using the combination of the following terms: dyspnea, non pharmacological measures and critical patients. Studies in English and published in the last 10 years were included. Data were extracted and synthesized qualitatively. Results | The most studied interventions in the treatment of dyspnea in critically ill patients include: i) controlled breathing techniques (such as diaphragmatic breathing and with half-closed lips); ii) non-invasive ventilatory support (non-invasive ventilation or high flow); iii) positioning interventions (such as semi-fowler position); iv) use of ventilation aimed at reducing anxiety (including mindfulness techniques); and v) sensory stimuli (cold air directed to the face or targeted ventilation). The results demonstrated that these interventions often reduce the perception of dyspnea, improve oxygenation and reduce anxiety associated with respiratory distress caused by dyspnea. Conclusion | Non-pharmacological measures offer an effective and complementary approach in the management of dyspnea in critically ill patients, especially when combined with pharmacological interventions. However, the heterogeneity of studies highlights the need for additional investigations with more robust methodologies to strengthen the evidence and guide clinical practice.
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Competência profissional Dispneia Dispneia - terapêutica Doença crítica Enfermagem médico cirúrgica Revisão scoping Dyspnea Dyspnea - therapy Medical surgical nursing Professional competence Scoping review
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