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Extubering av neurointensivvårdspatienter
Halmstad University, School of Social and Health Sciences (HOS).
Halmstad University, School of Social and Health Sciences (HOS).
2012 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesisAlternative title
Extubation of Neurocritical Care Patients (Swedish)
Abstract [sv]

Bakgrund: Många av patienterna på en neurointensivvårdsavdelning (NIVA) vårdas med respirator under en längre eller kortare period av vårdtiden. Neurointensivvårdspatienterna bedöms ibland utifrån de kriterier för urträning och extubering som används på allmänna intensivvårdspatienter. Detta kan leda till för tidig extubation med reintubation som följd. Syfte: Redogöra för vilka kriterier som ska bedömas hos neurointensivvårdspatienter inför en extubering. Metod: Litteraturstudie. Resultat och slutsats: Neurointensivvårdspatienter behöver uppfylla en kombination av kriterier inför extubation. Hänsyn ska tas till de generella extubationskriterierna avseende andning och cirkulation. Dessutom ska patienten ha en tillräckligt hög medvetandegrad för att kunna följa någon form av uppmaning. Till sist ska patientens förmåga att hålla fri luftväg bedömas genom observation av hostkraft, sekretmängd/konsistens och svalgfunktion. Det behövs ytterligare forskning för att utröna i hur hög grad neurointensivvårdspatienterna behöver vara medvetna inför extubering och på vilket sätt detta bäst bedöms. Forskning behövs kring ett enhetligt tillvägagångssätt för bedömning av hostkraft, sekretmängd/konsistens och svalgfunktion.

Abstract [en]

Background: Many of the patients cared for in a neurocritical unit are treated with mechanical ventilation for a longer or shorter period of time during their stay in the unit. When weaning or extubating neurocritical patients, they are sometimes assessed according to the criteria for weaning and extubation used in general intensive care patients. This can cause premature extubation, resulting in re-intubation. Aim: Describe the criteria to be assessed in neurocritical patients prior to extubation. Method: Literature review. Results and conclusion: Neurocritical patients need to fulfil a combination of criteria prior to extubation. The general criteria in terms of respiration and circulation must be taken in to consideration, as well as the patient’s level of consciousness. The patient has to be conscious enough to be able to take directions. Lastly the patient’s ability to protect the airway must be assessed by observation of cough strength, the quantities and viscosity of the secretions and the patient’s swallowing function. Further research is required to ascertain the level of consciousness required in the neurocritical patients prior to extubation and in which way the assessment is best carried out. There is also need for further research considering a standardized measurement for assessing cough strength, the quantities and viscosity of secretions and swallowing function in these patients.

Place, publisher, year, edition, pages
2012. , 17 p.
Keyword [en]
extubation, mechanical ventilation, neurocritical care, neurology, neurosurgery, weaning
Keyword [sv]
extubering, neurointensivvård, neurokirurgi, neurologi, respiratorvård, urträning
National Category
Nursing
Identifiers
URN: urn:nbn:se:hh:diva-17952OAI: oai:DiVA.org:hh-17952DiVA: diva2:533602
Uppsok
Medicine
Supervisors
Examiners
Available from: 2012-06-19 Created: 2012-06-14 Last updated: 2012-06-19Bibliographically approved

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