Introduction
Respiratory failure is a common clinical condition when people are not able to breathe on their own because the lungs do not get enough oxygen into the blood. Among the existing variety of forms, acute respiratory distress syndrome is prevalent and life-threatening, which results from non-hydrostatic pulmonary edema due to “increased alveolar capillary permeability” (Fernando et al., 2021, p. 761). As the risk of death is high among patients with respiratory failures, clinical care in the intensive care unit (ICU) is required. In most cases, healthcare providers can recognize the signs of this condition quickly and offer an emergency medical treatment to improve breathing and oxygen level in the system, not to promote organ damage. In addition to mechanical ventilation, patients need to be in a prone position, receive extracorporeal life support, and get pharmacologic therapy (Fernando et al., 2021). Each element of critical care for respiratory care has to be clearly explained and discussed not to make a mistake or take unnecessary steps. This paper contributes to critical care practice and aims to identify the most effective treatment strategy to save the lives of patients with respiratory failure.
Discussion and Analysis
People need oxygen to breathe and receive enough air into their lungs to ensure all body cells have the required gas for their work. Respiratory failure may occur quickly, and it is hard to predict its progress due to the absence of risk factors and no serious warning. Such diseases as pneumonia, stroke, septic shock, or overdose might provoke this condition (Fernando et al., 2021). However, some patients start noticing shortness of breath, fatigue, and sleep problems and have to be diagnosed immediately. In case of a respiratory emergency, the general priority is based on the promotion of oxygen to prevent hypoxia and respiratory acidosis (Pearson, Koyner and Patel, 2022). Multiple research projects have been conducted to explain what kind of help is necessary for patients with respiratory failure. The reviews and studies by Fernando et al. (2021), Liu and Li (2021), and Pearson, Koyner and Patel (2022) share the same opinion about mechanical ventilation as the cornerstone of critical care for respiratory failure. The literature says that using ventilators and tubes enhances respiratory support.
Ventilation is a prompt treatment strategy to help patients restore their breathing, but it has to be properly managed to predict complications. The ventilator must be working and correspond to the patient’s parameters and needs (Liu and Li, 2021). Mechanical ventilation is usually delivered in two basic ways: invasively (an endotracheal tube) and noninvasively (a face mask) (Pearson, Koyner and Patel, 2022). Nurses, guided by doctors or surgeons, should follow the prescribed mode, which is 100cc/cm H20 with 500 cc volume-controlled breath for patients with normal lung compliance (Pearson, Koyner and Patel, 2022). The noninvasive ventilator has to be connected correctly, focusing on the valve and the position of the intubation tube (Liu and Li, 2021). If a mask is applied, it is important to check its placement and the level of airway pressure. Fernando et al. (2021) add the importance of prone positioning to improve lung recruitment and increase expiratory lung volume. If respiratory failure is severe, venovenous extracorporeal membrane oxygenation is recommended to remove deoxygenated damage with low ventilatory pressures (Fernando et al., 2021). All these steps are clinically approved as a critical care strategy for respiratory failure.
The offered care has its advantages and disadvantages, and healthcare providers should inform patients and their families about both sides. On the one hand, evident benefits of mechanical ventilation include easy breathing, the removal of harmful carbon dioxide, and oxygenated blood circulation (Fernando et al., 2021). Patients do not waste their energy on breathing and get a chance to focus on other restoration processes. On the other hand, Pearson, Koyner and Patel (2022) inform that despite being a lifesaving therapy in critical care, it has the potential to cause harm if healthcare providers do not manage it properly. Alveolar distension and barotraumas are observed in patients with respiratory failure under mechanical ventilation (Pearson, Koyner and Patel, 2022). Finally, if nurses do not control the patient’s condition and neglect the principles of comprehensive care, adverse effects like pressure ulcers and infections may be developed (Liu and Li, 2021). Thus, critical care for respiratory failure includes multi-tasking and high-level cooperation between patients and healthcare providers. As a result, high costs may affect the patient’s decision to continue mechanical ventilation in ICUs.
The main findings of the chosen studies are related to the processes and outcomes of mechanical ventilation together with prone positioning and life support techniques. Respiratory failure is a serious respiratory disease that may be developed in different forms and need immediate interventions and the patient’s assessment (Liu and Li, 2021; Pearson, Koyner and Patel, 2022). Supportive management and lung-protective strategies under nurse guidance are necessary to minimize the risks of lung injuries in hospital settings (Fernando et al., 2021). Sometimes, critical care should be offered to patients out of hospitals, and the nursing staff is responsible for health education, adaptive treatment, and regular follow-ups (Liu and Li, 2021). This literature review is a solid background for nursing students and novel healthcare practitioners to understand the threats of respiratory failure and its emergency treatment steps.
The quality of the research shared in this review has to be checked according to a common critical appraisal tool, with special attention to its credibility, organization, and overall implications. All articles have clear structures and headings to demonstrate the consistency of their studies and the intention to explain the chosen research topic. Another common advantage is their publications in credible journals and the use of scholarly literature to support the discussion.
At the same time, there are several differences, which explain the shortages of the preferred research approaches. Fernando et al. (2021) and Pearson, Koyner and Patel (2022) developed systematic reviews, and Liu and Li (2021) used a questionnaire method to conduct controlled measurements. The strengths of Liu and Li’s (2021) project include standardization, low cost, safety, feasibility, and the application of different tests to check the level of respiratory failure. Its weakness is a small size because the researchers investigated only 50 patients. In their systematic reviews, the authors clearly identify their goals. Pearson, Koyner and Patel (2022) aimed to provide an overview of invasive and noninvasive mechanical ventilation, and Fernando et al. (2021) examined the techniques for diagnosing and managing acute respiratory distress syndrome. Compared to Pearson, Koyner and Patel (2022), who added mathematical terms to explain the peculiarities of ventilator management, Fernando et al. (2021) introduced the databases and targeted terms. In addition to these advantages, both studies have limitations due to clinical or statistical inconsistency and preconceived notions in the discussion.
Conclusion
Critical care for respiratory failure is an important topic for analysis because of the severity of this condition and the necessity of understanding the basics of its diagnosis and management. The chosen studies contribute to a better understanding of this type of failure and the use of mechanical ventilation as the major critical care approach. The oxygen volume must be constantly regulated to ensure the patient’s brain and other body systems work properly. Nurses, in their turn, are responsible for observing patients and maintaining regular check-ups and reports. Respiratory failure is associated with cardiovascular, renal, and nutritional complications, and critical care aims to optimize oxygenation and promote hemodynamic support.
In nursing practice, these findings can be commonly applied to ensure nurses follow the main steps and cooperate with patients and their families. It is important to know the appropriate dose of medications to reduce airway problems and the necessary respiratory stimulators that may increase ventilation and respiratory work in general. Some patients need reintubation, and nurses have to identify the conditions when additional help is required. Finally, the duration of mechanical ventilation depends on the interventions that healthcare providers choose, underlying the worth of early airway pressure. Thus, the information from the chosen articles will help plan care and learn what cooperation is critical.
In general, this critical review is characterized by three major lessons. First, enough material was gathered to prove respiratory failure is a serious life-threatening condition that requires immediate help, regular observations, and long-term care. Second, it was found that modern researchers use different methods to explain the peculiarities of respiratory failure, which might have their strengths and limitations. Third, respiratory failure may be provoked by different conditions, and critical care aims at managing the underlying cause and supporting the patient’s oxygenation. All these aspects of critical care for respiratory failure cannot be ignored to help patients recover and predict the progress of complications.
Reference List
Fernando, S. M. et al. (2021) ‘Diagnosis and management of acute respiratory distress syndrome’, Canadian Medical Association Journal, 193(21), pp. 761-768.
Liu, Q. and Li, W. (2021) ‘The way of severe nursing of respiratory system failure’, Journal of Healthcare Engineering.
Pearson, S. D., Koyner, J. L. and Patel, B. K. (2022) ‘Management of respiratory failure: ventilator management 101 and noninvasive ventilation’ Clinical Journal of the American Society of Nephrology, 17(4), pp. 572-580.