Spector Nancy, Connolly Maria A, Carlson Karen K
National Council of State Boards of Nursing, 111 E Wacker, Suite 2900, Chicago, IL 60601, USA.
AACN Adv Crit Care. 2007 Jan-Mar;18(1):45-58; quiz 59-60. doi: 10.4037/15597768-2007-1006.
Dyspnea is a common symptom in patients with acute and chronic critical illness as well as in patients receiving palliative care. While dyspnea can be found in a variety of clinical arenas and across many specialties, the mechanisms that cause dyspnea are similar. Although not often the cause for admission to critical care, it may complicate and extend length of stay. This article defines and describes dyspnea and its pathophysiology. Critical care nurses should strive to implement interventions supported by evidence whenever possible. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with dyspnea is outlined, using levels of recommendation based on the strength of available evidence. Two case studies are presented to illustrate its application to clinical practice.
呼吸困难是急慢性危重症患者以及接受姑息治疗患者的常见症状。虽然呼吸困难可见于各种临床领域及多个专科,但导致呼吸困难的机制相似。尽管它通常不是入住重症监护病房的原因,但可能会使病情复杂化并延长住院时间。本文对呼吸困难及其病理生理学进行了定义和描述。重症护理护士应尽可能努力实施有循证支持的干预措施。本文概述了一个基于现有证据强度的推荐等级,用于对呼吸困难患者进行评估、计划、干预和评价的循证护理计划。还介绍了两个案例研究以说明其在临床实践中的应用。