| Abstract | UVOD: Krajem 2019. godine u Wuhanu u Kini prvi je put izoliran novi koronavirus, kasnije
nazvan teškim akutnim respiratornim sindromom (SARS-CoV-2). Koronavirus uzrokuje skup
akutnih respiratornih bolesti, nazvan koronavirusna bolest 2019 (COVID-19). Najčešći razlog
prijema pacijenta u jedinicu intenzivnog liječenja razvoj je akutnog hipoksemičnog zatajenja
disanja, što je indikacija za primjenu neinvazivne ventilacije visokoprotočnim nazalnim
kanilama.
POSTUPCI: Za pisanje diplomskog rada korištena je opisna metoda pretraživanjem dostupnih
baza podataka na Internetu. Pretražene su znanstvene baze podataka Hrčak, Embasa, Google
Scholar, PubMed i Researchgate pomoću ključnih riječi. Kriterij uključenja je bila literatura
vezana za temu primjene visokoprotočnih nazalnih kanila u liječenju koronavirusne bolesti, dok
je kriterij isključenja bila literatura starija od 5 godina.
PRIKAZ TEME: Svijet se danas suočava s najvećim zdravstvenim izazovom 21. stoljeća
uzrokovanog virusom koji uzrokuje respiratornu bolest pod nazivom koronavirusna bolest
2019, odnosno bolest COVID-19. Kliničke manifestacije bolesti su raznolike, od
asimptomatske infekcije do akutnog sindroma respiratornog distresa koji zahtijeva prijem u
jedinice intenzivnog liječenja s endotrahealnom intubacijom i invazivnom mehaničkom
ventilacijom i povezana je s visokim rizikom za smrtnost. Nazalne kanile visokog protoka
(HFNC) ventilacijski je oslonac u stanju isporučiti velik protok pravilno zagrijanog i vlažnog
zraka. Omogućuje pouzdanu isporuku kisika i omogućuje povišeni udio udahnutog kisika
(FiO2), od 21 % do gotovo 100 %, sprječavajući razrjeđivanje kisika sobnim zrakom. Relativno
malo sučelje i fiziološka temperatura ove terapije omogućavaju vrlo visoku toleranciju.
ZAKLJUČAK: Medicinska sestra odgovorna je za pripremu uređaja, pripremu i monitoring
pacijenta, uz višekratno svakodnevno provođenje procjene respiratornog statusa pacijenta kako
bi se izbjeglo odgađanje intubacije ako se stanje pacijenta pogoršava. Medicinska sestra mora
poznavati mehanizam djelovanja HFNC potpore, njegove prednosti i nedostatke te očekivanu
korist za pacijenta. Isto tako, medicinska sestra će uspostaviti povjerljiv odnos s pacijentom,
biti na raspolaganju za odgovoriti na sva njegova pitanja i pružiti mu psihološku potporu. |
| Abstract (english) | INTRODUCTION: In late 2019, a new coronavirus, now called severe acute respiratory
syndrome (SARS-Cov-2), was isolated for the first time in Wuhan, China. Coronavirus causes
a set of acute respiratory diseases, called coronavirus disease 2019 (COVID-19). The most
common reason for admitting a patient to an intensive care unit is the development of acute
hypoxemic respiratory failure, which is an indication for the use of non-invasive ventilation
through high-flow nasal cannulas.
METHOD: A descriptive method was used to write the dissertation by searching the available
databases on the Internet. The scientific databases Hrčak, Embasa, Google Schoolar, PubMed
and Researchgate were searched using keywords. The inclusion criterion was the literature
related to the use of high-flow nasal cannulas in the treatment of coronavirus disease, while the
exclusion criterion was the literature older than 5 years.
OUTLINE: The world today is facing the biggest health challenge of the 21st century caused
by a virus that causes a respiratory disease called coronavirus disease 2019, or COVID-19
disease. The clinical manifestations of the disease are diverse, from asymptomatic infection to
acute respiratory distress syndrome requiring admission to intensive care units with
endotracheal intubation and invasive mechanical ventilation and is associated with a high risk
of mortality. The High Flow Nasal Cannula (HFNC) ventilation vent is able to deliver a large
flow of properly heated and moist air. It enables reliable oxygen delivery and allows an
increased proportion of inhaled oxygen (FiO2), from 21% to almost 100%, preventing the
dilution of oxygen by room air. The relatively small interface and physiological temperature of
this therapy allow for a very high tolerance.
CONCLUSION: Nurse is responsible for device preparation, preparation, and patient
monitoring, with multiple daily assessments of the patient's respiratory status to avoid delaying
intubation if the patient's condition worsens. The nurse must know the mechanism of action of
HFNC support, its advantages and disadvantages, and the expected benefit to the patient.
Likewise, the nurse will establish a confidential relationship with the patient, be available to
answer all of his or her questions, and provide psychological support. |
