運用肺部復健運動協助一位老年流感重症病人呼吸器脫離之護理經驗

本文描述一位老年個案因流感引發呼吸窘迫置放體外循環維生系統，擔心呼吸器脫離成效不佳需執行氣切手術，導致個案焦慮之加護經驗。護理期間自2018年9月12日～26日，藉由照護觀察、身體評估、筆談、病歷查閱等方式收集資料，運用生理、心理、社會及靈性四大層面進行整體性評估，確立護理問題為低效性呼吸型態、潛在危險性感染、焦慮。透過肺部復健運動讓個案感受到肌力的進步，進而降低焦慮對脫離呼吸器有信心。最終成功脫離呼吸器並順利轉出加護病房。期藉此照護經驗讓護理師應用於臨床重症個案，提升照護品質。

關鍵字

焦慮；肺部復健運動；流感重症；呼吸器脫離平衡

並列摘要

This article describes an elderly with serious influenza complications experiencing acute respiratory failure and receiving extracorporeal membrane oxygenation. The uncertainty during waning from mechanical ventilation and fear of receiving tracheostomy resulted in the patient anxiety. Data were collected via observation, physical examination, interviews, and medical records between 12 September and 26 September 2018. We found the patient's health problems included ineffective breath pattern, risk of infection, and anxiety. Pulmonary rehabilitation was applied to enhance respiratory and to reduce anxiety assisting the patient with weaning from mechanical ventilator. Finally, the weaning was successful and the patient was transferred out of the ICU. This case report is hoped to provide health professionals with as a reference when caring such patients in order to improve care quality.

並列關鍵字

anxiety ； pulmonary rehabilitation ； serious influenza complications ； weaning from mechanical ventilator

參考文獻

Prado, P. R. D., Bettencourt, A. R. D. C., & Lopes, J. D. L. (2019). Related factors of the nursing diagnosis ineffective breathing pattern in an intensive care unit. Revista Latino-americana De Enfermagem, 27, e3153. https://doi.org/10.1590/1518-8345.902.3153

王甯祺（2017）‧新興傳染病流行趨勢‧台北市醫師公會會刊，61(12)，52-54。