[Invasive and non-invasive ventilation: impact on nursing workload].

Area of Science:

• Critical Care Medicine
• Respiratory Therapy
• Nursing Management

Background:

• Non-invasive ventilation (NIV) is increasingly utilized in both intensive and non-intensive care settings.
• Understanding the nursing workload associated with different ventilation modes is crucial for resource allocation and patient care optimization.

Purpose of the Study:

• To evaluate and compare the nursing workload across various ventilation modes used in intensive care.
• To identify specific ventilation parameters that influence nursing demands.

Main Methods:

• A retrospective observational study involving 200 general Intensive Care Unit (ICU) patients.
• The Nursing Activities Score (NAS) was employed to quantify nursing workload.
• Ventilation modes analyzed included oxygen therapy, helmet Continuous Positive Airway Pressure (CPAP), controlled mechanical ventilation, and Invasive pressure support ventilation (I-PSV).

Main Results:

• The overall mean NAS score was 74.3%, indicating an ideal nurse/patient ratio of 0.7.
• Nursing workload varied significantly by ventilation mode: oxygen therapy (64.5%), helmet CPAP (69.7%), invasive assisted ventilation (76.4%), and controlled mechanical ventilation (86.1%).
• Helmet CPAP with FiO2 >0.6 and PEEP >10 cmH2O, and mask-PSV showed increased nursing workload comparable to invasive ventilation.

Conclusions:

• Helmet CPAP generally results in lower nursing workload compared to invasive ventilation.
• High-intensity settings for helmet CPAP (FiO2 >0.6, PEEP >10 cmH2O) and mask-PSV create a nursing workload similar to invasive ventilation.
• Controlled invasive ventilation demands a higher nursing workload than assisted invasive ventilation.