Atuação da enfermagem no tratamento com oxigenoterapia hiperbárica

Abstract

The authors discuss nursing activities in hyperbaric oxygen therapy through an experience report developed at the Medical Clinical of the Naval Hospital Marcílio Dias. This article presents a brief history of the procedure, its therapeutic effects, indications, collateral effects and complications. The authors believe that efforts are needed to create awareness about nursing activities in this new role as a labor market alternative in this growing specialty area.

Aspectos legais da enfermagem hiperbárica brasileira: por que regulamentar?

“…A enfermagem como profissão precisa de novas frentes para sua expansão e esse espaço é importante, principalmente no setor saúde. Esforços devem ser envidados para que a atuação da enfermagem nesse novo papel seja conscientizada como alternativa, uma vez que vem crescendo a cada dia (8) . Assim, considerando as legislações pertinentes à OHB é necessário implantar, implementar e cumprir vários parâmetros estabelecidos para que a enfermagem sistematize e organize todo o seu processo de trabalho nessa nova área de atuação, conforme preconiza a Resolução COFEN nº 272/2002 (Sistematização da Assistência de Enfermagem nas Instituições de Saúde Brasileiras) (5) radio, telefonia ou meios eletrônicos, onde não conste a assinatura dos mesmos.…”

Oxigenoterapia Hiperbárica, uma alternativa possível no tratamento para a Covid-19

“…A resposta inflamatória durante Covid-19 é provavelmente a causa para desenvolver-se a síndrome do desconforto respiratório agudo (SDRA). 4 Teoricamente a OHB pode tratar a hipoxemia da Covid-19 pela oferta de altos níveis de oxigênio podem ter efeitos antivirais e antiinflamatórios. 1,5 A OHB apresenta como contraindicação absoluta o pneumotórax não tratado.…”

Alterações cardiorrespiratórias de pacientes submetidos à oxigenoterapia hiperbárica

“…Nowadays, there are three types of oxygen therapy: Normobaric oxygen -surface or sea level O 2 , in which there is administration of O 2 (24% to 100%), at atmospheric pressure (an atmosphere absolute -ATA); Hyperbaric Oxygen -Inhalation of 100% O 2 at elevated pressures (> than one ATA); and Hypobaric or altitude O 2 -at altitude, due to humans' physiological limitation there is a demand for a concentration of O 2 higher than that inspired at sea level to avoid hypoxia" (2) . "This therapy is indicated for: decompression sickness or gas embolism, traumatic air embolism, gas gangrene, Fournier's gangrene, necrotizing soft tissue infections (fasciitis, myositis, and cellulitis), acute vasculitis triggered by allergic reaction, reaction to medication or biological toxins (3) , radiation injury, acute anemia, acute traumatic ischemia among others (1)(2)(3) .…”

“…Three studies have verified the hyperbaric oxygen therapy is an effective tool in the therapeutic arsenal (4)(5)(6) . In addition, "the benefits of the use of HBOT are described in clinical and surgical diseases with promising results, reducing hospitalization time and hospital costs" (3)(4)(5)(6)(7) . Absolute contraindications for HBOT use are: "only untreated pneumothorax and some chemotherapeutic agents, especially bleomycin, due to risk of pulmonary fibrosis.…”

“…Side effects that can be caused due to the application of HBOT are middle ear barotrauma and gas embolism, which is the most severe complication that occurs during decompression (3) , as it can lead to respiratory system toxicity (dry cough, retrosternal pain, hemoptysis, facial discomfort, and pulmonary edema), neurological toxicity (paresthesia and seizure), hearing discomforts, and transient visual changes (1)(2) . Interestingly, the biochemical and cellular effects of HBOT are not completely understood; the excessive exposure of O 2 in the organism was believed to cause the worsening of the lesions, but the beneficial effects of this therapy were mainly observed during reperfusion (8) .…”