Pediatric Bronchiolitis Obliterans and Bronchiolitis Obliterans Syndrome: Nursing Considerations.

IF 2 4区 医学 Q3 CRITICAL CARE MEDICINE
Jared Deffler
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引用次数: 0

Abstract

Background: Bronchiolitis obliterans/bronchiolitis obliterans syndrome is an irreversible, obstructive lung disease characterized by the narrowing of bronchioles by lung fibrosis, inflammation, and scarring.

Objective: To provide acute care, transplant, and critical care nurses a summary of the disease process, causes, and treatment options for bronchiolitis obliterans in pediatric patients to promote early recognition of signs in at-risk patients.

Methods: This descriptive literature review was limited to articles published in 2013 or later. Searches of the PubMed and CINAHL databases using the terms bronchiolitis obliterans and pediatric yielded 432 articles. Of these articles, 22 were used for this review. The Johns Hopkins Nursing Evidence-Based Practice appraisal tool was used to assess levels of evidence and methodologic quality of the articles.

Results: Patients in 3 main groups are at risk for bronchiolitis obliterans: those who have had respiratory infection, those who have received lung transplant, and those who have received stem cell transplant.

Discussion: A diagnosis of bronchiolitis obliterans requires lung biopsy and histopathology. For patients who are unable to undergo biopsy or whose biopsy results are inconclusive, bronchiolitis obliterans syndrome can be clinically identified with spirometry (forced expiratory volume in first second of expiration and forced expiratory flow at 25% to 75% of forced vital capacity) and high-resolution computed tomography. Systemic corticosteroids are often the first-line treatment; second-line strategies are under investigation.

Conclusion: Knowledge of risk factors, signs, and current treatments for bronchiolitis obliterans/bronchiolitis obliterans syndrome can help acute care and critical care nurses decelerate progression of the disease.

小儿闭塞性细支气管炎和闭塞性细支气管炎综合征:护理注意事项。
背景:闭塞性细支气管炎/闭塞性细支气管炎综合征是一种不可逆的阻塞性肺部疾病,其特征是细支气管因肺纤维化、炎症和瘢痕形成而变窄。目的:为儿科患者闭塞性细支气管炎的急性护理、移植和重症护理护士提供疾病过程、原因和治疗方案的总结,以促进对高危患者体征的早期识别。方法:本描述性文献综述限于2013年及以后发表的文章。在PubMed和CINAHL数据库中搜索“闭塞性细支气管炎”和“儿科”,得到432篇文章。在这些文章中,有22篇被用于本综述。使用约翰霍普金斯护理循证实践评估工具评估文章的证据水平和方法学质量。结果:呼吸道感染患者、肺移植患者和干细胞移植患者发生闭塞性细支气管炎的危险主要有3组。讨论:闭塞性细支气管炎的诊断需要肺活检和组织病理学检查。对于无法进行活检或活检结果不确定的患者,可通过肺活量测定法(呼气第一秒的用力呼气量和用力呼气流量为用力肺活量的25%至75%)和高分辨率计算机断层扫描在临床上识别闭塞性细支气管炎综合征。全身皮质类固醇通常是第一线治疗;二线策略正在调查中。结论:了解闭塞性细支气管炎/闭塞性细支气管炎综合征的危险因素、体征和目前的治疗方法可以帮助急症护理和重症护理护士减缓疾病的进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Critical care nurse
Critical care nurse 医学-护理
CiteScore
2.80
自引率
0.00%
发文量
68
审稿时长
>12 weeks
期刊介绍: Critical Care Nurse (CCN) is an official publication of the American Association of Critical-Care Nurses (AACN). Authors are invited to submit manuscripts for consideration and peer review. Clinical topics must meet the mission of CCN and address nursing practice of acute and critically ill patients.
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