Respiratory failure decreases a person's quality of life. Noninvasive ventilation therapy plays a key role in the stabilization of respiratory disease, which translates into evident gains for the patient. The objective of this chapter is to describe the gains and application of NIV and associated respiratory rehabilitation in patients with respiratory failure and the role of rehabilitation nursing. Seven articles were collected from the scientific databases, including only articles made in the last 10 years. The importance of NIV in the stabilization of respiratory disease is consensual. Respiratory rehabilitation is essential for improving respiratory functionality and should be performed during and after crisis. NIV is a therapy with recognized advantages in the control of respiratory failure: it's safe, effective, comfortable for the patient, and applicable to a wide range of events and chronic conditions. Respiratory rehabilitation reduces symptoms, improving quality of life. The rehabilitation nurse has an important role in success.
TopIntroduction
Respiratory failure consists of the inability of the respiratory system to properly perform blood oxygenation and consequent elimination of carbon dioxide (Ceriana & Nava, 2006). It is associated with chronic respiratory disease or with acute events and affects the activity and quality of life of the person (Ceriana & Nava, 2006; Shu, Mandal and Hart, 2013).
Currently, respiratory failure accounts for 19.3% of hospitalizations in Portugal and 11.8% of deaths (excluding death because of respiratory failure due to lung cancer) (OE, 2018). Thus, it becomes pertinent to approach respiratory failure in a broad perspective, considering gains to the individual (Roque et al., 2014). Noninvasive ventilation (NIV) can be used as treatment intended to correct gas exchange through the application of positive airway pressure (Roque et al., 2014).
NIV can be used in invasive ventilation weaning, thus avoiding muscle fatigue and postextubation respiratory failure, as well as in the context of respiratory failure, whether acute or chronic (Cordeiro & Menoita, 2012; Shu et al., 2013).
The use of resources for noninvasive ventilation dates from the beginning of the nineteenth century, wherein the first ventilators used negative pressure during inspiration by placing the surface of the thorax under subatmospheric pressures (Cordeiro & Menoita2012, OE 2018). It was advantageous to use it in individuals with muscle weakness during the polio epidemic; however, it was expensive and could not be transported, compromising an individual's independence (Cordeiro & Menoita, 2012; OE, 2018).
In the 1940s and 1950s, the NIV technique was developed using positive pressure; however, during the Second World War and in the 1960s and 1970s, it was abandoned due to the development of ventilators and tracheal tubes (Cordeiro & Menoita, 2012). In the 1980s, interest in NIV was resumed for the treatment of acute and chronic respiratory failure, and it was considered the first-line therapy in several acute respiratory diseases (Cordeiro & Menoita, 2012; Faverio et al., 2018).
Currently, NIV is used to manage respiratory changes in both the acute and community phases because it decreases respiratory work, promotes the resting of respiratory muscles, and improves gas exchange (Dyer et al., 2018; Suh et al., 2013).
This therapy can be used in situations of acute or chronic respiratory disease. In the acute phase, it shows benefit in terms of CO2 retention in individuals with Chronic Obstructive Pulmonary Disease (COPD), pulmonary tuberculosis status, neuromuscular diseases, and anomalies in the thoracic wall (mainly after thoracoplasty and kyphoscoliosis) (Dyer et al., 2018; Suh et al., 2013).