心因性肺水腫病人之護理評估與處置

Nursing Assessment and Management of Patients with Cardiogenic Pulmonary Edema

心因性肺水腫是臨床上高致死率的健康問題之一，由於會造成氣體交換障礙，使病人出現呼吸困難、血氧降低、急性呼吸衰竭，是一種嚴重且危及生命的急症。因此，除常規藥物治療外，本文之目的在於提供心因性肺水腫病人的臨床症狀評估及相關護理處置，同時也藉由實證方式，從 Cochrane、CINAHL、ScienceDirect查得四篇根據Oxford證據等級，分別為Ia及Ib的系統性文獻回顧及統合分析，綜整非侵入性正壓呼吸器的治療，尤其是連續性正壓呼吸器或雙向正壓呼吸器對心因性肺水腫的治療療效，研究結果建議，如果病人可以及早接受相關處置有助於降低病人插管機率、減少加護病房住院天數及死亡率，並提供接受非侵入性正壓呼吸器治療的相關護理措施。希望未來能有更多臨床實驗佐證，以提供護理人員臨床照護實證之適用性。

Cardiogenic pulmonary edema (CPE) is a clinical health problem that induces impaired gas exchange, dyspnea and hypoxia. This serious condition results in acute respiratory failure and high mortality rate. This article suggests an effective approach to CPE patient clinical symptom assessment and management. In accordance with evidence-based methods, we searched Cochrane, CINAHL and Science Direct and identified four Oxford Ia or Ib reports that employed a randomized controlled trial, systematic review and meta-analysis. Results suggest that prompt application of a non-invasive positive ventilator, especially continuous positive or bi-level positive airway pressure, can help patients reduce intubation risks, ICU stay days, and mortality rates. The authors hope to see more clinical trials on this topic to support evidence-based clinical nursing care.