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2017, Number Esp

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Rev Mex Enf Cardiol 2017; 25 (Esp)

Nursing process in a pediatric patient with cardiopulmonary failure undergoing extracorporeal membrane oxygenation

Solís SML, Aguilar ABS, García CD, García GJC, Cadena EJC

Language: Spanish
References: 29
Page: 14-24
PDF size: 241.33 Kb.


ABSTRACT

Background: Extracorporeal membrane oxygenation (ECMO) is an alternative treatment for patients with ventricular failure Postcardiotomy for surgical correction of Tetralogy of Fallot (TF); however, little evidence exists in Mexico for use in health institutions. Objective: To develop the process of nursing care (PAE) in infants patient with right lung failure and underwent ECMO. Methodology: Case study, prospective, longitudinal performed with the methodology of PAE in an institution of cardiovascular highly specialized in the mediate and immediate postoperative period. Altered human needs with cardiovascular assessment tool based nursing approach Henderson and expressly management tool for ECMO with hemodynamic and ventilatory variables were detected; nursing diagnoses (DE) real and assessed risk scoring DIANA, the higher the score greater independence were made; NIC interventions were raised. Data analyzed with descriptive statistics and paired t-test, significance p ‹ 0.05. Results: Altered Needs: aeration/circulation, thermoregulation, avoid hazards; nursing diagnosis: impaired gas exchange, decreased cardiac output, temperature imbalance, risk of infection, bleeding risk. Tas NIC interventions and management of ECMO DIANA score increased, increasing the GC, acid-base balance was maintained, improved gas exchange with low ventilatory parameters; reduced the need for vasopressors and only required pharmacological support (levosimendan) 48 hours after starting ECMO. By increasing the basal parameters ECMO day to day one, there are significant hemodynamic and ventilatory changes (p ‹ 0.05). On the 12th day ECMO is removed A successfully extubated. Conclusion: The perfusionist nurse through the implementation of SAP and ECMO, managed to provide quality care to pediatric patient safety and managing to satisfy the altered needs and solve the DE.


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