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Nursing interventions to the person with cardiac disease submitted to ECMO – integrative literature review

2021; Informa; Volume: 53; Issue: sup1 Linguagem: Inglês

10.1080/07853890.2021.1896014

1365-2060

João Reisinho, João Sardinha, Pedro Santos, Rita Rodrigues, Cidália Castro,

Cardiac Arrest and Resuscitation

Introduction Heart disease includes a variety of diseases, conditions, and disorders that affect the heart and blood vessels [1 Babič F, Olejár J, Vantová Z, et al. Predictive and descriptive analysis for heart disease diagnosis. 2017 Federated Conference on Computer Science and Information Systems. 2017;11:155–163.[Crossref] , [Google Scholar]]. Extracorporeal Membrane Oxygenation (ECMO) is a short-term Ventricular Assist Device (VAD), indicated in cardiogenic shock and respiratory failure, when surgical or conventional therapeutic measures are not successful, and the most used in the case of heart failure is venoarterial ECMO [2 Chen K, Chen Y, Yeh S, et al. Changes in quality of life and health status in patients with extracorporeal life support: a prospective longitudinal study. PLOS One. 2018;13(5):e0196778–16.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar],3 Farias ACA. Cuidado de enfermagem especializado à pessoa dependente de oxigenação por membrana extracorporal (ECMO). (Tese de Mestrado). Lisboa: Escola Superior de Enfermagem de Lisboa; 2015. [Google Scholar]]. The aim of this study is to understand the ECMO technique in adult patients with cardiac disease, as well as the associated Nursing Interventions.Materials and methods This study is an Integrative Literature Review by the PI[C]OD method. Available articles were searched in the Biblioteca do Conhecimento Online (B-On) and EBSCOhost databases, published between 2014 and 2019. The inclusion criteria were ECMO, person with cardiac disease and successfully nursing interventions. Of the total of twenty-seven articles, 14 were excluded by title, six by the abstract and four by full reading. Three articles were included in the corpus of the study.Results The articles included allowed to identify three main ideas: in the first article, a specific nursing care protocol was developed for patients with VAD [4 Machado RC, Gironés P, Souza AR, et al. Protocolo de cuidados de enfermagem a pacientes com dispositivo de assistência ventricular. Rev Bras Enf. 2017;70(2):353–359. [Google Scholar]]; in the second study, VADs can be an intermediary mean for cardiac transplantation [5 Aissaoui N, Morshuis M, Maoulida H, et al. Management of end-stage heart failure patients with or without ventricular assist device: an observational comparison of clinical and economic outcomes. Eur J Cardio-Thoracic Surg. 2018;53(1):170–177.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]; however, in the last study, ECMO may present physical complications and depressive symptoms [2 Chen K, Chen Y, Yeh S, et al. Changes in quality of life and health status in patients with extracorporeal life support: a prospective longitudinal study. PLOS One. 2018;13(5):e0196778–16.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]].Discussion and conclusions Studies have shown that in patients with unstable cardiac pathology “ECMO is life saving, and should therefore be considered a viable extension for conventional treatment options for critical care” [3 Farias ACA. Cuidado de enfermagem especializado à pessoa dependente de oxigenação por membrana extracorporal (ECMO). (Tese de Mestrado). Lisboa: Escola Superior de Enfermagem de Lisboa; 2015. [Google Scholar]]. Although VAD is a reliable alternative to transplantation, when it is not available or when the patient's condition is hemodynamically unstable, heart transplantation remains the first-line treatment [5 Aissaoui N, Morshuis M, Maoulida H, et al. Management of end-stage heart failure patients with or without ventricular assist device: an observational comparison of clinical and economic outcomes. Eur J Cardio-Thoracic Surg. 2018;53(1):170–177.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]. We think that the results of this study can subsidise the exercise of teaching nursing care, allowing students to build structured knowledge, which allows to identify the real needs of the person submitted to ECMO. At the level of clinical practice, it is important to discuss the results of this study within the team, ensuring patient safety and the quality of nursing care based on scientific evidence.