Implementation of extracorporeal cardiopulmonary resuscitation in a hospitalization unit
Section: Casos clínicos
Authors
Judith Prats Barrera1, Elena Querol Vallés2, Montserrat Venturas Nieto3, Silvia Pérez-Ortega4.
Position
1 Máster. Enfermera de Unidad de Cuidados Intensivos de Cirugía Cardiovascular. Instituto Clínico Cardiovascular. Hospital Clínic de Barcelona. 2 Máster, Enfermera de Unidad Cuidados Cardiacos Agudos. Instituto Clínico Cardiovascular. Hospital Clínic de Barcelona. 3 Doctora en Ciencias de la Enfermería. Jefa de Gestión Enfermera del Instituto Clínico Cardiovascular. Hospital Clínic de Barcelona. 4 Candidata a Doctora. Enfermera clínica del Instituto Clínico CardioVascular. Hospital Clínic Barcelona.
Contact address
Judith Prats Barrera. Hospital Clínic de Barcelona Instituto Clínico Cardiovascular. C/ Villaroel, 170. 08036 Barcelona
Contact email: judithprats@gmail.com
Abstract
Extracorporeal cardiopulmonary resuscitation represents a very valuable tool in situations of refractory cardiorespiratory arrest. At present, since the literature is scarce, it has been incorporated into clinical guidelines with a level of evidence IIb.
Its implementation consists of the placement of an extracorporeal circuit with oxygenation membrane. Its insertion is performed simultaneously to advanced life support maneuvers, hence the insertion is most commonly through the peripheral access, with the femoro-femoral access being most commonly used.
Patients who are recovering from a cardiac surgery, when suffering from a refractory cardiorespiratory arrest, require a different sequence of actions to be taken.
Next, we present the case of a patient who, after undergoing an elective aortic valve replacement, presents a refractory cardiorespiratory arrest in a hospitalization unit. Both emergent sternotomy and extracorporeal life support maneuvers were performed at the bedside. The device was inserted through the central access and he was stabilized at the very ward, prior to the operating room and without passing by the intensive care unit, so as to avoid movings that could contribute to his instability.
The patient required heart transplantation and developed myopathy of the critically ill patient. Thanks to the multidisciplinary work, to the patient‘s efforts and to the intensive rehabilitation, he could be discharged.
During his hospitalization, three nursing assessments were carried out that evaluated the patient‘s needs throughout the whole process.
Versión en Español
Título:
Implementación de reanimación cardiopulmonar extracorpórea en una unidad de hospitalización
Artículo completo no disponible en este idioma / Full article is not available in this language
Bibliography
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