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Enfermería en Cardiología

Enfermería en Cardiología

SEPTIEMBRE 2021 N° 84 Volumen 31

Case report: patient undergoing balloon pulmonary angioplasty due to chronic thromboembolic pulmonary hypertension

Section: Casos clínicos

Authors

Raquel Guzmán Carrasco

Position

Grado en Enfermería. Enfermera del Departamento de Hemodinámica del Hospital Universitario 12 de Octubre de Madrid

Contact address

Raquel Guzmán Carrasco. C/ Ana Frank, 45. 28342 Valdemoro (Madrid)

Contact email: raquelguzmanc@hotmail.com

Abstract

Chronic thromboembolic pulmonary hypertension is a pulmonary circulation disorder resulting from the persistent obstruction of the pulmonary vascular bed due to organized thrombotic material.

Thrombotic pulmonary hypertension represents the only potentially curable pulmonary hypertension subtype. The treatment of choice is a surgical intervention (pulmonary thromboendarterectomy) although it is not a viable option for a third of patients due to various reasons. As an alternative or additive therapy for inoperable patients, balloon pulmonary angioplasty has achieved excellent results regarding haemodynamic and clinical improvements in published studies, yet the procedure is not without its complications.

A nursing care program was described for a patient with inoperable chronic thromboembolic pulmonary hypertension who underwent balloon pulmonary angioplasty. Nursing assessment was performed using Marjory Gordon‘s functional patterns of health and NANDA, NOC, NIC taxonomies were applied to detected problems, thereby identifying the bleeding risk, anxiety, acute pain and infection risk. Goals of interventions and activities aiming to solve problems were set up and the assessment of their compliance was performed using evaluable indicators.

Implementation of the nursing care program enabled problem solving during the angioplasty procedure and the nursing team worked in a systematic way.

Keywords:

Hypertension; pulmonary; pulmonary embolism; angioplasty; balloon; complications; nursing process; Nursing diagnosis

Versión en Español

Título:

Caso clínico: paciente sometido a angioplastia pulmonar con balón por hipertensión pulmonar tromboembólica crónica

Artículo completo no disponible en este idioma / Full article is not available in this language

Bibliography

  1. Callejas JL, Or tego N. Aspectos generales: definición, clasificación, epidemiología, genética, patobiología y diagnóstico. En: Or tego N. Protocolos Nuevos retos en hipertensión pulmonar. Sociedad Española de Medicina Interna. ed. España: Elservier España, S.L.U; 2019. p.1-26.
  2. Pepke-Zaba J, Delcroix M, Lang I, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation.2011; 124:1973–1981.
  3. Galiè N, Humber t M, Vachiery J-L, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hyper tension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hyper tension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Hear t and Lung Transplantation (ISHLT). Eur Hear t J. 2016;37(1): 67–119.
  4. López Gude MJ, Pérez de la Sota E, For teza Gil A, et al. Tromboendar terectomía pulmonar en 106 pacientes con hiper tensión pulmonar tromboembólica crónica. Arch Bronconeumol. 2015; 51: 502-508.
  5. Olsson KM, Wiedenroth CB, Kamp JC, Breithecker A, Fuge J, Krombach GA, et al. Balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hyper tension: the initial German experience. Eur Respir J [internet]. 2017 [citado 26 Feb 2020]; 49:1-8.
  6. Freed DH, Thomson BM, Berman M, et al. Survival after pulmonary thromboendar te- rectomy: effect of residual pulmonary hyper tension. J Thorac Cardiovasc Surg. 2011; 141:383–387.
  7. Mayer E, Jenkins D, Lindner J,et al. Surgical management and outcome of patients with chronic thromboembolicpulmonary hyper tension: results from an international prospective registry. J Thorac Cardiovasc Surg. 2011; 141: 702–710.
  8. Velázquez MT, Albarrán A, Hernández I, López-Gude MJ, Sarnago F, Mar tín R, et al. Angioplastia pulmonar con balón en la hiper tensión pulmonar tromboémbolica crónica no operable. Estudio observacional en una unidad de referencia. Rev Esp Cardiol. 2019; 72(3): 224-232.
  9. Ogawa A, Satoh T, Fukuda T, et al. Balloon pulmonary angioplasty for chronic throm- boembolic pulmonary hyper-tension: results of a multicenter registry. Circ Cardiovasc Qual Outcomes [internet]. 2017 [citado 27 Feb 2020]; 10:11.
  10. NNNConsult: Herramienta online para la consulta y diseño de Planes de Cuidados de Enfermería [Internet]. Barcelona: Elsevier; 2015 [acceso 9 marzo 2020]. Disponible en: http://www.nnnconsult.com/