RESUMO
Many people throughout the world are living with a severe pulmonary disease, known as pulmonary arterial hypertension. This disease has various etiologies and is often not diagnosed appropriately or early in the disease process, leading to limited, long-term survival. Fortunately in the past 20 years, medications and other options have been developed that provide patients with life-prolonging treatments that also increase their quality of life. Pathophysiology, disease identification and classification, and treatment options, focusing on current pharmacological treatments, are discussed in this article.
Assuntos
Anti-Hipertensivos/administração & dosagem , Aprovação de Drogas , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/terapia , Administração por Inalação , Administração Oral , Anti-Hipertensivos/farmacologia , Terapia Combinada , Epoprostenol/administração & dosagem , Epoprostenol/análogos & derivados , Feminino , Humanos , Hipertensão Pulmonar/epidemiologia , Infusões Intravenosas , Injeções Subcutâneas , Masculino , Piperazinas/administração & dosagem , Prognóstico , Doença Cardiopulmonar/diagnóstico , Doença Cardiopulmonar/epidemiologia , Doença Cardiopulmonar/terapia , Purinas/administração & dosagem , Índice de Gravidade de Doença , Citrato de Sildenafila , Sulfonamidas/administração & dosagem , Taxa de Sobrevida , Resultado do Tratamento , Estados Unidos , United States Food and Drug AdministrationRESUMO
Many people throughout the world are living with heart disease and advanced heart failure. They may be in need of a heart transplant, but because of the limited amount of donor hearts available, other options need to be available. Because of the advancement of technology, there are now other options, and one option available would be a mechanical circulatory and cardiac support device. Ventricular assist devices (VADs) have been developed over the past 30 years. From larger, earlier pulsatile devices to smaller, hand-held, newer axial flow or rotary pump devices, VADs are implanted cardiac assist devices. They are implanted to provide cardiac support and can be used temporarily as a bridge to transplant (for those awaiting a heart transplant) or implanted permanently, which is known as destination therapy. With the changes in the size of device, decrease in the size of drive line, increased length of battery life, as well as length of device life, thousands of people now have these implanted VAD devices and are living quality lives and functioning at high levels. Currently, there are 3 generations of the left ventricular assist devices being used throughout the world. Five of the most well-known type of left ventricular assist devices are discussed in this article.
Assuntos
Insuficiência Cardíaca/enfermagem , Coração Auxiliar , Desenho de Equipamento , Insuficiência Cardíaca/cirurgia , HumanosRESUMO
Delirium has been recognized in the literature as a significant problem in the care and treatment of the critical care patient. Delirium, a medical disorder that results in the morbidity and mortality of the patients, especially in the elderly, is often misdiagnosed and inappropriately treated. Nurses and other health care professionals need in-depth education about delirium, validated and understandable assessment tools, and astute clinical observational skills. A comprehensive and aggressive clinical management plan that incorporates appropriate pharmacological agents will result in less morbidity and improved long-term outcomes.