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1.
J Cardiovasc Nurs ; 35(2): 217-222, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31904695

RESUMEN

OBJECTIVE: The aim of this study was to compare the effect of 2 hemostasis devices on the incidence of radial artery occlusion (RAO) after transradial cardiac catheterization. BACKGROUND: Radial artery occlusion is the most prevalent ischemic complication after radial artery catheterization. There is still no predictive pattern of vessel patency assessment, and the comparative effectiveness of different hemostasis techniques has yet to be established. METHODS: This study used a randomized clinical trial of adult patients undergoing transradial cardiac catheterization. Participants were randomized into an intervention group (hemostasis with the TR Band device) and a control group (hemostasis with a conventional pressure dressing). The primary end point was the incidence of RAO (at discharge and at 30 days post catheterization). RESULTS: Among the 600 patients included (301 in the intervention group and 299 controls), immediate RAO occurred in 24 (8%) in the TR Band group and 19 (6%) in the pressure-dressing group; at 30 days, RAO was present in 5 patients (5%) in the TR Band group and 7 (6%) in the pressure-dressing group. On multivariate analysis, peripheral vascular disease was the only independent predictor of RAO at discharge and at 30 days. ConclusionsThe incidence of RAO was similar in patients who received hemostasis with a TR Band versus a pressure dressing after transradial cardiac catheterization.


Asunto(s)
Arteriopatías Oclusivas/etiología , Cateterismo Cardíaco/métodos , Técnicas Hemostáticas/efectos adversos , Técnicas Hemostáticas/instrumentación , Arteria Radial , Anciano , Arteriopatías Oclusivas/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Método Simple Ciego
2.
Rev Gaucha Enferm ; 39: e20170292, 2018 Oct 22.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-30365756

RESUMEN

OBJECTIVE: To describe the precipitating factors of heart failure decompensation between adherent and non-adherent patients to treatment. METHODS: Cross-sectional study of a multicenter cohort study. Patients over 18 years of age with decompensated heart failure (functional class III/IV) were eligible. The structured questionnaire was used to collect the data and evaluate the reasons for decompensation. The irregular use of medication prior to hospitalization and inadequate salt and fluid intake were considered as poor adherence to treatment. RESULTS: A total of 556 patients were included, mean age 61 ± 14 years old, 362 (65%) male. The main factor of decompensation was poor adherence, representing 55% of the sample. Patients who reported irregular use of medications in the last week had a 22% greater risk of being hospitalized due to poor adherence than the patients who adhered to treatment. CONCLUSION: The EMBRACE study showed that in patients with heart failure, poor adherence was the main factor of exacerbation.


Asunto(s)
Insuficiencia Cardíaca/etiología , Cumplimiento de la Medicación/estadística & datos numéricos , Estudios de Cohortes , Estudios Transversales , Femenino , Insuficiencia Cardíaca/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Factores Desencadenantes , Autoinforme
3.
Rev Gaucha Enferm ; 38(3): e66789, 2018 Mar 12.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-29538608

RESUMEN

OBJECTIVE: To validate interventions and nursing activities proposed by the Nursing Interventions Classification for patients with acute renal failure or acute chronic renal disease in hemodialysis therapy with the Excess Fluid Volume and Risk for Imbalanced Fluid Volume nursing diagnoses. METHODS: Validation of content with 19 expert nurses from a university hospital. The data collection was made from September to November 2011 through instruments that contained the interventions and nursing activities in study. The data analysis considered the average of scores obtained in the validation process. RESULTS: The Fluid Management was validated as a priority intervention (mean ≥ 0.8), with eight main activities for the Excess Fluid Volume nursing diagnosis and eight for the Risk for Imbalanced Fluid Volume nursing diagnosis. CONCLUSION: The validated intervation of the Fluid Management enables the monitoring of the hydric balance and facilitates the prevention of complications, which are important activities in the nursing care of the patients in hemodialysis therapy.


Asunto(s)
Diálisis Renal/enfermería , Lesión Renal Aguda/enfermería , Lesión Renal Aguda/terapia , Femenino , Unidades de Hemodiálisis en Hospital , Hospitales Universitarios , Humanos , Unidades de Cuidados Intensivos , Fallo Renal Crónico/enfermería , Fallo Renal Crónico/terapia , Masculino , Diagnóstico de Enfermería , Diálisis Renal/efectos adversos , Especialidades de Enfermería , Equilibrio Hidroelectrolítico , Desequilibrio Hidroelectrolítico/etiología , Desequilibrio Hidroelectrolítico/enfermería , Desequilibrio Hidroelectrolítico/prevención & control
4.
Rev Gaucha Enferm ; 39: e20170257, 2018 Aug 02.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-30088607

RESUMEN

OBJECTIVE: Randomized clinical trial protocol to evaluate the incidence of radial artery occlusion with two different arterial compression devices after transradial procedures. METHODS: Barbeau's test will be performed in adults scheduled to undergo transradial interventional procedures. Those with A, B, or C plethysmographic patterns will be selected. At the end of the procedure, patients will be randomly assigned (1:1) to receive patent haemostasis with TR Band™ device or conventional haemostasis with an elastic adhesive bandage. The primary outcome is the incidence of radial artery occlusion. Secondary outcomes are Barbeau's test curve change, additional time to achieve haemostasis, incidence of bleeding at the puncture site, pain severity, development of arteriovenous fistula, radial pseudo aneurysm, any access-site complication requiring vascular surgery intervention and costs between the two devices. DISCUSSION: The results of this trial should provide valuable additional information on the best approach for haemostasis after transradial percutaneous cardiovascular interventions.


Asunto(s)
Angioplastia Coronaria con Balón/efectos adversos , Cateterismo Cardíaco/efectos adversos , Vendajes de Compresión , Hemorragia/terapia , Técnicas Hemostáticas/instrumentación , Arteria Radial , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Brasil , Cateterismo Cardíaco/métodos , Protocolos Clínicos , Circulación Colateral , Mano/irrigación sanguínea , Hemorragia/etiología , Humanos , Oximetría , Selección de Paciente , Punciones , Arteria Radial/lesiones , Ensayos Clínicos Controlados Aleatorios como Asunto/ética
5.
Rev Gaucha Enferm ; 37(2): e61554, 2016 Jun.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-27410675

RESUMEN

OBJECTIVE: The purpose of this study was to test the clinical applicability of the Nursing Outcomes Classification in patients with decompensated heart failure and the nursing diagnosis of fluid volume excess. METHODS: This is a longitudinal study conducted in two stages at a university hospital, in 2013. During the first stage the consensus of experts was used to select the nursing outcomes and the indicators related to diagnosing fluid volume excess. The longitudinal study was conducted in the second stage to clinically evaluate the patients using the instrument containing the results and indicators produced in the consensus. RESULTS: A total of 17 patients were assessed. The nursing outcomes were measured during the clinical evaluation by analysing their indicators. The scores increased in six of the results, in comparison with the average results of the first and last assessment. The Nursing Outcomes Classification during medical practice revealed a clinical improvement among the patient who were admitted following decompensated heart failure. CONCLUSION: The Nursing Outcomes Classification managed to detect changes in the clinical status of patients.


Asunto(s)
Insuficiencia Cardíaca/enfermería , Evaluación en Enfermería/métodos , Terminología Normalizada de Enfermería , Desequilibrio Hidroelectrolítico/enfermería , Anciano , Brasil , Consenso , Femenino , Corazón/fisiopatología , Insuficiencia Cardíaca/clasificación , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/fisiopatología , Hospitales Universitarios , Humanos , Riñón/fisiopatología , Masculino , Persona de Mediana Edad , Diagnóstico de Enfermería , Resultado del Tratamiento , Desequilibrio Hidroelectrolítico/clasificación , Desequilibrio Hidroelectrolítico/dietoterapia , Desequilibrio Hidroelectrolítico/etiología
6.
J Thromb Thrombolysis ; 37(3): 338-44, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23771743

RESUMEN

Significant inter-individual variability on the effect of vitamin K to reverse overanticoagulation has been identified. Genetic polymorphisms of the vitamin K epoxide reductase complex subunit 1 (VKORC1) gene might explain in part this variability. The objective of this study was to evaluate the influence of VKORC1 -1639G>A and 3730G>A polymorphisms on the effect of oral vitamin K supplementation in overanticoagulated patients. We performed an interventional trial of oral vitamin K supplementation in over-anticoagulated outpatients (international normalized ratio [INR] ≥ 4). Subjects received vitamin K (2.5-5.0 mg) according to baseline INR and were genotyped by real time polymerase chain reaction (PCR). INR values were determined at 3, 6, 24 and 72 h after supplementation. We evaluated 33 outpatients, 61 % were males, with a mean age of 62 ± 12 years old. There was a significant decrease in INR values over time for both polymorphisms after oral vitamin K. At 3 h after supplementation, patients carrying the G allele for the -1639G>A polymorphism had a greater decrease in INR values compared to AA patients (p < 0.05 for difference among groups; p < 0.001 for time variation; p = 0.001 for time × group interaction), with differences of -1.01 for GG versus AA (p = 0.003) and -0.84 for GA versus AA (p = 0.024). Mean INR value at 24 h was 1.9 ± 0.6 and at 72 h was 2.1 ± 0.7, with no differences among genotypes. No significant interaction was identified between the 3730G>A polymorphism and vitamin K supplementation. Our study indicated that the VKORC1 -1639G>A polymorphism plays a role in the response to acute vitamin K supplementation in over-anticoagulated patients, with faster decrease of INR value in patients carrying the G allele.


Asunto(s)
Alelos , Anticoagulantes/administración & dosificación , Antifibrinolíticos/administración & dosificación , Polimorfismo Genético , Vitamina K Epóxido Reductasas/genética , Vitamina K/administración & dosificación , Administración Oral , Anciano , Femenino , Humanos , Relación Normalizada Internacional , Masculino , Persona de Mediana Edad
8.
Int J Nurs Knowl ; 2023 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-37990774

RESUMEN

PURPOSE: This study aims to perform specific causal validation of nursing diagnosis Risk for thrombosis (00291) of the NANDA International (NANDA-I) classification. METHODS: This is a case-control study conducted in a university hospital from January to October 2020. A total of 516 adult patients were included-344 in the Case Group (with venous or arterial thrombosis evidenced by imaging) and 172 in the Control Group (without thrombosis). Statistical analysis was performed by univariate and multivariate logistic regression test, and odds ratios were calculated to measure the effect of exposure between groups. The study was approved by the Research Ethics Committee. FINDINGS: The patients were predominantly female and aged 59 ± 16 years. In the univariate logistic analysis, five risk factors were significantly associated with thrombosis, two at-risk populations and 12 associated conditions. In the multivariate regression model, the following risk factors remained independently associated (p < 0.05): inadequate knowledge of modifiable factors (OR: 3.03; 95% CI: 1.25-8.56) and ineffective medication self-management (OR: 3.2; 95% CI:1.77-6.26); at-risk populations with history (OR: 2.16; 95% CI: 1.29-3.66) and family history of thrombosis (OR:2.60; 95% CI: 1.03-7.49); and the conditions associated with vascular diseases (OR:6.12; 95% CI:1.69-39.42), blood coagulation disorders (OR: 5.14; 95% CI:1.85-18.37), atherosclerosis (OR:2.07; 95% CI: 1.32-3.27), critical illness (OR: 2.28; 95% CI: 1.42-3.70), and immobility (OR: 2.09; 95% CI: 1.10-4.12). CONCLUSIONS: The clinical validation allowed to establish strong evidence for the refinement of the diagnosis Risk for thrombosis and, consequently, to raise its level of evidence in the classification of NANDA-I. IMPLICATIONS FOR NURSING PRACTICE: The evidence pointed out by this study favors the establishment of thrombosis diagnosis in an accurate way by nurses in clinical practice, directing preventive interventions to patients in this risk condition.


OBJETIVO: Realizar a validação causal específica do diagnóstico de enfermagem Risco de trombose (00291) da classificação diagnóstica da NANDA International, Inc. MÉTODOS: Estudo de caso-controle, realizado em hospital universitário entre janeiro e outubro de 2020. Foram incluídos 516 pacientes adultos - 344 no Grupo Caso (com trombose venosa ou arterial evidenciada em exame de imagem) e 172 no Grupo Controle (sem trombose). A análise estatística ocorreu por teste de regressão logística univariada e multivariada, e Odds ratios calculados para medir o efeito da exposição entre os grupos. O estudo foi aprovado em Comitê de Ética. RESULTADOS: Os pacientes foram predominantemente do sexo feminino e idade de 59±16 anos. Na análise logística univariada foi associado significativamente á trombose: cinco fatores de risco, duas populações em risco e 12 condições associadas. No modelo de regressão multivariada permaneceram independentemente associados (P<0,05) os fatores de risco conhecimento inadequado sobre os fatores modificáveis (OR:3,03; IC95%:1,25-8,56) e autogestão ineficaz de medicamentos (OR:3,24; IC95%:1,77-6,26); as populações em risco com história prévia (OR:2,16; IC95%:1,29-3,66) e história familiar de trombose (OR:2,60; IC95%:1,03-7,49); e as condições associadas a doenças vasculares (OR:6,12; IC95%:1,69-39,42), distúrbios de coagulaçõo (OR:5,14; IC95%:1,85-18,37),aterosclerose (OR:2,07; IC95%:1,32-3,27), doença crítica (OR:2,28; IC95%:1,42-3,70) e imobilidade (OR:2,09; IC95%:1,10-4,12). CONCLUSÕES: A validação clínica permitiu estabelecer fortes evidências para o refinamento do diagnóstico Risco de trombose e, consequentemente, elevar seu nível de evidência na classificação da NANDA-I. IMPLICAÇÕES PARA A PRÁTICA: As evidências apontadas pelo estudo favorecem o estabelecimento deste diagnóstico de forma acurada pelos enfermeiros na prática clínica, direcionando intervenções preventivas aos pacientes nesta condiçõo de risco.

9.
Rev Gaucha Enferm ; 32(3): 590-5, 2011 Sep.
Artículo en Portugués | MEDLINE | ID: mdl-22165408

RESUMEN

The aim of this study is to identify the signs and symptoms of patients admitted for decompensated heart failure (HF) in order to infer the priority nursing diagnoses (ND). This is a cross-sectional study undertaken in a university hospital. The data were collected by nurses trained to deal with HF and registered in a file containing identification items, and demographic and clinical variables. We included 303 patients. Most patients were in emergency departments (95.7%) with functional class III (65.7%). The signs and symptoms identified at the time of admission were dyspnea (91.4%), paroxysmal nocturnal dyspnea (87.5%), fatigue (67.3%), edema (63.7%), orthopnea (55.4 %) and jugular vein distention (28.7%). From the signs and symptoms raised, that became the set of relevant clues and consistent as an indicator for ND, we conclude that Decreased Cardiac Output and Fluid Volume Excess diagnoses were the priorities for this population.


Asunto(s)
Insuficiencia Cardíaca/diagnóstico , Diagnóstico de Enfermería , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad
10.
Rev Lat Am Enfermagem ; 18(6): 1145-51, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21340280

RESUMEN

This cross-sectional study aimed to describe the prescription of non-pharmacological management of patients with heart failure attending the emergency care of a hospital and the effectiveness of the practice. 256 patients aged 63 ± 13 years, 153 (60%) men, participated in the research. The most commonly prescribed non-pharmacological treatment was sodium restriction, 240 (95%), followed by weight control, 135 (53%). Fluid restriction and fluid balance were the least commonly prescribed treatments, 95 (37%) and 72 (28%), respectively. Only 38 (54%) of balances, 89 (67%) of weight controls and 69 (57%) of diuresis controls were performed. Concerning patients' previous knowledge of the treatments, 229 (90%) were advised to restrict salt intake, and 163 (64%) were advised to restrict fluid intake. Weight control was the least commonly known care, 117 (46%). Except for salt control, the other treatments were prescribed in slightly more than half of the samples, and were ineffective.


Asunto(s)
Tratamiento de Urgencia , Insuficiencia Cardíaca/terapia , Estudios Transversales , Atención a la Salud , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad
11.
Rev Lat Am Enfermagem ; 18(4): 696-702, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20922315

RESUMEN

Adherence to chronic Oral Anticoagulant Therapy (OAT) is directly related to patients' understanding of the therapy. This study verified the knowledge of patients with mechanical valve prostheses concerning OAT. This is a contemporary cross-sectional study, the sample is composed of patients with mechanical valve prostheses (MVP) in outpatient follow-up. A 10-question instrument was used; answers were 'know' (1 point), 'know partially' (half point), or 'do not know' (zero). Patients were grouped according to the result obtained: ≤ 4 points was considered insufficient knowledge; > 4 ≤ 8 equated to moderate knowledge; and > 8 was considered appropriate knowledge. Of the 110 patients, 61.8% presented moderate knowledge, 40.9% were not able to name at least one factor that may alter the INR (International Normalized Ratio) and 37.3% were not able to report their INR target range. The majority of patients presented moderate knowledge concerning the treatment. Strategies to improve knowledge on the topic should be implemented to minimize risks.


Asunto(s)
Anticoagulantes/administración & dosificación , Prótesis Valvulares Cardíacas , Pacientes Ambulatorios , Administración Oral , Adulto , Anciano , Brasil , Estudios Transversales , Interpretación Estadística de Datos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Factores de Tiempo
12.
Rev Gaucha Enferm ; 31(2): 225-31, 2010 Jun.
Artículo en Portugués | MEDLINE | ID: mdl-21500500

RESUMEN

Non-compliance in heart failure (HF) patients is one of the factors leading to hospital readmissions. Under this perspective, a study was carried out in a university hospital in Rio Grande do Sul, Brazil to describe the compliance with pharmacological and non-pharmacological treatments of patients admitted with decompensated HF, relating the compliance to the number of hospital admissions and readmissions during a years period. The pharmacological compliance was measured through Morisky scale and the non-pharmacological compliance was measured through a previously validated questionnaire. The sample was composed of 252 patients, median age 63 +/- 13, 151 (60%) male. For the pharmacological compliance, 118 (47%) patients demonstrated high compliance, and 45 (18%) adhered to non-pharmacological treatment. There was no relation found between treatment compliance (pharmacological or non-pharmacological) and readmissions. Patients who had been treated for HF, had knowledge about non-pharmacological care and were able to identify congestion symptoms demonstrated high compliance.


Asunto(s)
Insuficiencia Cardíaca/terapia , Cooperación del Paciente/estadística & datos numéricos , Estudios Transversales , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Persona de Mediana Edad
13.
Rev Gaucha Enferm ; 41(spe): e20190095, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32294683

RESUMEN

AIM: To analyze the behavior of B-type natriuretic peptide (BNP) in the presence of defining characteristics (DCs) of the nursing diagnosis Excess fluid volume (00026) in patients hospitalized for acute decompensated heart failure. METHODS: Cohort study of patients admitted with acute decompensated heart failure (September 2015 to September 2016) defined by Boston Criteria. Patients hospitalized for up to 36 h with BNP values ≥ 100 pg/ml were included; BNP values at baseline-final assessment were compared by Wilcoxon test, the number of DCs at baseline-final assessment was compared by paired t-test. RESULTS: Sixty-four patients were included; there was a significant positive correlation between delta of BNP and the number of DCs present at initial clinical assessment. CONCLUSIONS: The behavior of BNP was correlated to the DCs indicating congestion. With clinical compensation, DCs and BNP decreased. The use of this biomarker may provide additional precision to the nursing assessment.


Asunto(s)
Insuficiencia Cardíaca/sangre , Péptido Natriurético Encefálico/sangre , Diagnóstico de Enfermería , Desequilibrio Hidroelectrolítico/diagnóstico , Anciano , Biomarcadores/sangre , Estudios de Cohortes , Servicios Médicos de Urgencia , Femenino , Insuficiencia Cardíaca/enfermería , Insuficiencia Cardíaca/fisiopatología , Humanos , Masculino , Tamaño de la Muestra , Volumen Sistólico , Desequilibrio Hidroelectrolítico/sangre
14.
Trials ; 20(1): 414, 2019 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-31288854

RESUMEN

BACKGROUND: Only one-third of hypertensive patients achieve and maintain blood-pressure control. This is attributed to low treatment adherence and has a negative impact on clinical outcomes. Adherence is multidimensional and involves aspects both related to patient characteristics and to the chronic nature of the disease. In this context, motivational interviewing has been proposed as an approach to foster patients' motivations to change their behavior for the benefit of their own health, thus providing more lasting behavioral changes. DESIGN AND METHODS: Single-center, parallel, randomized controlled trial with outcome-assessor blinding. This study will select adult patients (n = 120) diagnosed with hypertension who receive regular follow-up in a specialized outpatient clinic. Patients will be randomly allocated across two groups: the intervention group will have appointments focused on motivational interviewing, while the control group will have traditional appointments. Patients will be monitored face-to-face, once monthly for six months. The primary outcomes will be a reduction of at least 8 mmHg in systolic blood pressure and changes in mean blood pressure measured by 24-h ambulatory blood pressure monitoring. Secondary outcomes include improvement of adherence to a low-sodium diet, adherence to self-care behaviors, regular use of antihypertensive medications, increase or maintenance of physical activity, weight reduction, evaluation of changes in daytime sleepiness, and cessation of smoking. DISCUSSION: This study shows an intervention strategy that will be tested and, if effective, warrant replication in monitoring of other chronic diseases. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02892929 . Registered on 24 August 2016.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Cumplimiento de la Medicación , Entrevista Motivacional , Conducta de Reducción del Riesgo , Autocuidado , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Dieta Hiposódica , Ejercicio Físico , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Sueño , Factores de Tiempo , Resultado del Tratamiento , Pérdida de Peso , Adulto Joven
15.
Rev Lat Am Enfermagem ; 16(4): 707-11, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18833452

RESUMEN

OBJECTIVES: to identify the prevalent nursing diagnoses (ND) in the hospitalized elder care; to compare the prevalent ND with the duration of hospital stay and with the prescribed cares for their respective diagnoses. METHOD: Transversal historical study carried through in Porto Alegre, RS, by analyzing patient records age e60 years old, interned in clinical unities of a university hospital. RESULTS: 1665 records were analyzed; the four prevalent NANDA nursing diagnoses--within 62 identified ones--were: Self-Care Deficit--Bathing/Hygiene, Imbalanced Nutrition--Less than Body Requirements, Risk for Infection and Ineffective Breathing Patterns, varying from 14 to 17 days of hospital stay. THE MAIN CARES WERE: aiding bed bath, communicating diet acceptance, implementing routines of care in venous puncture and checking respiratory pattern. CONCLUSION: four prevalent ND were identified with the appropriate prescribed care. However, other care could have been established as a priority.


Asunto(s)
Enfermería Geriátrica/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Diagnóstico de Enfermería/estadística & datos numéricos , Anciano , Femenino , Humanos , Masculino , Prevalencia
16.
Nutrition ; 54: 111-117, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29793053

RESUMEN

OBJECTIVES: Sodium and fluid restriction is commonly prescribed for heart failure patients. However, its role in the treatment of heart failure with preserved ejection fraction (HFpEF) remains unclear. The aim of this study was to compare the effect of a diet with sodium and fluid restriction with an unrestricted diet in patients admitted for decompensated HFpEF. METHODS: Patients were randomized to a diet with sodium (0.8 g/d) and fluid (800 mL/d) restriction (intervention group [IG]) or an unrestricted diet (control group [CG]) and followed for 7 d or hospital discharge. The primary outcome was weight loss. Secondary outcomes included clinical stability, perception of thirst, neurohormonal activation, nutrient intake, readmission, and mortality rate after 30 d. RESULTS: Fifty-three patients were included (30, IG; 23, CG). The mean ejection fraction was 62% ± 8% for IG and 60% ± 7% for CG (P = 0.44). Weight loss was similar in both groups, being 1.6 ± 2.2 kg in the IG and 1.8 ± 2.1 kg in CG (P = 0.49) as well as the reduction in the congestion score (IG = 3.4 ± 3.5; CG = 3.8 ± 3.4; P = 0.70). The daily perception of thirst was higher in the IG (P = 0.03). Lower energy consumption was seen in the IG (P <0.001). No significant between-group differences at 30 d were found. CONCLUSIONS: Aggressive sodium and fluid restriction does not provide symptomatic or prognosis benefits, but does produce greater perception of thirst, may impair the patient's food intake, and does not seem to have an important neurohormonal effect in patients admitted for decompensated HFpEF.


Asunto(s)
Dieta Hiposódica/métodos , Insuficiencia Cardíaca/dietoterapia , Volumen Sistólico , Privación de Agua , Anciano , Anciano de 80 o más Años , Ingestión de Energía , Femenino , Insuficiencia Cardíaca/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Sed , Resultado del Tratamiento , Pérdida de Peso
17.
Rev Lat Am Enfermagem ; 15(2): 344-9, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17546370

RESUMEN

Congestive heart failure (CHF) presents, besides the magnitude of epidemiological data, relevant characteristics, including frequent hospitalizations caused by severe signs and symptoms, which should be studied to reduce the negative impact of the disease on the public health system. With the advent of several clinical trials in the area of CHF, the treatment has become more complex, with the need of a more organized structure to assist these patients. Education is considered essential to reduce morbidity and mortality. The setting, to begin or to continue the educational process, can be a hospital (hospitalization), outpatient clinic, home, a day-hospital or yet, a combination of these. The main researches in this area recognize and motivate an investigation of other paths to get better results in the pharmacological and non-pharmacological treatments. In this study we review recent data, approaching several educational settings in the management of patients with CHF.


Asunto(s)
Educación en Enfermería , Insuficiencia Cardíaca/terapia , Brasil , Insuficiencia Cardíaca/rehabilitación , Hospitalización , Visita Domiciliaria , Humanos , Autocuidado/métodos
18.
Rev Lat Am Enfermagem ; 15(1): 165-70, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17375248

RESUMEN

The most important objective of heart failure (HF) treatment is to reach and preserve patients' clinical stability. Several studies have shown that programs aimed at systematic education, developed by multidisciplinary teams, are positive strategies to work with these patients. Nurses active in HF clinics play a fundamental role in the educational process and continuity of patient care. The objectives of these processes are to teach, reinforce, improve and constantly evaluate patients' self-care abilities, which include weight monitoring, sodium and fluid restrictions, physical activities, regular medication use, monitoring signs and symptoms of disease worsening and early search for medical care. Therefore, education to understand HF and the development of self-care abilities are considered key points to improve adherence, avoid decompensation crises and, consequently, to maintain patients clinically stable. This article presents a careful review of the aspects involved in the patient education process by nurses in the context of HF clinics.


Asunto(s)
Instituciones de Atención Ambulatoria , Insuficiencia Cardíaca , Rol de la Enfermera , Educación del Paciente como Asunto , Brasil , Humanos
19.
Online braz. j. nurs. (Online) ; 21: e20226580, 01 jan 2022. ilus, tab
Artículo en Inglés, Portugués | BDENF - enfermagem (Brasil), LILACS | ID: biblio-1412025

RESUMEN

OBJETIVO: analisar o conceito de trombose e identificar aplicações, atributos definidores, antecedentes, consequentes e referenciais empíricos. MÉTODO: análise de conceito, segundo Walker e Avant. RESULTADOS: os atributos definidores mais citados foram trombo (s), tríade de Virchow e comprometimento total/ parcial do fluxo sanguíneo. Os antecedentes mais frequentes foram câncer/uso de quimioterápicos, trombofilias e diabetes. Várias manifestações compuseram os consequentes, conforme o leito vascular comprometido. Os mais citados foram: acidente vascular cerebral ou acidente isquêmico transitório, infarto agudo do miocárdio e tromboembolismo pulmonar. Os referenciais empíricos se relacionaram a exames clínicos, testes de coagulação e escores de risco. A tomografia computadorizada foi o exame de imagem mais citado. CONCLUSÃO: a análise de conceito de trombose evidenciou o uso deste termo na literatura atual, bem como os atributos definidores, antecedentes, consequentes e referenciais empíricos. Este estudo agrega conhecimento à prática clínica de enfermeiros e pode contribuir com o refinamento dos sistemas de linguagens padronizadas.


OBJECTIVE: to analyze the concept of thrombosis and identify its applications, defining attributes, antecedents, consequences, and empirical references. METHOD: a concept analysis was carried out using Walker and Avant's framework. RESULTS: the most cited defining attributes were thrombus, Virchow's triad, and total/partial impairment of blood flow. The most frequent antecedents were cancer/chemotherapy, thrombophilia, and diabetes. Several manifestations composed the consequences, according to the compromised vascular bed. The most cited were stroke or transient ischemic attack, acute myocardial infarction, and pulmonary thromboembolism. The empirical references were related to clinical examinations, coagulation tests, and risk scores. Computed tomography was the most cited imaging test. CONCLUSION: The analysis of the thrombosis concept showed the use of this term in the current literature, its defining attributes, antecedents, consequences, and empirical references. This study adds knowledge to nurses' clinical practice and can contribute to the refinement of standardized language systems.


Asunto(s)
Práctica Profesional , Trombosis , Enfermería , Atributos de Enfermedad
20.
Rev Lat Am Enfermagem ; 24: e2796, 2016.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-27463113

RESUMEN

OBJECTIVE: to compare the incidence of vascular complications in patients undergoing transfemoral cardiac catheterization with a 6F introducer sheath followed by 3-hour versus 5-hour rest. METHODS: randomized clinical trial. Subjects in the intervention group (IG) ambulated 3 hours after sheath removal, versus 5 hours in the control group (CG). All patients remained in the catheterization laboratory for 5 hours and were assessed hourly, and were contacted 24, 48, and 72 h after hospital discharge. RESULTS: the sample comprised 367 patients in the IG and 363 in the GC. During cath lab stay, hematoma was the most common complication in both groups, occurring in 12 (3%) IG and 13 (4%) CG subjects (P=0.87). Bleeding occurred in 4 (1%) IG and 6 (2%) CG subjects (P=0.51), and vasovagal reaction in 5 (1.4%) IG and 4 (1.1%) CG subjects (P=0.75). At 24-h, 48-h, and 72-h bruising was the most commonly reported complication in both groups. None of the comparisons revealed any significant between-group differences. CONCLUSION: the results of this trial show that reducing bed rest time to 3 hours after elective cardiac catheterization is safe and does not increase complications as compared with a 5-hour rest. ClinicalTrials.gov Identifier: NCT-01740856.


Asunto(s)
Reposo en Cama/estadística & datos numéricos , Cateterismo Cardíaco/efectos adversos , Enfermedades Vasculares/epidemiología , Enfermedades Vasculares/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Método Simple Ciego , Factores de Tiempo
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