RESUMEN
SUMMARY BACKGROUND: Cerebrovascular accident (or stroke) and ischemic heart disease are the the major causes of death in the world. It is estimated that about 85% of strokes are ischemic in origin. Reperfusion therapy in the acute phase of ischemic stroke with a recombinant human tissue plasminogen activator is effective, but some factors influence the success of this treatment. OBJECTIVE: The aim of this study was to evaluate clinical aspects and possible determinants for reperfusion after venous thrombolysis. METHODS: This is a retrospective, cross-sectional, observational study based on a review of hospital records of inpatients diagnosed with ischemic stroke treated with intravenous thrombolysis, the main outcome being reperfusion or not. RESULTS: Data from this study revealed a predominance of females in the group of reperfused patients and males in the non-reperfused group, both maintaining moderate severity on the National Institutes of Health Stroke Scale and admission without statistical significance (p>0.18). In addition, the mean admission severity score was 13.2 for the group of reperfused patients and 14.2 for those not reperfused, and the mean ejection fraction of both groups was within normal functionality, with a mean of 0.50 for reperfused patients and 0.62 for non-reperfused patients. CONCLUSION: We found an association between successful venous chemical thrombolysis reperfusion and lower mortality in patients with acute stroke.
RESUMEN
BACKGROUND: Cerebrovascular accident (or stroke) and ischemic heart disease are the the major causes of death in the world. It is estimated that about 85% of strokes are ischemic in origin. Reperfusion therapy in the acute phase of ischemic stroke with a recombinant human tissue plasminogen activator is effective, but some factors influence the success of this treatment. OBJECTIVE: The aim of this study was to evaluate clinical aspects and possible determinants for reperfusion after venous thrombolysis. METHODS: This is a retrospective, cross-sectional, observational study based on a review of hospital records of inpatients diagnosed with ischemic stroke treated with intravenous thrombolysis, the main outcome being reperfusion or not. RESULTS: Data from this study revealed a predominance of females in the group of reperfused patients and males in the non-reperfused group, both maintaining moderate severity on the National Institutes of Health Stroke Scale and admission without statistical significance (p>0.18). In addition, the mean admission severity score was 13.2 for the group of reperfused patients and 14.2 for those not reperfused, and the mean ejection fraction of both groups was within normal functionality, with a mean of 0.50 for reperfused patients and 0.62 for non-reperfused patients. CONCLUSION: We found an association between successful venous chemical thrombolysis reperfusion and lower mortality in patients with acute stroke.
Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Femenino , Humanos , Masculino , Isquemia Encefálica/complicaciones , Estudios Transversales , Accidente Cerebrovascular Isquémico/complicaciones , Accidente Cerebrovascular Isquémico/tratamiento farmacológico , Estudios Observacionales como Asunto , Reperfusión , Estudios Retrospectivos , Accidente Cerebrovascular/tratamiento farmacológico , Activador de Tejido Plasminógeno/uso terapéutico , Resultado del TratamientoRESUMEN
Objetivo: descrever as estratégias utilizadas por enfermeiras para minimizar a ocorrência de delirium em pacientes internados em unidade de terapia intensiva (UTI). Método: estudo exploratório-descritivo, de abordagem qualitativa, desenvolvido em um hospital de ensino, público, de grande porte da cidade de Salvador. Foi realizado nos meses de setembro e outubro de 2018, participaram do estudo 16 enfermeiras. Os dados foram coletados mediante entrevista semiestruturada e analisados por meio da "Técnica de Análise de Conteúdo Temática". Resultados: da análise dos dados emergiram duas categorias temáticas, denominadas: "Desconhecimento sobre monitorização do delirium em UTI" e "Estratégias das enfermeiras para minimizar a ocorrência de delirium em UTI". Conclusão: apesar do pouco conhecimento das enfermeiras sobre o delirium existe uma coerência quantos aos métodos de intervenções para preveni-lo. A implementação de protocolos e atividades educativas são imprescindíveis para empoderar o enfermeiro quanto às intervenções realizadas.
Objective: to describe the strategies used by nurses to minimize the occurrence of delirium in patients admitted to the intensive care unit (ICU). Method: exploratory-descriptive study, with a qualitative approach, developed in a large public teaching hospital in the city of Salvador. It was carried out in September and October 2018, 16 nurses participated in the study. Data were collected through semi-structured interviews and analyzed using the "Thematic Content Analysis Technique". Results: from the data analysis, two thematic categories emerged, named: "Lack of knowledge about monitoring delirium in the ICU" and "Strategies of nurses to minimize the occurrence of delirium in the ICU". Conclusion: although the nurses' lack of knowledge about delirium, there is a coherence in the methods of interventions to prevent it. The implementation of protocols and educational activities are essential to empower nurses regarding the interventions performed.
Objetivo: describir estrategias utilizadas por enfermeras para minimizar la aparición de delirio en pacientes ingresados en unidad de cuidados intensivos (UCI). Método: estudio exploratorio, descriptivo, con enfoque cualitativo, desarrollado en un gran hospital público docente de la ciudad de Salvador. Se realizó en septiembre y octubre de 2018, con 16 enfermeras participantes del estudio. Los datos fueron recolectados por entrevistas semiestructuradas y analizados utilizando la "Técnica de análisis de contenido temático". Resultados: del análisis de datos, surgieron dos categorías temáticas, llamadas: "Falta de conocimiento sobre el monitoreo del delirio en la UCI" y "Estrategias de las enfermeras para minimizar la aparición de delirio en la UCI". Conclusión: a pesar de la falta de conocimiento de las enfermeras sobre el delirio, existe coherencia en los métodos de intervención para prevenirlo. La implementación de protocolos y actividades educativas es esencial para empoderar a las enfermeras con respecto a las intervenciones realizadas.