Heart failure is an important public health problem associated with morbidity, mortality and health expenditures and there are various options in its treatment. Left ventricular assist devices are a frequently used treatment alternative to heart transplantation in endstage heart failure. Left ventricular assist devices are used both as a temporary treatment until a suitable donor is found in patients who are waiting for a heart transplant, and as a lifelong treatment when the patient is not suitable for a heart transplant. Although the survival rates are quite high in this treatment option, clinical follow-up and systematic care of patients are critical. Although left ventricular assist devices are a life-saving treatment option, these patients may experience some major complications due to advanced heart failure, open heart surgery technique and implanted device. Major complications seen in these patients are bleeding, cardiac arrhythmias, infections and neurological events. These complications affect quality of life and survival. Therefore, management of complications in the postoperative period becomes the focal point in patients who have implanted left ventricular assist device. Although these complications are not easy to manage, nurses should be equipped with advanced knowledge about the causes, symptoms, and appropriate nursing care of these complications. At the same time, nurses need to know about the technology of left ventricular assist devices for the management of these complications. In this article, major complications seen after left ventricular assist device implantation and nursing care are discussed.
Keywords: Heart-assist devices; nursing care; postoperative complications
e Kalp yetersizliği morbidite, mortalite ve sağlık harcamaları ile ilişkili önemli bir halk sağlığı sorunu olup tedavisinde çeşitli seçenekler bulunmaktadır. Sol ventrikül destek cihazları son evre kalp yetersizliğinde kalp nakline alternatif sık kullanılan bir tedavi seçeneğidir. Sol ventrikül destek cihazları hem kalp nakli bekleyen hastalarda uygun donör bulununcaya kadar geçici bir tedavi olarak hem de hastanın kalp nakli için uygun olmadığı durumlarda ömür boyu sürecek bir tedavi olarak kullanılmaktadır. Bu tedavi seçeneğinde sağ kalım oranları oldukça yüksek olmakla birlikte hastaların klinik takip ve sistematik bakımları kritik önem taşımaktadır. Sol ventrikül destek cihazları hayat kurtarıcı bir tedavi seçeneği olmakla birlikte bu hastalar ileri evre kalp yetersizliği, açık kalp cerrahisi tekniği ve implante edilen cihaz nedeniyle major komplikasyonlar yaşayabilirler. Bu hastalarda görülen major komplikasyonlar kanamalar, kardiyak aritmiler, enfeksiyonlar ve nörolojik olaylardır. Bu komplikasyonlar yaşam kalitesini ve sağ kalımı etkilemektedir. Bu sebeple sol ventrikül destek cihazı implante edilen hastalarda, ameliyat sonrası dönemde komplikasyonların yönetimi odak nokta haline gelmektedir. Bu komplikasyonların yönetimi kolay olmamakla birlikte hemşireler bu komplikasyonların nedenleri, belirtileri ve uygun hemşirelik bakımı hakkında ileri düzeyde bilgi ile donatılmalıdır. Aynı zamanda bu komplikasyonların yönetimi için hemşirelerin sol ventrikül destek cihazlarının teknolojisi hakkında da bilgi sahibi olması gerekmektedir. Bu makalede sol ventrikül destek cihazı implantasyonundan sonra görülen major komplikasyonlar ve hemşirelik bakımı ele alınmaktadır.
Anahtar Kelimeler: Kalp destek cihazları; hemşirelik bakımı; postoperatif komplikasyonlar
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