Caso clínico: miocarditis vírica linfocitaria fulminante con soporte biventricular en el contexto epidemiológico del COVID-19: ¿qué podemos ofrecer como profesionales de enfermería?

Background. Fulminant myocarditis (MF) is defined as an inflammatory process involving myocardial tissue as a result of a viral process, among others. Treatment is based on the rapid recovery of myocardial contractility using inotropic and vasoactive drugs. However, the evolution can be turbulent re...

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Veröffentlicht in:Enfermería en cardiología: revista científica e informativa de la Asociación Española de Enfermería en Cardiología 2021 (82), p.58-67
Hauptverfasser: Gázquez Toscano, Axel, Galán Malón, Laia
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Sprache:spa
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Zusammenfassung:Background. Fulminant myocarditis (MF) is defined as an inflammatory process involving myocardial tissue as a result of a viral process, among others. Treatment is based on the rapid recovery of myocardial contractility using inotropic and vasoactive drugs. However, the evolution can be turbulent requiring the use of a ventricular assist device. We present the case of a patient who developed MF with cardiogenic shock requiring cardiac support with a biventricular assist device. Once the acute phase resolved, the patient developed psychosocial disorders such as anxiety, fear and loneliness stemming from the critical illness experience. Objectives. To carry out a standardized nursing care plan for the management of ventricular assist device, and the potential complications derived from the use of mechanical circulatory support, in addition to a care plan focused on the psychosocial support of the patient and his family. Methods. Two areas of interest were identified during the admission process: the first one focused on the patient’s critical illness and its assessment; the second one addressed psychosocial aspects of the patient’s care by defining a care plan based on the NANDA, NIC and NOC taxonomy, once the patient’s clinical state has been stabilized. Results. The patient and his family were treated using the interventions described in the care plan, significantly reducing the presentation of anxiety and fear. Conclusions. Carrying out a care plan focused on biopsychosocial aspects is essential to help patients and their families accept sudden onset critical illness. Antecedentes. La miocarditis fulminante (MF) se define como una afectación inflamatoria del tejido miocárdico como consecuencia de un proceso vírico, entre otros. El tratamiento se fundamenta en la rápida recuperación de la contractilidad miocárdica utilizando fármacos inotrópicos y vasoactivos. No obstante, la evolución puede resultar tórpida y puede requerir de algún dispositivo de asistencia ventricular. Se presenta el caso de un paciente que desarrolla una MF con shock cardiogénico que requiere soporte vital con una asistencia biventricular. Una vez resuelta la situación aguda, el paciente comienza a desarrollar trastornos de ansiedad, temor y soledad por la situación vivida. Objetivos. Realizar un plan de cuidados de enfermería estandarizado para el manejo del dispositivo ventricular exponiendo los problemas de colaboración y las posibles complicaciones derivadas del soporte circulatori
ISSN:1575-4146