Costa Nuno, Henriques Helga Rafael, Durao Candida
Unidade Local de Saúde São José - Hospital de São José, Lisboa, Portugal.
Escola Superior de Enfermagem de Lisboa, Lisboa, Portugal.
SAGE Open Nurs. 2024 Jul 26;10:23779608241262651. doi: 10.1177/23779608241262651. eCollection 2024 Jan-Dec.
People during extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation find themselves in a high degree of physical and psychological vulnerability, which could cause additional problems for their health status. Therefore, this review aims to identify the interventions that shape critical nursing care to minimize patient vulnerability during ECMO as a bridge to lung transplantation.
A literature review was performed using CINAHL, MEDLINE, PubMed, Scopus and Web of Science databases with searches conducted in March 2023, with temporal restriction of articles published between 2013 and 2023. After selecting articles involving adults in critical situations on ECMO, their quality was assessed using the critical appraisal tools from the Joanna Briggs Institute. Articles with the pediatric population, reviews, and opinion articles were excluded. A spreadsheet was built for data extraction and a narrative analysis was performed.
Three articles were included involving 40 participants in total. Interventions that shape critical nursing care to minimize a person's vulnerability are in the physical domain (basic precautions to prevent infection) and in the psychological domain (trusting relationships, consistent and clear communication, physical presence of nurses and family members and the use of advocacy). The Awake ECMO strategy was identified as beneficial for reducing vulnerability.
By recognizing and identifying the person's vulnerability during ECMO as a bridge to lung transplantation, nurses can implement effective interventions to minimize vulnerability in this population, thus contributing to the person's well-being through personalization and individualization of care. Additionally, the results of this review could be useful for developing tools to assess the degree of vulnerability and for implementing person-centered care measures and policies. However, further research is warranted given the scarcity of literature on these topics.
作为肺移植桥梁的体外膜肺氧合（ECMO）患者身体和心理极为脆弱，这可能给他们的健康状况带来更多问题。因此，本综述旨在确定在作为肺移植桥梁的ECMO期间，形成关键护理以尽量减少患者脆弱性的干预措施。
于2023年3月使用CINAHL、MEDLINE、PubMed、Scopus和Web of Science数据库进行文献综述，检索2013年至2023年发表的文章，并设置时间限制。在选择涉及处于ECMO危急情况的成年人的文章后，使用乔安娜·布里格斯研究所的批判性评估工具对其质量进行评估。排除涉及儿科人群、综述和观点文章。构建电子表格进行数据提取并进行叙述性分析。
纳入3篇文章，共40名参与者。形成关键护理以尽量减少个体脆弱性的干预措施包括身体领域（预防感染的基本预防措施）和心理领域（信任关系、一致且清晰的沟通、护士和家庭成员的实际陪伴以及支持性措施的使用）。清醒ECMO策略被认为有利于降低脆弱性。
通过识别和确定作为肺移植桥梁的ECMO期间个体的脆弱性，护士可以实施有效的干预措施，以尽量减少该人群的脆弱性，从而通过护理的个性化和个体化促进个体的健康。此外，本综述的结果可能有助于开发评估脆弱程度的工具以及实施以患者为中心的护理措施和政策。然而，鉴于这些主题的文献稀缺，有必要进行进一步研究。
