Cardiovascular Perfusion and Nursing 2019 , Vol 1, Issue 1
Cardiovascular critical care nursing procedures in patients on venoarterial extracorporeal membrane oxygenation
Naim Boran Tümer1,Atike Tekeli Kunt1,Serdar Günaydın1,Orhan Eren Günertem1,Kanat Özışık1,Ali Baran Budak1
1Department of Cardiovascular Surgery, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey DOI : 10.5606/e-cvpn.2019.122 Objectives: This study aims to evaluate nursing care procedures and outcomes in patients with post-cardiotomy cardiogenic shock (PCCS) requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Patients and methods: Between June 2016 and June 2017, a total of five patients (1 male, 4 females; mean age 67.2 years; range, 55 to 81 years) who received VA-ECMO for PCCS in our clinic were retrospectively analyzed. The ECMO device was implanted in the operating room or in the cardiovascular intensive care unit CICU by an experienced cardiovascular surgeon. Air and thrombus formation and blood flow were monitored by the perfusionists. Daily nursing care included monitorization, control of bleeding, sedation management, pain control, nutrition, control of skin integrity and infection, sponge bath, changing the position of endotracheal tube, dressing replacement, decubitus control, changing sheets, and back hygiene.

Results: Two patients who were successfully weaned off VA-ECMO survived to hospital discharge. The median duration of daily nursing care was 62 (range, 45 to 65) min. The longest steps in daily nursing were sponge bath and elevation of the patient. None of the patients suffered from decannulation or displacement of the VA-ECMO cannulas during nursing.

Conclusion: We conclude that nurses are fundamental in the care of VA-ECMO patients for the early diagnosis and intervention of procedure-related complications. Keywords : Cardiovascular critical care unit, care, extracorporeal membrane oxygenation, nursing