Clinical Evolution of Patients Using Ventricular Assist Devices as a Bridge for Transplantation.

Autor: Cestari V; Nursing Department, State University of Ceará, Fortaleza, Brazil. Electronic address: virna.ribeiro@hotmail.com., Pessoa VL; Nursing Department, State University of Ceará, Fortaleza, Brazil., de Souza Neto JD; Transplantation and Heart Failure Unit, Dr. Carlos Alberto Studart Gomes Messejana Hospital, Fortaleza, Brazil., Moreira T; Nursing Department, State University of Ceará, Fortaleza, Brazil., Florêncio R; Graduate Program in Collective Health, State University of Ceará, Fortaleza, Brazil., de Vasconcelos GG; Transplantation, State University of Ceará, Fortaleza, Brazil., Souza L; Transplantation, State University of Ceará, Fortaleza, Brazil., Braga A; Transplantation and Heart Failure Unit, Dr. Carlos Alberto Studart Gomes Messejana Hospital, Fortaleza, Brazil., Sobral MG; Child and Adolescent Health, State University of Ceará, Fortaleza, Brazil.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2018 Apr; Vol. 50 (3), pp. 796-803.
DOI: 10.1016/j.transproceed.2018.02.014
Abstrakt: Objective: To evaluate the clinical evolution of patients with implantation of ventricular assist device (VAD) and identify the intervening factors for death.
Methods: This analytical, retrospective study was carried out in a public reference hospital in cardiopulmonary diseases located in northeastern Brazil. The study population encompassed the medical records of 16 patients who underwent VAD implantation. Data collection took place from January to August 2016, through the consultation of medical records. Descriptive analysis, odds ratio, and the Fisher's Exact, Wilcoxon, Friedman and t-tests were used to analyze the data.
Results: All patients experienced complications during the use of the device, with bleeding being the main cause (11 [68.8%]). There was a significant decrease in noradrenaline (P = .025), milrinone (Primacor; P = .007), and dobutamine (P = .046) flow rates with the clinical evolution of patients. Regarding hematologic parameters, the use of VAD promoted a significant improvement in hemoglobin (P < .001), hematocrit (P = .003), activated partial thromboplastin time (P = .013), and fibrinogen (P = .049) values at the 3 time points analyzed. Regarding the clinical outcome of the patients, the majority (10 [62.5%]) underwent cardiac transplantation.
Conclusions: This study allowed for better knowledge of the clinical evolution of patients with VAD implantation, highlighting the benefits of this type of device as a bridge for heart transplantation.
(Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: