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Vulnerabilidade da pessoa sob extracorporeal membrane oxygenation em ponte para transplante pulmonar
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Abstract(s)
Para a pessoa com doença pulmonar crónica terminal, o transplante pulmonar constituí o último tratamento disponível para a sua condição. No entanto, a escassez de órgãos e a mortalidade das pessoas em lista de espera tem suscitado o interesse e aumento no uso da extracorporal membrane oxygenation (ECMO) como ponte para transplante pulmonar na pessoa que se encontra em situação crítica.
A incerteza do transplante, a possibilidade de uso prolongado da ECMO e o risco de desenvolvimento de complicações evidenciam a vulnerabilidade experienciada pela pessoa em ponte para transplante pulmonar.
Sendo a vulnerabilidade um fenómeno que desafia a prática de enfermagem, uma vez que a sua presença traduz implicações para a saúde e outcomes da pessoa, torna-se fundamental identificar e reconhecer a intervenção especializada de enfermagem com a finalidade de minimizar a vulnerabilidade da pessoa sob ECMO em ponte para transplante pulmonar, evidenciando-se a produção de conhecimento com a realização de uma revisão integrativa da literatura, e respetiva disseminação.
Este percurso visou o cuidar de enfermagem sustentado na evidência científica, mas também norteado por referenciais teóricos de enfermagem, nomeadamente, na teoria Nursing as Caring e na teoria da Vigilância.
O presente relatório concretiza o desenvolvimento de competências, segundo o modelo de Dreyfus aplicado à enfermagem por Benner, inerentes ao grau de mestre e enfermeiro especialista em enfermagem médico-cirúrgica na área de intervenção à pessoa em situação crítica, através da descrição, análise e reflexão crítica do percurso académico efetuado, sendo o mesmo alicerçado na metodologia de projeto, com foco em vivências nos contextos de estágio em serviço de urgência e unidades de cuidados intensivos.
Encontrando-se a vulnerabilidade intrinsecamente ligada ao ato de cuidar, reitera-se a necessidade de sensibilizar as equipas de saúde para este fenómeno, como um dever ético e deontológico.
For people with end-stage chronic lung disease, lung transplantation is the last available treatment for their condition. However, the shortage of organs and the mortality of people on the waiting list have raised interest and increased the use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation in people who are in critical condition. The uncertainty of transplantation, the possibility of prolonged ECMO use and the risk of developing complications highlight the vulnerability experienced by the person awaiting lung transplantation. Since vulnerability is a phenomenon that challenges nursing practice, as its presence has implications for the person's health and outcomes, it is essential to identify and recognize specialized nursing intervention aimed at minimizing person’s vulnerability during ECMO as a bridge to lung transplantation, highlighting the production of knowledge by carrying out an integrative review of the literature and its dissemination. This path aimed to provide nursing care based on scientific evidence, but also guided by nursing theories, namely the Nursing as Caring theory and the Vigilance theory. This report concretizes the development of skills, according to the Dreyfus model applied to nursing by Benner, inherent to the master's degree and specialist nurse in medical-surgical nursing in the area of intervention for people in critical conditions, through description, analysis and critical reflection of the academic path undertaken, which is based on project methodology, focusing on experiences in the context of internships in emergency services and intensive care units. Finding vulnerability intrinsically linked to the act of caring, the need to raise awareness among healthcare teams about this phenomenon is reiterated as an ethical and deontological duty.
For people with end-stage chronic lung disease, lung transplantation is the last available treatment for their condition. However, the shortage of organs and the mortality of people on the waiting list have raised interest and increased the use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation in people who are in critical condition. The uncertainty of transplantation, the possibility of prolonged ECMO use and the risk of developing complications highlight the vulnerability experienced by the person awaiting lung transplantation. Since vulnerability is a phenomenon that challenges nursing practice, as its presence has implications for the person's health and outcomes, it is essential to identify and recognize specialized nursing intervention aimed at minimizing person’s vulnerability during ECMO as a bridge to lung transplantation, highlighting the production of knowledge by carrying out an integrative review of the literature and its dissemination. This path aimed to provide nursing care based on scientific evidence, but also guided by nursing theories, namely the Nursing as Caring theory and the Vigilance theory. This report concretizes the development of skills, according to the Dreyfus model applied to nursing by Benner, inherent to the master's degree and specialist nurse in medical-surgical nursing in the area of intervention for people in critical conditions, through description, analysis and critical reflection of the academic path undertaken, which is based on project methodology, focusing on experiences in the context of internships in emergency services and intensive care units. Finding vulnerability intrinsically linked to the act of caring, the need to raise awareness among healthcare teams about this phenomenon is reiterated as an ethical and deontological duty.
Description
Keywords
Enfermagem de cuidados intensivos Transplante de pulmão Vulnerabilidade em saúde