Dysfunctional Ventilatory Weaning Response: Nursing Diagnosis and Evidence-based Care Plan for Patients Undergoing Open Heart Surgery
Nursing Diagnosis and Evidence-based Care Plan for Patients Undergoing Open Heart Surgery
Keywords:
ventilator weaning, open heart surgery, dysfunctional ventilatory weaning response, evidence-based nursingAbstract
The majority of patients having open heart surgery were transferred to the cardiovascular-thoracic intensive care unit while having a mechanical ventilation. As a result, closed monitoring is required to identify the early warning signs and symptoms of dysfunctional ventilatory weaning response (DVWR). To minimize complications caused by prolonged intubation or 48-hour re-intubation, evidence-based nursing care is useful in preventing DVWR and promoting readiness for extubation. The purpose of this article is to describe DVWR, its symptoms and signs, and associated factors in patients who underwent open heart surgery. Additionally, the evidence-based care to prevent DVWR during pre-extubation, extubation, and post-extubation periods with implications in two open-heart case examples are included.
References
D'Agostino RS, Jacobs JP, Badhwar V, Fernandez FG, Paone G, Wormuth DW, et al. The society of thoracic surgeons adult cardiac surgery database: 2019 update on outcomes and quality. Annals of thoracic surgery [internet]. 2019[cited 2023 Mar 23]. Available from: http://www.annalsthoracicsurgery.org/article/S0003497518316266/fulltext. doi.org/10.1016/j.athoracsur.2018.10.004
Report of srinagarind hospital adult cardiac surgery database. Khon kaen:Cardiovascular Thoracic Intensive Care Unit;2020.
Hardin SR, Kaplow R. Cardiac surgery essentials for critical care nursing. Jones and Bartlett Publishers; 2010. 462-71.
Badhwar V, Esper S, Brooks M, al. et. Extubating in the operating room after adult cardiac surgery safely improves outcomes and lowers costs. J Thorac Cardiovasc Surg 2014;148:3101-9. doi.org/10.1016/j.jtcvs.2014.07.037
Innok S, Dokphueng W, Udol K, Slisatkorn W, Sawasdiwipachai P. Clinical outcomes and cost of ventilator weaning and endotracheal extubation guided by an established ventilator weaning protocol in patients undergoing elective cardiac surgery. Siriraj Med J 2021;73(12):815-22. doi.org/10.33192/Smj.2021.106
Shoji CY, De Figuereido LC, Calixtre EM, Rodrigues CDA, Falcão ALE, Martins PP, et al. Reintubation of patients submitted to cardiac surgery: a retrospective analysis. Rev Bras Ter Intensiva [Internet]. 2017 [cited 2023 Jan 31]. Available from: /pmc/articles/PMC5496752/
doi.org/10.5935/0103-507X.20170028
Herdman HT, Kamitsuru S, Takao Lopes C. NANDA international nursing diagnoses : definitions and classification. New York: Thieme Medical Publishers, 2021.
Sangjun C. Incidences and causes of reintubation after undergoing general anesthesia at songkhla hospital. JHSP [Internet]. 2022 [cited 2023 Feb 24]. Available from: https://www.tci-thaijo.org/index.php/JHSP
Brovman EY, Steen TL, Urman RD. Associated risk factors and complications in vascular surgery patients requiring unplanned postoperative reintubation. J Cardiothorac Vasc Anesth 2017;31(2):554-61. doi.org/10.1053/j.jvca.2016.11.013
Zerang F, Amouzeshi A, Barkhordari-Sharifabad M. Comparison of the effect of incentive spirometry and deep breathing exercises on hemodynamic parameters of patients undergoing coronary artery bypass graft surgery: A Clinical Trial. J Vasc Nurs 2022(3):134-9. doi.org/10.1016/j.jvn.2022.08.002
Xue W, Xinlan Z, Xiaoyan Z. Effectiveness of early cardiac rehabilitation in patients with heart valve surgery: a randomized, controlled trial. J Int Med Res [Internet]. 2022 [cited 2023 Feb 24]. Available from: /pmc/articles/PMC9340911/. oi.org/10.1177/03000605211044320
Hamadnalla H, Sessler DI, Troianos CA, Fang J, Rivas E, Ma C, et al. Optimal interval and duration of CAM-ICU assessments for delirium detection after cardiac surgery. J Clin Anesth 2021;71-9. doi.org/10.1016/j.jclinane.2021.110233
Li M, Zhang J, Gan TJ, Qin G, Wang L, Zhu M, et al. Enhanced recovery after surgery pathway for patients undergoing cardiac surgery: A randomized clinical trial. Eur J Cardiothorac Surg 2018(3):491-7. doi.org/10.1093/ejcts/ezy100
Sawangsri K. Pain management in patients undergoing open heart surgery. Thai Journal of Cardio-thoracic Nursing 2017(28):2-15.
Joseph J, Lobo D. Effectiveness of dual nursing interventions on anxiety, pain and bio-physiological parameters among patients undergoing cardiac surgery. Int Res J Pub Environ Health 2022;9(5):156-63. doi.org/10.15739/irjpeh.22.019
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