La gestione infermieristica e la prevenzione delle complicanze nel paziente portatore di dispositivo di assistenza ventricolare Impella

Ricevuto: 17 gennaio 2024
Accettato: 17 marzo 2024
Pubblicato: 4 aprile 2024
Abstract Views: 1347
PDF: 245
PDF (English): 58
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Autori

Introduzione: recentemente l’utilizzo del dispositivo di assistenza ventricolare Impella nei pazienti con insufficienza cardiaca acuta, ha riportato benefici tali da incrementarne l’utilizzo. Tuttavia, le complicanze correlate al dispositivo Impella sono molteplici e di diversa entità. A fronte di ciò, risulta fondamentale la centralità della professione infermieristica adeguatamente formata per garantire la corretta assistenza al paziente portatore di tale dispositivo in qualsiasi circostanza.

Scopo: lo scopo dello studio è quello di individuare le complicanze associate al paziente portatore di dispositivo Impella e i relativi metodi di monitoraggio, gestione e prevenzione nei quali la professione infermieristica è chiamata ad agire.

Materiali e Metodi: è stata svolta una revisione della letteratura presente nelle principali banche dati online, quali Pubmed e Google Scholar, degli ultimi 10 anni ed è stato utilizzato il metodo PIO per lo sviluppo delle parole chiave.

Risultati: dalla ricerca effettuata sono stati selezionati 29 articoli. Da tali articoli risulta che le complicanze più comuni correlate al dispositivo Impella riguardano il sanguinamento, la lesione vascolare e l’ischemia dell’arto ma è da considerare meritevole di attenzione anche la complicanza infettiva e di emolisi.

Conclusioni: dall’analisi delle complicanze, riscontrate in letteratura, si deduce che tali condizioni richiedono formazione specifica degli infermieri di area critica anche attraverso simulazioni e check list vista l’assenza di linee guida o protocolli comuni a livello internazionale per la gestione del paziente portatore di Impella. Nello studio si suggerisce una check list redatta sulle evidenze riscontrate in letteratura.

Dimensions

Altmetric

PlumX Metrics

Downloads

I dati di download non sono ancora disponibili.

Citations

Budassi S. Impella: nuove evidenze sulla sua efficacia nel trattamento dei pazienti con shock cardiogeno. Disponibile su: https://wps.centrolottainfarto.com/allnews/impella-nuove-evidenze-sulla-sua-efficacia-nel-trattamento-dei-pazienti-con-shock-cardiogeno/
ANSA.it. Impella promossa a un livello superiore nelle raccomandazioni delle linee guida ESC più aggiornate. 2021. Disponibile su: https://www.ansa.it/sito/notizie/economia/business_wire/news/2021-11-03_103253898.html
Glazier JJ, Kaki A. The Impella Device: historical background, clinical applications and future directions. Int J Angiol Off Publ Int Coll Angiol Inc 2019;28:118-23.
Papolos AI, Barnett CF, Tuli A, et al. Impella management for the cardiac intensivist. ASAIO J 2022;68:753-8.
Lüsebrink E, Kellnar A, Krieg K, et al. Percutaneous transvalvular microaxial flow pump support in cardiology. Circulation 2022;145:1254-84.
Tewelde SZ, Liu SS, Winters ME. Cardiogenic Shock. Cardiol Clin 2018;36:53-61.
Panhwar MS, Reed GW, Jain V, et al. Impella in acute myocardial infarction complicated by Cardiogenic Shock: history and current controversies. J Invasive Cardiol 2022;34:E709-19.
Abiomed lnc. Safety Information | Abiomed.com. Disponibile su: https://www.abiomed.com/important-safety-information
Abiomed lnc. Impella ventricular support systems for use during cardiogenic shock and high-risk PCI. Impella 2.5, 5.0, LD and Impella CP instructions for use and clinical reference manual. Disponibile su: https://www.accessdata.fda.gov/cdrh_docs/pdf14/p140003s018d.pdf
Asber SR, Shanahan KP, Lussier L, et al. Nursing Management of Patients Requiring Acute Mechanical Circulatory Support Devices. Crit Care Nurse 2020;40:e1-11.
Abiomed Inc. Assessing and Maintaining the Impella® Access Site. Disponibile su: https://www.heartrecovery.com/education/education-library/impella-patient-care-nursing-video
Jarding EK, Flynn Makic MB. Central line care and management: adopting evidence-based nursing interventions. J PeriAnesthesia Nursing 2021;36:328-33.
Tan Z, Zeng LA. Post-operative infection in mechanical circulatory support patients. Ann Transl Med 2020;8:831.
Stevenson LW, Pagani FD, Young JB, et al. INTERMACS profiles of advanced heart failure: the current picture. J Heart Lung Transplant 2009;28:535-41.
Schiller P, Vikholm P, Hellgren L. The Impella® Recover mechanical assist device in acute cardiogenic shock: a single-centre experience of 66 patients. Interact Cardiovasc Thorac Surg 2016;22:452-8.
Lemaire A, Anderson MB, Lee LY, et al. The Impella device for acute mechanical circulatory support in patients in cardiogenic shock. Ann Thorac Surg 2014;97:133-8.
Nouri SN, Malick W, Masoumi A, et al. Impella percutaneous left ventricular assist device as mechanical circulatory support for cardiogenic shock: A retrospective analysis from a tertiary academic medical center. Catheter Cardiovasc Interv 2022;99:37-47.
Jensen PB, Kann SH, Veien KT, et al. Single-centre experience with the Impella CP, 5.0 and RP in 109 consecutive patients with profound cardiogenic shock. Eur Heart J Acute Cardiovasc Care 2018;7:53-61.
Turkelson C, Keiser M. Using checklists and repetitive simulation to improve patient safety: a pilot project with the Impella® left ventricular assist device. Clinical Simulation in Nursing 2017;13:53-63.
Ancona MB, Montorfano M, Masiero G, et al. Device-related complications after Impella mechanical circulatory support implantation: an IMP-IT observational multicentre registry substudy. Eur Heart J Acute Cardiovasc Care 2021;10:999-1006.
Balthazar T, Vandenbriele C, Verbrugge FH, et al. Managing patients with short-term mechanical circulatory support: JACC review topic of the week. J Am Coll Cardiol 2021;77:1243-56.
Schrage B, Ibrahim K, Loehn T, et al. impella support for acute myocardial infarction complicated by Cardiogenic Shock. Circulation 2019;139:1249-58.
Ouweneel DM, Eriksen E, Sjauw KD, et al. percutaneous mechanical circulatory support versus intra-aortic balloon pump in Cardiogenic Shock after acute myocardial infarction. J Am Coll Cardiol 2017;69:278-87.
Rock JR, Kos CA, Lemaire A, et al. Single center first year experience and outcomes with Impella 5.5 left ventricular assist device. J Cardiothorac Surg 2022;17:124.
Tarabichi S, Ikegami H, Russo MJ, et al. The role of the axillary Impella 5.0 device on patients with acute cardiogenic shock. J Cardiothorac Surg 2020;15:218.
Vetrovec GW, Kaki A, Wollmuth J, Dahle TG. Post reducing vascular and bleeding risk for percutaneous left ventricular assist device-supported high-risk percutaneous coronary intervention. Heart Int 2022;16:105-11.
Abaunza M, Kabbani LS, Nypaver T, et al. Incidence and prognosis of vascular complications after percutaneous placement of left ventricular assist device. J Vasc Surg 2015;62:417-23.
Cuculi F, Burkart P, Cioffi G, et al. Manual compression versus MANTA device for access management after Impella removal on the ICU. Sci Rep 2022;12:14060.
Iannaccone M, Albani S, Giannini F, et al. Short term outcomes of Impella in cardiogenic shock: A review and meta-analysis of observational studies. Int J Cardiol 2020;324:44-51.
Shuster M, Konopka CI, Verlinden NJ. Incidence and timing of thrombocytopenia in patients receiving Impella Ventricular Assist Device support. ASAIO J 2022;68:1135-40.
Pietrasik A, Gąsecka A, Jasińska-Gniadzik K, et al. Roadmap towards an institutional Impella programme for high-risk coronary interventions. ESC Heart Fail 2023;10:2200-13.
Nakamura M, Imamura T, Ueno H, et al. Impact of the whole activated clotting time during Impella support on short-term prognosis. J Artif Organs 2022;25:9-15.
Beavers CJ, Di Domenico RJ, Dunn SP, et al. Optimizing anticoagulation for patients receiving Impella support. Pharmacotherapy 2021;41:932-42.
Lee MC, Peters C, Rai N, et al. Unfractionated Heparin Protocol During Percutaneous Left Ventricular Mechanical Circulatory (Impella) Support. J Cardiovasc Pharmacol Ther 2019;24:251-3.
Burzotta F, Trani C, Doshi SN, et al. Impella ventricular support in clinical practice: Collaborative viewpoint from a European expert user group. Int J Cardiol 2015;201:684-91.
Jackson S. Developing an Impella educational program for the critical care registered nurse. 2018. Disponibile su: http://www.proquest.com/en-US/products/dissertations/individuals.shtml
Chen S, Paone D, Spellman L, et al. Comparison of device-specific adverse event profiles between Impella platforms. J Card Surg 2020;35:3310-6.

Come citare

Simion, C., Vanin, M., & Vokrri, L. (2024). La gestione infermieristica e la prevenzione delle complicanze nel paziente portatore di dispositivo di assistenza ventricolare Impella. Scenario® - Il Nursing Nella Sopravvivenza, 41(1). https://doi.org/10.4081/scenario.2024.580