espanolLa revascularizacion miocardica (RVM) como tratamiento quirurgico de la enfermedad coronaria (EC), es considerada hoy en dia como un procedimiento de rutina, teniendo en cuenta la elevada prevalencia de esta patologia en el mundo, dato sustentado a nivel nacional por las estadisticas del DANE, segun las cuales el grupo de enfermedades cardiovasculares es la primera causa de morbi-mortalidad sobresaliendo la EC(1). Es uno de los avances mas importantes de la Medicina durante el siglo XX. En Bogota, los registros de las estadisticas de las instituciones en las que se realiza este procedimiento muestran que mas del 50% del total de cirugias cardiovasculares corresponde a RVM (Fundacion Cardio-Infantil, Clinica Shaio, Clinica San Rafael, Hospital Universitario de San Ignacio)(2). Este articulo presenta los eventos clinicos que requieren cuidado de enfermeria (ECRCE) caracteristicos del paciente que se encuentra en postoperatorio temprano de RVM (48 a 96h), teniendo en cuenta que este paciente presenta cambios tanto en su esfera psico-social como en la biologica secundarios al procedimiento, a nivel de los sistemas neurologico, cardiovascular, respiratorio, gastrointestinal, de eliminacion y de la piel. Dichos eventos clinicos constituyen los datos cuantitativos de la tesis doctoral titulada “Cuidado de Enfermeria al paciente en postoperatorio temprano de una revascularizacion miocardica”. Para su determinacion se utilizo la observacion y la revision de la historia clinica de 151 pacientes que se encontraban dentro del periodo postoperatorio. Se registraron ademas, las condiciones en que estuvo el paciente a las 24 y 48 horas del postoperatorio, lo cual permitio lograr mayor informacion sobre los ECRCE, en este tipo de paciente. Una vez recolectada la informacion, esta fue procesada mediante la metodos estadisticos univariados tales como estadistica descriptiva y modelo de Rasch en conjunto con el Programa de Winsteps, con el fin de categorizar cada una de las variables contempladas en el estudio. Los hallazgos resultantes del procesamiento de la informacion, conforman los ECRCE. EnglishMyocardial revascularization (MRV) is currently considered as a routine procedure in the surgical treatment of coronary disease (CD). The high prevalence of this pathology worldwide is locally supported by data from the National Department of Statistics of Colombia (DANE). According to DANE, the group of cardiovascular diseases is the main cause of morbidity and mortality, among which the CD stands out(1). MRV is, as well, one of the most important advances in medicine during the 20th century. Statistics of institutions that perform this procedure demonstrate that in Bogota, more than 50% of the total cardiovascular surgeries corresponds to MRV (Fundacion CardioInfantil, Clinica Shaio, Clinica San Rafael, Hospital Universitario de San Ignacio)(2). This paper presents the distinctive clinical events that require nursing care (CERNC) of MRV early post-surgery patient (48 to 96h). After the procedure, the patient experiences changes both on his/her psycho-social and biological environment. Biological include neurological, cardiovascular, respiratory, gastrointestinal system changes, and elimination of skin. Clinical events represent the quantitative data of the doctoral dissertation entitled “Nursing care in an early postoperatory pacient of a myocardial revascularization”. To conduct the research, the portion corresponding to the period between the 48th and 96th hours of post-surgical clinical history of 151 patients, was studied and reviewed. Significant physiological changes experienced overnight by the EC patient during its process of recovery, were taken into account. In addition, the conditions in which the patients were at the 24th and 48th hours in the post-surgical period were registered; this made possible to acquire greater information on the CERNC for this type of patient. The review of the clinical history was conducted by the researcher with the purpose of obtaining information on the general data of the patient, the status of the patient at the 24th and 48th hours of the postsurgery procedure, diagnosis media, and other data related to the MRV. The information obtained was recorded on a sheet, previously designed for such purpose. With the purpose of categorize each of the variables considered in the study, the data were processed using univariated statistics methods, such as descriptive statistics and Rasch model, together with the Winsteps program. The resulting findings of this processing make up the CERNC.
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FuenteEnfermería en cardiología: revista científica e informativa de la Asociación Española de Enfermería en Cardiología