ENHANCED RECOVERY AFTER CARDIAC SURGERY PROTOCOL

Yıl 2021, Cilt: 37 Sayı: 2, 157 - 170, 27.08.2021

Selda Mert Boğa Aylin Aydın Sayılan

https://doi.org/10.53490/egehemsire.651868

Öz

KALP CERRAHİSİ SONRASI HIZLANDIRILMIŞ İYİLEŞME PROTOKOLÜ

Öz

Son yıllarda ortaya çıkan gelişmeler, sağlık bakım hizmetini doğrudan etkilemektedir. Cerrahi Sonrası Hızlandırılmış İyileşme Protokolü, cerrahi bakım kalitesini yükseltmeyi hedefleyen, ameliyat öncesi ve sonrası iyileşmeyi kapsayan bir süreç olup, sağlık bakım hizmetlerinde çok önemli bir rol üstlenmiştir. Kalp cerrahisine yönelik hızlandırılmış iyileşme protokolü ise oldukça yeni uygulanmaya başlanmıştır. Kalp cerrahisine özgü geliştirilen kanıta dayalı cerrahi dönem bakım rehberi, klinik sonuçlarda iyileşme ve maliyette azalma olarak olumlu etkisini göstermekte; kalp cerrahisi uygulanan hastaların iyileşmesinde standart bir bakımı hedeflemektedir. Bu derlemenin içeriğinde; ameliyat öncesi dönem izlemleri (hemoglobin A1 ölçümü, albumin ölçümü, beslenme yetersizliğinin düzeltilmesi, anestezi öncesi berrak sıvı tüketimi, karbonhidrat yüklemesi, hasta tarafından iletilen sorunlara yönelik eğitim, uygulamalar, prehabilitasyon, sigara ve alkol tüketimi), ameliyat sırası izlem (cerrahi alan enfeksiyonunu azaltma, hipertermi, sert sternal fiksasyon, traneksamik asit veya epsilon aminokaproik asit) ve ameliyat sonrası izlem (glisemik kontrol, insülin infüzyonu, ağrı yönetimi, sistematik deliryum taraması, inatçı hipotermi, göğüs tüpü açıklığı, tromboprofilaksi, ekstübasyon, böbrek stresi ve akut böbrek hasarı, hedefe yönelik sıvı tedavisi) ve diğer cerrahi sonrası hızlandırılmış iyileşme önerileri yer almaktadır. Elde edilen veriler derecelendirilerek, önerilerde bulunulmaktadır. Bu öneriler Cerrahi Sonrası Hızlandırılmış İyileşme Derneği tarafından onaylanmıştır. Bu derlemede, Engelman ve ark. (2019) tarafından kalp cerrahisine özgü oluşturulan hızlandırılmış iyileşme protokolü önerilerinden söz edilmektedir.

Anahtar Kelimeler

Cerrahi Sonrası Hızlandırılmış İyileşme, kalp cerrahisi, hemşire

Kaynakça

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