ABSTRACT
La insuficiencia hepática aguda grave (IHAG), también conocida como hepatitis fulminante, presenta un cuadro clínico poco frecuente y extraordinariamente grave ya que cursa con una elevada mortalidad. Su rápida evolución y la complejidad en el manejo del tratamiento, crea la necesidad de prestar unos cuidados inmediatos por parte de un equipo especializado en cuidados intensivos. Esta descompensación aguda normalmente va asociada a otras alteraciones como la coagulopatía y la encefalopatía hepática, siendo responsable de importantes complicaciones que pueden derivar en fallo multiorgánico. En nuestro medio la etiología más frecuente es la desconocida, seguida de la infección aguda por el virus de la hepatitis B. El tratamiento de este síndrome se basa en las medidas generales aplicables a cualquier paciente crítico: tratar la causa y detectar precozmente las complicaciones extrahepáticas, siendo el trasplante hepático urgente una de las alternativas con mejor pronóstico.En este artículo se presenta un caso clínico en el que se describe el seguimiento de una mujer irlandesa de 20años que es derivada desde un hospital de Ibiza a un hospital de Barcelona, por sospecha diagnóstica de IHAG. Siguiendo el modelo conceptual de Virginia Henderson, se han descrito los problemas de colaboración y los diagnósticos de enfermería, presentando el plan de cuidados según la taxonomía North American Nursing Association (NANDA), Nursing Intervention Classification (NIC), Nursing Outcomes Classification (NOC). Este caso ayuda a establecer un plan de cuidados individualizado en el que orienta a los profesionales enfermeros en el cuidado del paciente crítico reforzando los conocimientos relacionados con la IHAG (AU)
Fulminant hepatic failure (FHF), also known as fulminant hepatitis, is a rare and extremely serious condition with a high mortality rate. Its rapid evolution and complexity in managing the treatment, creates the need to provide some immediate care by a team that specialises in intensive care. This acute decompensation is usually associated with other disorders, such as coagulopathy and hepatic encephalopathy, being responsible for major complications that can lead to organ failure. In our region the most common origin is unknown, followed by acute infection with hepatitis B. The treatment of this syndrome is based on the general measures applicable to any critically ill patient: treat the cause and early detection of extrahepatic complications, urgent liver transplantation being one of the alternatives with a better prognosis.This article presents a case report describing the monitoring of an Irish woman of 20years who was transferred from a hospital in Ibiza to a hospital in Barcelona, with a suspected diagnosis of FHF. Following the conceptual model of Virginia Henderson, the collaborative problems and nursing diagnoses are described, presenting a care plan according to NANDA (North American Nursing Association), NIC (Nursing Intervention Classification), NOC (Nursing Outcomes Classification). This case helps to establish an individualised care plan that provides guidance to nurse professionals in critical patient care by increasing the knowledge of FHF (AU)
Subject(s)
Humans , Liver Failure, Acute/nursing , Critical Care/methods , Nursing Care/methods , Patient Care Planning/organization & administration , Nursing AssessmentABSTRACT
Fulminant hepatic failure (FHF), also known as fulminant hepatitis, is a rare and extremely serious condition with a high mortality rate. Its rapid evolution and complexity in managing the treatment, creates the need to provide some immediate care by a team that specialises in intensive care. This acute decompensation is usually associated with other disorders, such as coagulopathy and hepatic encephalopathy, being responsible for major complications that can lead to organ failure. In our region the most common origin is unknown, followed by acute infection with hepatitis B. The treatment of this syndrome is based on the general measures applicable to any critically ill patient: treat the cause and early detection of extrahepatic complications, urgent liver transplantation being one of the alternatives with a better prognosis. This article presents a case report describing the monitoring of an Irish woman of 20 years who was transferred from a hospital in Ibiza to a hospital in Barcelona, with a suspected diagnosis of FHF. Following the conceptual model of Virginia Henderson, the collaborative problems and nursing diagnoses are described, presenting a care plan according to NANDA (North American Nursing Association), NIC (Nursing Intervention Classification), NOC (Nursing Outcomes Classification). This case helps to establish an individualised care plan that provides guidance to nurse professionals in critical patient care by increasing the knowledge of FHF.
