ABSTRACT
Background: Cardiovascular intensive care units have evolved in time, from being exclusively dedicated to the care of myocardial infarction patients, to treating complex and varied cardiovascular pathologies. We do not have data about the characteristics of patients in cardiovascular intensive care units in Peru. Material and Methods: We prospectively evaluated the clinical and epidemiological characteristics of patients admitted between July and November 2018 to the intensive and intermediate care unit of the National Cardiovascular Institute INCOR in Lima, Peru. Results: A total of 199 patients were enrolled in the study. The median age was 67 years, 20% older than 80 years and 75.8% males. 60% of cases they came from the emergency unit. The most frequent admissions diagnoses were acute coronary syndromes (ACS) (35%) and acutely decompensated heart failure (20%). In-hospital mortality was 4.5%, higher (12%) in patients with readmissions to intensive care. Conclusions: In this first registry of cardiac critical care in Peru, ACS continues to be the main cause of admission followed by acutely decompensated heart failure. The in-hospital mortality was higher in patients with readmissions to the intensive care unit.
ABSTRACT
Introducción. En México las cardiopatías congénitas ocupan la 2ª y 4ª causa de mortalidad, anualmente se calcula que 21.000 niños mexicanos padecen una cardiopatía; Por tal motivo fueron creadas las unidades de tercer nivel que da tratamiento medico-quirúrgico como el Instituto Nacional de pediatría (INP) el cual cuenta con la unidad de cuidados intensivos cardiovasculares (UCICV) que brinda tratamiento pre y post quirúrgico donde los infantes permanecen hospitalizados hasta por siete meses según su evolución, es aquí donde los padres pasan a ser cuidadores primarios (CP) permaneciendo 24 horas y solo 30 minutos de visita hospitalaria exponiéndose a un escenario desconocido, reglas y horarios restrictivos y poco contacto físico debido al estado de salud de su niño, lo cual genera diversas experiencias durante dicha visita. Objetivo: Analizar la experiencia del CP durante la visita hospitalaria a un niño con cardiopatía congénita en una UCICV del Instituto Nacional de Pediatría (INP) de la Ciudad de México. Material y Método. Estudio cualitativo, descriptivo, fenomenológico, técnica de muestreo por bola de nieve; recolección de información mediante entrevista a profundidad semi-estructurada audio gravada. Análisis de contenido línea por línea, codificación abierta con categorías y subcategorías, validez por medio de saturación de contenido y triangulación teórica. Hallazgos: Emergieron dos categorías 1) ""Sentir con el hijo"" con las subcategorías: si mi hijo está bien yo estoy bien/si mi hijo está mal yo estoy mal"", ""la fortaleza de los niños y las niñas"", ""vida-muerte de los niños y niñas"", ""lo consiento y lo cuido""; 2)""Pensar en el hijo"" ""yo no importo"", ""nosotros seguimos aquí"", ""estamos afuera esperándote"". Las cuales expresan el sentir de las experiencias que viven los CP durante el tiempo de la visita hospitalaria. Conclusiones: Los resultados nos hacen reflexionar sobre mejorar diversos protocolos institucionales y disciplinares con respecto a la visita, encaminados a la humanización y solidaridad pero sobre todo al acompañamiento donde el personal de enfermería es clave para mejorar la calidad de la atención puesto que el CP es pieza clave para la mejora en la salud del niño hospitalizado.
Introduction. In Mexico, congenital heart disease is the second and fourth cause of death, annually it is estimated that 21,000 Mexican children suffer from heart disease; For this reason, the third level units were created that provide medical-surgical treatment, such as the National Institute of Pediatrics (INP), which has a cardiovascular intensive care unit (UCICV) that provides pre-and post-surgical treatment where infants remain hospitalized up to seven months according to their evolution, it is here that parents become primary caregivers (CP) staying 24 hours and only 30 minutes of hospital visit exposed to an unknown scenario, restrictive rules and schedules and little physical contact due to health status of your child, which generates diverse experiences during that visit. Objective: To analyze the experience of CP duringthe hospital visit to a child with congenital heart disease in a UCICV of the National Institute of Pediatrics (INP) of Mexico City. Material and Method. Qualitative, descriptive, phenomenological study, snowball sampling technique; collection of information through semi-structured recorded audio depth interviews. Content analysis line by line, open coding with categories and subcategories, validity through content saturation and theoretical triangulation. Findings: Two categories emerged: 1) "Feeling withthe child" with the subcategories: if my child is well I am fine / if my child is wrong I am wrong","the strength of the boys and girls " death of children","I consent and care for it"; 2)"Thinking about the child "I do not care", "we are still here", "we are outside waiting for you". Which express the feeling of the experiences that live the CP during the time of the hospital visit. Conclusions: The results make us reflect on improving various institutional and disciplinary protocols with respect to thevisit, aimed at humanization and solidarity, but especially at the accompaniment where nurses are key to improve the quality of care since the CP is key to improving the health of the hospitalized child.