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da Silva RC, Gondim MC, Melo GM, da Silva VM, Cavalcante AMRZ, Almeida MDA, Lucena ADF. Decreased cardiac output: an integrative review. Rev Bras Enferm 2023; 76:e20220265. [PMID: 36753257 PMCID: PMC9901357 DOI: 10.1590/0034-7167-2022-0265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/02/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE to identify, in the scientific literature, the defining characteristics and contributing factors (related factors, associated conditions and populations at risk) for nursing diagnosis decreased cardiac output. METHOD an integrative literature review, conducted between September and October 2020, with an update in March 2022, in the MEDLINE via PubMed, LILACS, SciELO, CINAHL and EMBASE databases. Using acronym PEO, studies published in the last 10 years in Portuguese, English and Spanish were included. A descriptive analysis was carried out to present the elements mapped in the literature. RESULTS analysis of 31 articles identified different elements, highlighting 4 new related factors: hyperglycemic stress, prone position, left lateral position, sleep deprivation. Individuals with a history of cardiovascular disease and males were identified as possible populations at risk. FINAL CONSIDERATIONS the elements for decreased cardiac output, identified in the literature, add evidence that justifies the permanence of this diagnosis in the NANDA-I classification.
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Silva RCD, Gondim MC, Melo GM, Silva VMD, Cavalcante AMRZ, Almeida MDA, Lucena ADF. Débito cardíaco diminuído: revisão integrativa. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0265pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
RESUMO Objetivo: identificar, na literatura científica, as características definidoras e fatores contribuintes (fatores relacionados, condições associadas e populações em risco) para o diagnóstico de enfermagem débito cardíaco diminuído. Método: revisão integrativa da literatura, conduzida entre setembro e outubro de 2020, com atualização em março de 2022, nas bases de dados MEDLINE via PubMed, LILACS, SciELO, CINAHL e EMBASE. Com uso do acrônimo PEO, foram incluídos estudos publicados nos últimos 10 anos em português, inglês e espanhol. Realizouse análise descritiva para apresentar os elementos mapeados na literatura. Resultados: análise de 31 artigos identificou diferentes elementos, com destaque para 4 novos fatores relacionados: estresse hiperglicêmico, posição prona, posição lateral esquerda, privação do sono. Indivíduos com história de doença cardiovascular e do sexo masculino foram apontados como possíveis populações em risco. Considerações finais: os elementos para débito cardíaco diminuído, identificados na literatura, agregam evidências que justificam a permanência desse diagnóstico na classificação da NANDA-I.
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Zhou X, Pan J, Wang Y, Wang H, Xu Z, Zhuo W. Left ventricular-arterial coupling as a predictor of stroke volume response to norepinephrine in septic shock - a prospective cohort study. BMC Anesthesiol 2021; 21:56. [PMID: 33596822 PMCID: PMC7886849 DOI: 10.1186/s12871-021-01276-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 01/28/2021] [Indexed: 12/17/2022] Open
Abstract
Background Left ventricular-arterial coupling (VAC), defined as the ratio of arterial elastance (Ea) to left ventricular end-systolic elastance (Ees), is a key determinant of cardiovascular performance. This study aims to evaluate whether left VAC can predict stroke volume (SV) response to norepinephrine (NE) in septic shock patients. Methods This was a prospective cohort study conducted in an intensive care unit of a tertiary teaching hospital in China. We recruited septic shock patients who had persistent hypotension despite fluid resuscitation and required NE to maintain mean arterial pressure (MAP) > 65 mmHg. Those patients in whom the target MAP was not reached after NE infusion were ineligible. Echocardiographic variables were measured before (baseline) and after NE infusion. SV responder was defined by a ≥ 15% increase in SV after NE infusion. Results Of 34 septic shock patients included, 19 (56%) were SV responders. Before NE infusion, SV responders had a lower Ees (1.13 ± 0.24 mmHg/mL versus 1.50 ± 0.46 mmHg/mL, P = 0.005) and a higher Ea/Ees ratio (1.47 ± 0.40 versus 1.02 ± 0.30, P = 0.001) than non-responders, and Ea in SV responders was comparable to that in non-responders (1.62 ± 0.36 mmHg/mL versus 1.43 ± 0.28 mmHg/mL, P = 0.092). NE significantly increased Ea and Ees in both groups. The Ea/Ees ratio was normalized by NE administration in SV responders but unchanged in non-responders. The baseline Ea/Ees ratio was positively correlated with NE-induced SV increases (r = 0.688, P < 0.001). Logistic regression analysis indicated that the baseline Ea/Ees ratio was a predictor of SV increases induced by NE (odd ratio 0.008, 95% confidence interval (CI): 0.000 to 0.293), with an area under the receiver operating characteristic curve of 0.816 (95% CI: 0.646 to 0.927). Conclusions The left VAC has the ability to predict SV response to NE infusion in septic shock patients. Trial registration Chinese Clinical Trial Registry, ChiCTR1900024031, Registered 23 June 2019 - Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=40359&htm=4.
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Affiliation(s)
- Xiaoyang Zhou
- Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China
| | - Jianneng Pan
- Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China
| | - Yang Wang
- Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China
| | - Hua Wang
- Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China
| | - Zhaojun Xu
- Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China. .,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, 315000, China.
| | - Weibo Zhuo
- Department of Intensive Care Medicine, Ningbo Fenghua District Hospital of Traditional Chinese Medicine Medical Community, Ningbo, Zhejiang, 315500, China.
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