Heart and lung transplantation for end-stage pulmonary vascular hypertension.
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Adult↗
Biomedical subjects
J A Shinn
Publications and source records attributed to J A Shinn.
Cardiopulmonary transplantation: initial experience.
Cardiopulmonary transplantation may offer extended survival for patients with end-stage cardiopulmonary disease who were previously not potential transplant candidates. Clinical experience at this time has been limited to four patients at this institution. Cyclosporin A and the reduced need for large-dose immunosuppression may increase long-term survival for the cardiopulmonary transplant patient. The first recipient at this institution is alive and well more than 9 months after surgery and the second at 7 months; a third patient died on the third postoperative day as a result of complications related to a prolonged period of cardiopulmonary bypass necessitated by a severe coagulopathy; and a fourth is recovering 4 weeks after receiving his transplant (November 1981). Nursing assessment skills required for these patients are both physiological and psychological in nature. Each is of equal importance to ensure optimal recovery. Key factors that have been identified and discussed are the reimplantation response, compromised PaO2, compromised nutritional status, and the psychosocial impact.
Animals↗
Pulmonary artery balloon counterpulsation for acute right ventricular failure.
The development and availability of right ventricular assist devices has not kept pace with the evolution of devices designed to mechanically support the systemic circulation. This report describes the application of the counterpulsation concept to the pulmonary circuit to unload the failing right ventricle and augment pulmonary blood flow. Conventional, widely available balloon pumping equipment was employed. Use of this double balloon pump system enabled a patient to be weaned from cardiopulmonary bypass after all other measures had failed. Other relevant potential clinical applications for this technique are discussed.
Assisted Circulation↗
Expected and realized benefits from cardiac surgery: an update.
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Activities of Daily Living↗
Left ventricular assist device as a bridge to heart transplantation: a case study.
Stanford University Medical Center has successfully utilized a left ventricular assist device as bridge support for 9 days in a 52-year-old man awaiting heart transplantation. During this time he developed a pericardial tamponade, but no other serious medical complications occurred. Major nursing care issues focused on pain control, vigorous pulmonary toilet, and left ventricular assist device timing. This article outlines the responsibilities of critical care nurses and what was learned from the experience. The recipient was discharged home 106 days after heart transplantation.
Assisted Circulation↗
Effect of intermittent positive pressure ventilation upon pulmonary artery and pulmonary capillary wedge pressures in acutely ill patients.
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Adult↗
Life satisfaction following heart transplantation.
This study investigated perceived life satisfaction and quality of life reported by heart transplant recipients. The impact of life change following transplantation and problems associated with side-effects of the immunosuppressive therapy were also examined. Questionnaires were mailed to one hundred heart transplant recipients. All had survived at least six months after the operation. Seventy-five completed the questionnaire. Eighty-nine percent of those reported good to excellent quality of life. Life satisfaction was reported as good to very satisfactory by 82%. The considerable change in life style following transplantation was mostly perceived as positive. All recipients experienced some side-effects from the immunosuppressive therapy. However, these physical symptoms had little impact upon the overall positive evaluation of life quality and life satisfaction.
Adult↗
A randomized clinical trial of nursing care for recovery from cardiac surgery.
OBJECTIVE: To determine the efficacy of a psychoeducational nursing intervention in patients who receive coronary artery bypass graft and valve repair surgery. DESIGN: A cluster-randomized controlled trial design. SETTING: Two hospitals in the western United States--a large community hospital with an active cardiovascular surgery practice and a health-sciences research center. SUBJECTS: 156 patients between 25 and 75 years of age, 125 (81.1%) men, and 31 (19.9%) women, all with primary care givers. OUTCOME MEASURES: Self-efficacy expectations, activities (behavior performance), quality of life, mood state. INTERVENTION: Supplemental in-hospital education followed by telephone contact from discharge to eighth week after discharge. RESULTS: Patients in the experimental group reported significantly greater self-efficacy expectations for walking and behavior performance for walking, lifting, climbing stairs, general exertion and, where applicable, for working. CONCLUSION: This trial suggests that a low-intensity psychoeducational nursing intervention can promote self-efficacy expectations for walking in recovery and is associated with more self-reported walking and lifting behavior after cardiac surgery.
Activities of Daily Living↗