Nursing Care of Children Post-Cardiac Surgery in Intensive Care Units: An Integrative Review

Abstract

Introduction: Congenital heart disease is one of the most common congenital disorders, affecting between 0.8% and 1.2% of live births worldwide. The treatment of children with congenital heart defects is highly specialized and includes, among others, surgical treatment as the first-choice approach and postoperative care in intensive care units. The aim of this review is to explore nursing care plans for post-cardiac surgery children during their stay in intensive care units. Methods: An integrative review was performed to obtain articles from the online databases SCOPUS, ScienceDirect, Scielo, PubMed, EMBASE, and Redalyc. The synthesis of information was performed based on diagnoses and interventions. In addition, complications and associated factors were identified. Results: Nursing diagnoses and interventions focus on problem-centered care to respond to cardiovascular and ventilatory needs, sedation and analgesia, infection control, and nutrition. The main complications identified were increased time on mechanical ventilation, postoperative infection, renal failure, and mortality. Complications were associated with intrinsic conditions such as age, gender, or type of malformation and clinical and procedural conditions such as extracorporeal circulation, mechanical ventilation, or higher postoperative risk index. Discussion: This review identified problem-focused nursing diagnoses and interventions with a strong focus on the physiological conditions of the child. Although the results of this study show the conceptual level of nurses for specialized care, it denotes the need to complement the nursing process through diagnoses and interventions that promote the transversality of care beyond the problem-centered approach based on the possibilities of the response of the child and the family.