COVİD-19 PANDEMİSİNDE KÖK HÜCRE NAKLİ YAPILAN YOĞUN BAKIM HASTALARININ HEMŞİRELİK BAKIM PLANLARININ DEĞERLENDİRİLMESİ
Abstract
Amaç: Bu makalede Covid-19 pandemisinde kök hücre nakli yapılan yoğun bakım hastalarının hemşirelik bakımını ele almak amaçlandı.
Yöntem: İstanbul’da bir pandemi hastanesinin erişkin anestezi yoğun bakım ünitelerinde 01.03.2020 – 01.03.2021 tarihleri arasında yatarak tedavi gören ve tedavisi sırasında kök hücre nakli yapılan hastaların retrospektif olarak incelenmesi yapıldı. Kesitsel ve tanımlayıcı tasarımlı çalışma etik kurul ve kurum izinleri alındıktan sonra hastaların arşiv dosyaları incelenerek tamamlandı. Araştırmanın evrenini yoğun bakım ünitelerinde yatan ve kök hücre nakli yapılan tüm hastalar oluşturdu (n=32) ve örneklem seçimine sadece dosya arşivi incelendiği için gidilmedi.
Bulgular: Çalışma kapsamına alınan hastaların yaş ortalaması 52.16±7,4’tür. Yaş gruplarına göre çoğunluğunun 51-60 yaş aralığında %40,6 (n=13) olduğu belirlendi. Hastaların %87,5’i (n=28) erkek, %65,6’sının (n=21) kronik hastalığı olduğu, %96,9’unun PCR (Polimeraz Zincir Reaksiyonu) testi pozitif, %96,9’ unun bilgisayarlı tomografisinde (BT) COVID-19 belirtisi olan buzlu cam görüntüleri olduğu izlendi. Hastaların %9,4’üne (n=3) bir seans, %40,6’sına (n=13) iki seans, %50,0’sine (n=16) üç seans kök hücre tedavisi uygulandığı izlendi. Hemşirelik bakım planı tanılarının dağılımları incelendiğinde; en çok enfeksiyon riski hemşirelik bakım planı tanısı %100 (n=32) ve yetersiz solunum ve hava yolu açıklığı hemşirelik bakım planı tanısının %93,8 (n=30) sistem üzerinden girilmiş olduğu tespit edildi.
Sonuç: Yoğun bakım ihtiyacı olan COVID-19 hastalarının kök hücre tedavisinden fayda gördükleri ancak hasta sayısının azlığından kaynaklı etkinliğinin değerlendirilemediği, uygulanan hemşirelik bakım planlarının doğru tanılar ile doğru girişimlerle yapıldığı ve hemşirelik tanılarına uygun olarak hastaların semptomlarında belirgin azalma ve iyileşme sağlandığı izlendi.
Supporting Institution
-
Project Number
-
References
- 1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et.al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382:727-733
- 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
- 3. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Corona-virus Disease 2019 in China. N Engl J Med. 2020;382:1708-1720.
- 4. Reddm WD, Zhou JC, Hathorn KE, McCarty TR, Bazarbashi AN, Thompson CC et al. Prevalence and Characteristics of Gastrointestinal Symptoms in Patients with SARS-CoV-2 Infection in the United States: A Multicenter Cohort Study. Gastroenterology 2020;S0016- 5085(20)30564–3.
- 5. Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology. 2020;158:1518–9.
- 6. Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020.
- 7. Metcalfe SM. Mesenchymal stem cells and management of COVID-19 pneumonia. Medicine in drug discovery, 2020, 5: 100019.
- 8. Golchin A, Farahany TZ. Biological products: cellular therapy and FDA approved products. Stem cell reviews and reports, 2019, 15.2: 166-175.
- 9. Golchin A, Farahany TZ, Khojasteh A, Soleimanifar F, Ardeshirylajimi A. The clinical trials of Mesenchymal stem cell therapy in skin diseases: An update and concise review. Curr Stem Cell Res Ther. Current Stem Cell Research & Therapy. 2019; 14:22-33.
- 10. Prockop DJ. The exciting prospects of new therapies with mesenchymal stromal cells. Cyto-therapy. 2017; 19:1‐8.
- 11. Connick P, Kolappan M, Crawley C, Webber DJ, Patani R, Michell AW, et al. Autologous mesenchymal stem cells for the treatment of secondary progressive multiple sclerosis: an open-label phase 2a proof-of-concept study. Lancet Neurol. 2012; 11:150‐156.
- 12. Wilson JG, Liu KD, Zhuo NJ, Caballero L, McMillan M, Fang X, et al. Mesenchymal stem (stromal) cells for treatment of ARDS: a phase 1 clinical trial. Lancet Respir Med. 2015; 3:24‐32.
- 13. Wu Z, mcgoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 [COVID-19] Outbreak in China: Summary of a Report of 72 314 Cases From the Chi-nese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242.
- 14. Chan MC, Kuok DI, Leung CY, Hui KP, Valkenburg SA, Lau EH, et al. Peiris JS. Human mesenchymal stromal cells reduce influenza A H5N1- associated acute lung injury in vitro and in vivo. Proceedings of the National Academiy of Sciences of the United States of America. 2016; 113:3621‐3626
- 15. Chen J, Hu C, Chen L, Tang L, Zhu Y, Xu X, et al. Clinical study of mesenchymal stem cell treating acute respiratory distress syndrome induced by epidemic Influenza A (H7N9) infec-tion, a hint for COVID-19 treatment. Engineering (Beijing). 2020.
- 16. Vergano M, Bertolini G, Giannini A, Gristina GR, Livigni S, Mistraletti G et al. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: The Italian perspective during the COVID-19 epidemic. Critical Care. 2020 Nis 22;24(1).
- 17. Velioğlu P. Hemşirelikte kavram ve kuramlar. İstanbul: Alaş Ofis; 2012.
- 18. Atabek Aştı T. Hemşirelik esasları uygulama rehberi. İstanbul: Akademi Yayın ve Basıncılık; 2020
- 19. Kacaroğlu AV, Gülseven BK, Ecevit ŞA. 2012-2014 NANDA-I hemşirelik tanılarının yaşam aktivitelerine dayalı hemşirelik modeline göre sınıflandırılması. Journal of Human Sciences 2015; 12(2): 1626-36.
- 20. Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol. 2020;92(5):479-90.
- 21. World Health Organization (WHO). Q&A on smoking and COVID‐19. Erişim Adre-si:www.who.int/publications/i/item/WHO-2019- nCoV-Sci_Brief-Smoking-2020.2. Erişim tarihi: 05.05.2021
- 22. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteris- tics of 138 Hospital-ized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069.
- 23. Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, et al. Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell Metabolism 2020.
- 24. Badawi A, Ryoo SG. Prevalence of diabetes in the 2009 influenza A (H1N1) and the Middle East respiratory syndrome coronavirus: a systematic review and meta-analysis. J Public Health Res 2016;5(3):733.
- 25. Patel AB, Verma A. COVID-19 and angiotensin-converting enzyme inhibitors and angioten-sin receptor blockers: what is the evidence? JAMA 2020.
- 26. Mao B, Liu Y, Chai YH, Jin XY, Lu HW, Yang JW, et al. Assessing risk factors for SARS-CoV-2 infection in patients presenting with symptoms in Shanghai, China: a multicentre, ob-servational cohort study. The Lancet Digital Health.
- 27. Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep 2020;69(15):458- 64.
- 28. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. European Respiratory Journal 2020;55(5):2000547.
- 29. Wu C, Chen X, Cai Y, Xia Ja, Zhou X, Xu S, et al. Risk factors associated with acute respira-tory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wu-han, China. JAMA Internal Medicine 2020.
- 30. Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of corona-virus disease 2019 (COVID-19) in China: a systematic review and meta-analysis. J Infect 2020:S0163-4453(20)30170-5.
- 31. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson J, et al. COVID-19: consider cytokine storm syndromes and immunosuppression, Lancet (London, England), 2020, 395(10229), 1033-1034.
- 32. Lazarus HM, Haynesworth SE, Gerson SL, Rosenthal NS, Caplan AI. Ex vivo expansion and subsequent infusion of human bone marrow-derived stromal progenitor cells (mesenchy-mal progenitor cells): implications for therapeutic use. Bone Marrow Transplant. 1995;16(4):557-564.
- 33. Liu, S, Peng, D, Qiu, H, Yang, K, Fu, Z, et al., Mesenchymal stem cells as a potential therapy for COVID-19, Stem Cell Research and Therapy, 2020, 11(1), 169.
- 34. Liang B, Chen J, Li T, Wu H, Yang W, Li Y, et al. Clinical remission of a critically ill COVID-19 patient treated by human umbilical cord mesenchymal stem cells: A case report, Medicine (Baltimore), 2020, 99(31).
- 35. Leng Z, Zhu R, Hou W, Feng Y, Yang Y, Han Q, et al. Transplantation of ACE2- Mesenchy-mal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia, Aging and disease, 2020, 11(2), 216-228.
EXAMINATION OF NURSING CARE PLANS OF INTENSIVE CARE PATIENTS WITH STEM CELL TRANSPLANT IN THE COVID-19 PANDEMIC
Abstract
Objective: In this article, it was aimed to discuss the nursing care of intensive care patients undergoing stem cell transplantation in the Covid-19 pandemic.
Method: A retrospective examination of patients who were hospitalized in the adult anesthesia intensive care units of a pandemic hospital in Istanbul between March 1, 2020, and March 1, 2021, and who underwent stem cell transplantation during their treatment was carried out. The cross-sectional and descriptive study was completed by examining the archive files of the patients after the ethics committee and institutional permissions were obtained. The population of the study consisted of all patients hospitalized in intensive care units and undergoing stem cell transplantation (n=32). Sample selection was not made because only the file archive was examined.
Results: The mean age of the patients included in the study was 52.16±7.4 years. According to age groups, it was determined that the majority of them were between the ages of 51-60, 40.6% (n=13). Of the patients, 87.5% (n=28) were male, 65.6% (n=21) had a chronic disease, 96.9% had a positive PCR (Polymerase Chain Reaction) test, 96.9% had Computed tomography (CT) showed ground glass images with signs of COVID-19. It was observed that 9.4% (n=3) of the patients received one session, 40.6% (n=13) two sessions, 50.0% (n=16) three sessions of stem cell transplant. When the distribution of nursing care plan diagnoses is examined; it was determined that the most risk of infection nursing care plan diagnosis was 100% (n=32) and the diagnosis of inadequate respiratory and airway patency nursing care plan was 93.8% (n=30) entered through the system.
Conclusion: It was observed that COVID-19 patients in need of intensive care benefited from stem cell therapy, but its effectiveness could not be evaluated due to the low number of patients, the applied nursing care plans were made with correct diagnoses and correct interventions, and a significant reduction in the symptoms of the patients were achieved, showing a remarkable improvement, in accordance with the nursing diagnoses.
Project Number
-
References
- 1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et.al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382:727-733
- 2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
- 3. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Corona-virus Disease 2019 in China. N Engl J Med. 2020;382:1708-1720.
- 4. Reddm WD, Zhou JC, Hathorn KE, McCarty TR, Bazarbashi AN, Thompson CC et al. Prevalence and Characteristics of Gastrointestinal Symptoms in Patients with SARS-CoV-2 Infection in the United States: A Multicenter Cohort Study. Gastroenterology 2020;S0016- 5085(20)30564–3.
- 5. Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology. 2020;158:1518–9.
- 6. Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020.
- 7. Metcalfe SM. Mesenchymal stem cells and management of COVID-19 pneumonia. Medicine in drug discovery, 2020, 5: 100019.
- 8. Golchin A, Farahany TZ. Biological products: cellular therapy and FDA approved products. Stem cell reviews and reports, 2019, 15.2: 166-175.
- 9. Golchin A, Farahany TZ, Khojasteh A, Soleimanifar F, Ardeshirylajimi A. The clinical trials of Mesenchymal stem cell therapy in skin diseases: An update and concise review. Curr Stem Cell Res Ther. Current Stem Cell Research & Therapy. 2019; 14:22-33.
- 10. Prockop DJ. The exciting prospects of new therapies with mesenchymal stromal cells. Cyto-therapy. 2017; 19:1‐8.
- 11. Connick P, Kolappan M, Crawley C, Webber DJ, Patani R, Michell AW, et al. Autologous mesenchymal stem cells for the treatment of secondary progressive multiple sclerosis: an open-label phase 2a proof-of-concept study. Lancet Neurol. 2012; 11:150‐156.
- 12. Wilson JG, Liu KD, Zhuo NJ, Caballero L, McMillan M, Fang X, et al. Mesenchymal stem (stromal) cells for treatment of ARDS: a phase 1 clinical trial. Lancet Respir Med. 2015; 3:24‐32.
- 13. Wu Z, mcgoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 [COVID-19] Outbreak in China: Summary of a Report of 72 314 Cases From the Chi-nese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242.
- 14. Chan MC, Kuok DI, Leung CY, Hui KP, Valkenburg SA, Lau EH, et al. Peiris JS. Human mesenchymal stromal cells reduce influenza A H5N1- associated acute lung injury in vitro and in vivo. Proceedings of the National Academiy of Sciences of the United States of America. 2016; 113:3621‐3626
- 15. Chen J, Hu C, Chen L, Tang L, Zhu Y, Xu X, et al. Clinical study of mesenchymal stem cell treating acute respiratory distress syndrome induced by epidemic Influenza A (H7N9) infec-tion, a hint for COVID-19 treatment. Engineering (Beijing). 2020.
- 16. Vergano M, Bertolini G, Giannini A, Gristina GR, Livigni S, Mistraletti G et al. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: The Italian perspective during the COVID-19 epidemic. Critical Care. 2020 Nis 22;24(1).
- 17. Velioğlu P. Hemşirelikte kavram ve kuramlar. İstanbul: Alaş Ofis; 2012.
- 18. Atabek Aştı T. Hemşirelik esasları uygulama rehberi. İstanbul: Akademi Yayın ve Basıncılık; 2020
- 19. Kacaroğlu AV, Gülseven BK, Ecevit ŞA. 2012-2014 NANDA-I hemşirelik tanılarının yaşam aktivitelerine dayalı hemşirelik modeline göre sınıflandırılması. Journal of Human Sciences 2015; 12(2): 1626-36.
- 20. Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol. 2020;92(5):479-90.
- 21. World Health Organization (WHO). Q&A on smoking and COVID‐19. Erişim Adre-si:www.who.int/publications/i/item/WHO-2019- nCoV-Sci_Brief-Smoking-2020.2. Erişim tarihi: 05.05.2021
- 22. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteris- tics of 138 Hospital-ized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069.
- 23. Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, et al. Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell Metabolism 2020.
- 24. Badawi A, Ryoo SG. Prevalence of diabetes in the 2009 influenza A (H1N1) and the Middle East respiratory syndrome coronavirus: a systematic review and meta-analysis. J Public Health Res 2016;5(3):733.
- 25. Patel AB, Verma A. COVID-19 and angiotensin-converting enzyme inhibitors and angioten-sin receptor blockers: what is the evidence? JAMA 2020.
- 26. Mao B, Liu Y, Chai YH, Jin XY, Lu HW, Yang JW, et al. Assessing risk factors for SARS-CoV-2 infection in patients presenting with symptoms in Shanghai, China: a multicentre, ob-servational cohort study. The Lancet Digital Health.
- 27. Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep 2020;69(15):458- 64.
- 28. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. European Respiratory Journal 2020;55(5):2000547.
- 29. Wu C, Chen X, Cai Y, Xia Ja, Zhou X, Xu S, et al. Risk factors associated with acute respira-tory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wu-han, China. JAMA Internal Medicine 2020.
- 30. Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of corona-virus disease 2019 (COVID-19) in China: a systematic review and meta-analysis. J Infect 2020:S0163-4453(20)30170-5.
- 31. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson J, et al. COVID-19: consider cytokine storm syndromes and immunosuppression, Lancet (London, England), 2020, 395(10229), 1033-1034.
- 32. Lazarus HM, Haynesworth SE, Gerson SL, Rosenthal NS, Caplan AI. Ex vivo expansion and subsequent infusion of human bone marrow-derived stromal progenitor cells (mesenchy-mal progenitor cells): implications for therapeutic use. Bone Marrow Transplant. 1995;16(4):557-564.
- 33. Liu, S, Peng, D, Qiu, H, Yang, K, Fu, Z, et al., Mesenchymal stem cells as a potential therapy for COVID-19, Stem Cell Research and Therapy, 2020, 11(1), 169.
- 34. Liang B, Chen J, Li T, Wu H, Yang W, Li Y, et al. Clinical remission of a critically ill COVID-19 patient treated by human umbilical cord mesenchymal stem cells: A case report, Medicine (Baltimore), 2020, 99(31).
- 35. Leng Z, Zhu R, Hou W, Feng Y, Yang Y, Han Q, et al. Transplantation of ACE2- Mesenchy-mal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia, Aging and disease, 2020, 11(2), 216-228.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Nursing |
| Journal Section | Research |
| Authors | |
| Project Number | - |
| Publication Date | December 24, 2021 |
| Published in Issue | Year 2021 Volume: 25 Issue: 3 |
Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License