Uso de alteplase no tratamento do acidente vascular encefálico isquêmico agudo: o que sabem os enfermeiros?

Abstract

474Rev Bras Enferm, Brasília 2012 mai-jun; 65(3): 474-81. ABSTRACTThe study aimed at analyzing the knowledge of nurses about the use of alteplase in the treatment of acute ischemic stroke. An exploratory descriptive study was conducted in a stroke unit of a public hospital in the city of Fortaleza, Brazil, in the month of October 2010. The study included ten nurses, with a mean age of 25 years. The benefi ts of medication were presented in juxtaposition with the limitations of use. Strategies to expand the use of alteplase were pointed out by nurses. The knowledge of the investigation may contribute to the construction of nursing knowledge and help nurses who provide direct care to patients who undergo this treatment. Key words: Stroke; Alteplase; Nursing Care. RESUMENEl estudio tuvo como objetivo analizar el conocimiento de los enfermeros sobre el uso de alteplase en el tratamiento del accidente cerebrovascular isquémico agudo. Estudio exploratorio descriptivo, realizado en una unidad de accidente cerebrovascular de un hospital público en la ciudad de Fortaleza, en el mes de octubre de 2010. Participaron diez enfermeros del estudio, con edad media de 25 años. Los benefi cios de la medicación se presentaron en yuxtaposición con las limitaciones de uso. Las estrategias para ampliar el uso de alteplase han sido señaladas por los enfermeros. El conocimiento de la realidad investigada puede contribuir en la construcción del conocimiento de enfermería y ayudar a los enfermeros que prestan atención directa a los pacientes que se someten a este tratamiento. Palabras clave: Accidente Cerebrovascular; Alteplase; Atención de Enfermería. Samia Jardelle Costa de Freitas Maniva E-mail: samia_jardelle@yahoo.com.br AUTOR CORRESPONDENTE Uso de alteplase no tratamento do acidente vascular encefálico isquêmico agudo: o que sabem os enfermeiros? 475Rev Bras Enferm, Brasília 2012 mai-jun; 65(3): 474-81.

Comparação da severidade do déficit neurológico de pacientes com acidente vascular cerebral isquêmico agudo submetidos ou não à terapia trombolítica

“…The most important study evaluating thrombolytics role in stroke showed improvement of at least four points in NIHSS 24 hours after the onset of the symptoms 18 . The positive results of such study prompted the adoption of the thrombolytic agent alteplase (rtPA) in June 1996 6 . The protocol used in the NINDS is recommended in several countries 18 .…”

“…Some authors defend the thrombolytic treatment, regardless the patient age or the stroke severity 19 , whereas others show a proportional increase in the hemorrhagic transformation 9 . However, a consensus was not reached on the importance of early treatment as indispensable for obtaining any benefit [6][7][8][9]19,21,22 .…”

“…The events from ischemic origin correspond to 85% of all the strokes 6 . Early treatment with thrombolytic agent acts on the dissolution of the clot blocking the artery, preventing the occurrence of irreversible tissue damage, and is the most indicated treatment for acute ischemic stroke (AIS) 6,7 .…”

“…The events from ischemic origin correspond to 85% of all the strokes 6 . Early treatment with thrombolytic agent acts on the dissolution of the clot blocking the artery, preventing the occurrence of irreversible tissue damage, and is the most indicated treatment for acute ischemic stroke (AIS) 6,7 . Strong evidences exist in the literature on the efficacy of intravenous recombinant tissue plasminogen activator (rtPA) associated with the reduction in neurological damages [6][7][8] .…”

“…Early treatment with thrombolytic agent acts on the dissolution of the clot blocking the artery, preventing the occurrence of irreversible tissue damage, and is the most indicated treatment for acute ischemic stroke (AIS) 6,7 . Strong evidences exist in the literature on the efficacy of intravenous recombinant tissue plasminogen activator (rtPA) associated with the reduction in neurological damages [6][7][8] . Over the years, several protocols were implemented to accelerate the reperfusion therapy and, thus, high expectation was raised regarding the resolution of the damages caused by stroke 7,8 .…”