Insuficiência cardíaca de fração de ejeção reduzida: elaboração de protocolo de manejo clínico ambulatorial e emergencial para o hospital das clínicas da faculdade de medicina de Botucatu
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Data
2021-05-27
Autores
Nascimento, Monize Aparecida Gonçalves do
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Universidade Estadual Paulista (Unesp)
Resumo
A insuficiência cardíaca (IC) é um importante problema de saúde pública tendo em vista os desfechos com os quais está relacionada, como morte e internação hospitalar. Representa a principal causa de internação no Sistema Único de Saúde (SUS) a partir dos 65 anos. Além disso, o tratamento da IC vem sofrendo modificações ao longo dos anos a fim de melhorar prognóstico e qualidade de vida do paciente. Podemos dizer que a primeira etapa do tratamento se inicia na unidade básica de saúde ou nos consultórios médicos por meio do controle rigoroso de comorbidades que levam a IC. Por isso, a importância de obter conhecimento a respeito desta síndrome clínica. Objetivo: Elaborar um protocolo para orientar a avaliação e o manejo clínico ambulatorial e emergencial dos pacientes com insuficiência cardíaca de fração de ejeção reduzida do Hospital das Clinicas da Faculdade de Medicina de Botucatu (HC-FMB). Métodos: Foi realizada revisão da literatura buscando artigos de relevância entre artigos originais, artigos de revisão, revisões sistemáticas, meta-análises, pesquisando, nas bases de dados Embase, Cochrane Librany, Lilacs, BVS, Pubmed, Medline e Scielo, utilizando-se as Diretrizes Brasileiras, Americanas e Europeias e considerados artigos nos idiomas inglês e português. Resultados: Os produtos técnicos que resultaram desse estudo foram as construções de protocolos estruturados em fluxogramas de atendimento clínico ambulatorial e atendimento clínico emergencial de pacientes com insuficiência cardíaca de fração de ejeção reduzida. Conclusões: O presente estudo atingiu os objetivos gerando protocolos que possam ser utilizados de forma prática e rápida no atendimento ambulatorial e emergencial de pacientes com IC de fração de ejeção reduzida.
Heart failure (HF) is an important public health problem in view of the outcomes with which it is related, such as death and hospitalization. It represents the main cause of hospitalization in the Unified Health System (SUS) from the age of 65. In addition, the treatment of HF has undergone changes over the years in order to improve the patient's prognosis and quality of life. We can say that the first stage of treatment begins in the basic health unit or in doctors' offices through the strict control of comorbidities that lead to HF. Therefore, the importance of obtaining knowledge about this clinical syndrome. Objective: To develop a protocol to guide the assessment and clinical management of outpatient and emergency patients with heart failure with reduced ejection fraction, Hospital das Clinicas, Botucatu Medical School. Methods: Literature review was carried out looking for articles of relevance among original articles, review articles, systematic reviews, meta-analyzes, searching the Embase, Cochrane Librany, Lilacs, BVS, Pubmed, Medline and Scielo databases, using the Brazilian, American and European Guidelines and considered articles in English and Portuguese. Results: The technical products that resulted from this study were the construction of protocols structured in flowcharts of outpatient clinical care and emergency clinical care of patients with reduced ejection fraction heart failure. Conclusions: The present study achieved the objectives by generating protocols that can be used in a practical and fast way in outpatient and emergency care for patients with HF with reduced ejection fraction.
Heart failure (HF) is an important public health problem in view of the outcomes with which it is related, such as death and hospitalization. It represents the main cause of hospitalization in the Unified Health System (SUS) from the age of 65. In addition, the treatment of HF has undergone changes over the years in order to improve the patient's prognosis and quality of life. We can say that the first stage of treatment begins in the basic health unit or in doctors' offices through the strict control of comorbidities that lead to HF. Therefore, the importance of obtaining knowledge about this clinical syndrome. Objective: To develop a protocol to guide the assessment and clinical management of outpatient and emergency patients with heart failure with reduced ejection fraction, Hospital das Clinicas, Botucatu Medical School. Methods: Literature review was carried out looking for articles of relevance among original articles, review articles, systematic reviews, meta-analyzes, searching the Embase, Cochrane Librany, Lilacs, BVS, Pubmed, Medline and Scielo databases, using the Brazilian, American and European Guidelines and considered articles in English and Portuguese. Results: The technical products that resulted from this study were the construction of protocols structured in flowcharts of outpatient clinical care and emergency clinical care of patients with reduced ejection fraction heart failure. Conclusions: The present study achieved the objectives by generating protocols that can be used in a practical and fast way in outpatient and emergency care for patients with HF with reduced ejection fraction.
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Insuficiência cardíaca, Manejo ambulatorial, Manejo emergencial, Diagnóstico, Heart failure, Outpatient management, Emergency management, Diagnosis