Title Ketoacidoza u djece lječenih u jedinici intenzivnog liječenja
Title (english) Ketacidosis in pediatric intensive care unit
Author Besa Osmani
Mentor Mario Ćuk (mentor)
Committee member Danko Milošević (predsjednik povjerenstva)
Committee member Marija Jelušić (član povjerenstva)
Committee member Mario Ćuk (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Pediatrics) Zagreb
Defense date and country 2016-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Abstract Ketoacidoza je stanje metaboličke acidoze uzrokovane visokom koncentracijom ketonskih tijela u krvi i tkivima. Ketonska tijela nastaju zbog beta oksidacije masnih kiselina usred poremećenog metabolizma ugljikohidrata. Najčešće, stanje ketoacidoze nastaje kao komplikacija diabetesa mellitusa te se očituje voćnim zadahom, dispnejom, mučninom i povraćanjem, poremećajem mentalnog statusa, dehidracijom, gubitkom težine te, u uznapredovalom stadiju, komom i smrću. Simptomi ovise o stadiju dijabetičke ketoacidoze, a najčešći simptomi nalikuju kliničkoj slici akutnog abdomena te je potreban dobar klinički pregled. Epidemiologija dijabetičke ketoacidoze varira ovisno o incidenciji DM I u populaciji, socioekonomskom statusu te organizaciji zdravstvenoga sustava.
Dijabetička ketoacidoza je životno ugrožavajuće stanje. Može nastati unutar par sati ili par dana. Nastaje najčešće u nereguliranih ili loše reguliranih pacijenata za vrijeme infekcije ili stresa, a u 15% slučajeva bude prvi simptom bolesti. Dehidracija organizma je uzrokovana osmotičkom diurezom, te kombinirana s acidozom i gubitkom elektrolita može dovesti do osmolarnosti moždanih stanica što dovodi do promijene stanja svijesti pacijenta. Liječenje je kompleksno te zahtijeva znanje i vještinu liječnika, te predanost roditelja i djeteta. Primarno se odvija u jedinici intenzivnog liječenja kako bi se izašlo iz životno ugrožavajućeg stanja. Dijabetička ketoacidoza nastavlja biti vodeći uzrok smrti u pedijatrijskoj populaciji s DM I. Također uzrokuje neke od rijetkih posljedica uključujući cerebralni edem, hiperkoagulabilnost te duboku vensku trombozu, rabdomiolizu, poremećaj probavnog i dišnog sustava te negativan utjecaj na dugoročno pamćenje.
Abstract (english) Ketoacidosis is a state of metabolic acidosis caused by high concentrations of ketone bodies in the blood and tissues. Ketone bodies are created because of beta oxidation of fatty acids amidst a disordered carbohydrate metabolism. Most often the state of ketoacidosis happens as a diabetes mellitus complication and presents with fruity breath, dyspnea, nausea and vomiting, mental state disorder, dehydration, weight loss and, in advanced stages, coma and death. Symptoms depend on the state of diabetic ketoacidosis, and the most common symptoms look like the clinical presentation of an acute abdomen, so a good clinical examination is necessary. Epidemiology of diabetic ketoacidosis varies depending on the DM I incidence in the population, the socioeconomic status and the health care organization.
Diabetic ketoacidosis is a life-threatening state. It can happen within a few hours or a few days. Most commonly it happens in unregulated or poorly regulated patients during the time of an infection or stress and in 15% of cases it is the first symptom of the disease. General dehydration is caused by osmotic diuresis combined with acidosis and electrolyte loss and can lead to osmolarity of brain cells which then leads to a change in the patient’s mental state. The treatment is complex and requires the doctor’s knowledge and skill as well as the parent’s and child’s devotion. Primarily it is conducted in the intensive care unit in order to counter the life-threatening state. Diabetic ketoacidosis continues to be the leading cause of death in the pediatric population with DM I. Also, it causes some of the rare consequences including cerebral edema, hypercoagulability and deep vein thrombosis, rhabdomyolysis, digestive and pulmonary system disorders and a negative effect on long-term memory.
Keywords
ketoacidoza
dijabetička ketoacidoza
jedinica intenzivnog liječenja
dehidracija i elektrolitski disbalans
djeca
Keywords (english)
ketoacidosis
diabetic ketoacidosis
intensive care unit
dehydration and electrolyte imbalance
children
Language croatian
URN:NBN urn:nbn:hr:105:723233
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2017-07-14 07:27:38