Title Hipotermija u liječenju teške traumatske ozljede mozga
Title (english) Hypothermia in the treatment of severe traumatic brain injury
Author Mirjana Meštrović
Mentor Ante Sekulić (mentor)
Committee member Mladen Perić (predsjednik povjerenstva)
Committee member DINKO TONKOVIĆ (član povjerenstva)
Committee member Ante Sekulić (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities) Zagreb
Defense date and country 2014-09-25, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Anesthesiology and Reanimatology
Abstract Traumatske ozljede mozga diljem svijeta predstavljaju javnozdravstveni problem. Vodeći su uzrok smrti i doživotnih oštećenja ne samo zbog primarne ozljede koja nastaje u trenutku ozljeđivanja već zbog razvoja sekundarnih ozljeda koje slijede zbog izrazite vulnerabilnosti mozga.Liječenje i zdravstvena njega pacijenata usmjereni su sprečavanju razvoja sekundarnih ozljeda mozga. Stoga je važno održavati adekvatan krvni tlak, cerebralni perfuzijski tlak, zadovoljavajuću oksigenaciju, normotermiju, glikemiju te prevenirati epi atake kako bi se smanjila daljnja oštećenja mozga. Veliki broj patoloških procesa koji slijede primarnu ozljedu mozga ovise o tjelesnoj temperaturi. Poznato je da ih povišena tjelesna tempratura stimulira, a blaga ili umjerena hipotermija može ih ublažiti ili zaustaviti.Neuroprotektivni učinci hipotermije poznati su odavno, međutim primjena terapijske hipotermije u liječenju teške traumatske ozljede mozga predmet je kliničkih istraživanja.Do sada je poznato da djeluje na snižavanje intrakranijskog tlaka, međutim utjecaj na smanjenje smrtnosti i poboljšanje neurološkog ishoda još uvijek nije posve dokazana.Dosadašnja istraživanja upućuju da primjena blage do umjerene hipotermije (32-35°C), kroz duže vrijeme (> 48 sati) uz sporo i kontrolirano zagrijavanje donosi najveću dobit.Pothlađivanje se može provoditi selektivno, samo određenog dijela tijela ili sistemsko, hlađenje čitavog tijela.Neovisno o načinu pothlađivanja, tijekom terapijske hipotermije mogu se razviti komplikacija. Cilj ovog rada je prikazati primjenu terapijske hipotermije u liječenju pacijenata s teškom traumatskom ozljedom mozga, načine hlađenja, učinke na snižavanje povišenog ICP i ishod liječenja kao i komplikacije.
Abstract (english) Traumatic brain injury around the world represents a public health problem. The leading cause of death and lifelong damage, not only due to the primary injury that occurs at the time of injury, but because of the development of secondary injury following the extreme vulnerability of the brain.Treatment and medical care are aimed at preventing the development of secondary brain injury. Therefore, it is important to maintain adequate blood pressure, cerebral perfusion pressure, oxygenation, normothermia, glycemia and prevent epileptic attacks to reduce further damage. A large number of pathological processes that follow primary brain injury depends on body temperature. It is known that a high body temperature stimulates pathological processes, and mild or moderate hypothermia can mitigate or block them. The neuroprotective effects of hypothermia have been known since long ago, however, the application of therapeutic hypothermia in the treatment of traumatic brain injury is a subject of clinical research today. So far, it is known to act on reducing intracranial pressure, however the impact on mortality and improve neurological outcome is still not perfectly clear. Previous studies have suggested that the use of mild to moderate hypothermia ( 32-35 °C), for a greater time period (> 48 hours) with slow and controlled heating provides the best results. Hypothermia can be carried out selectively, only a certain part of the body or systemic, whole body cooling. Regardless of the method of hypothermia, during hypothermia therapy there are always the possiblities of developing complications. The aim of this study was to describe the application of therapeutic hypothermia in the treatment of patients with severe traumatic brain injury, cooling methods, the effects of reducing elevated ICP, treatment outcomes as well as complications.
Keywords
traumatska ozljeda mozga
intentivna skrb
hipotermija
Keywords (english)
traumatic brain injury
intensive care
therapeutic hypothermia
Language croatian
URN:NBN urn:nbn:hr:105:818824
Study programme Title: Studies in Nursing Study programme type: university Study level: graduate Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2015-11-05 15:28:07