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doctoral thesis
Obilježja bolesnika liječenih plazmaferezom
Zagreb: University of Zagreb, School of Medicine, 2015. urn:nbn:hr:105:979143
Brunetta Gavranić, Bruna
University of Zagreb
School of Medicine

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Brunetta Gavranić, B. (2015). Obilježja bolesnika liječenih plazmaferezom (Doctoral thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:979143

Brunetta Gavranić, Bruna. "Obilježja bolesnika liječenih plazmaferezom ." Doctoral thesis, University of Zagreb, School of Medicine, 2015. https://urn.nsk.hr/urn:nbn:hr:105:979143

Brunetta Gavranić, Bruna. "Obilježja bolesnika liječenih plazmaferezom ." Doctoral thesis, University of Zagreb, School of Medicine, 2015. https://urn.nsk.hr/urn:nbn:hr:105:979143

Brunetta Gavranić, B. (2015). 'Obilježja bolesnika liječenih plazmaferezom ', Doctoral thesis, University of Zagreb, School of Medicine, accessed 21 December 2024, https://urn.nsk.hr/urn:nbn:hr:105:979143

Brunetta Gavranić B. Obilježja bolesnika liječenih plazmaferezom [Doctoral thesis]. Zagreb: University of Zagreb, School of Medicine; 2015 [cited 2024 December 21] Available at: https://urn.nsk.hr/urn:nbn:hr:105:979143

B. Brunetta Gavranić, "Obilježja bolesnika liječenih plazmaferezom ", Doctoral thesis, University of Zagreb, School of Medicine, Zagreb, 2015. Available at: https://urn.nsk.hr/urn:nbn:hr:105:979143

Metadata
TitleObilježja bolesnika liječenih plazmaferezom
Title (english)Characteristics of patients treated with plasmapheresis
AuthorBruna Brunetta Gavranić
VIAF: 305728577
MentorPetar Kes (mentor)
Committee membernije dostupno (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
Zagreb
Defense date and country2015-07-23, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Universal decimal classification
(UDC)		61 - Medical sciences
Abstract
Učestalija primjena terapijske plazmafereze te napredak medicine i tehnologije donijeli su značajne promjene metode, indikacija, komplikacija i obilježja bolesnika liječenih ovim postupkom. Unatoč tome, mnoga pitanja i dalje su ostala otvorena. Retrospektivno je analizirana baza podataka terapijskih afereza Referentnog centra za Ministarstva zdravstva za nadomještanje bubrežne funkcije, plazmaferezu i aferezu Republike Hrvatske nastala tijekom 27 godina praćenja. Istražena je dinamika promjena u indikacijama, komplikacijama, metodi i epidemiološkim osobitostima bolesnika podvrgnutih postupcima. Zabilježeno je povećanje broja postupaka i bolesnika te njihove dobi. Dominiraju neurološke indikacije, uz značajne promjene u spektru indikacija. Značajno su se promijenile i metode provođenja TPF-a: manja se rabi nefrakcionirani heparin, volumeni izmjene sve su veći, a postupci se češće provode putem CVK. Komplikacije su zabilježene u 10,8 % postupaka. Veći udio komplikacija zabilježen je tijekom postupaka u kojima se rabi niskomolekularni heparin i SSP te postupaka koji se provode zbog hematoloških indikacija i u kroničnom programu. Manji udio zabilježen je tijekom postupaka putem AV fistule, uz profilaktičku nadoknadu kalija i kod bolesnika srednje dobi. Tijekom LDL afereza komplikacije su zabilježene u 7,4 % postupaka. Složenost postupaka afereze, moguće komplikacije, ali i visoka cijena zahtijevaju da se poštuju, trajno preispituju i dorađuju smjernice za njezinu uporabu. Nacionalni registar afereza Republike Hrvatske pridonio bi unapređenju kvalitete i sigurnosti provođenja terapijske plazmafereze, te pomogao u pronalaženju najbolje terapijske mogućnosti.
Abstract (english)
Frequent use of therapeutic plasmapheresis and advances in medicine and technology generated significant changes in indications, complications, method and epidemiological characteristics of patients treated with this procedure. Nevertheless many questions still remain open. Database of the National Referral Centre for therapeutic plasmapheresis and apheresis was retrospectively analyzed for changes in indications, complications, method and epidemiological characteristics of patients treated during 27 years of follow-up. An increase in number of procedures, patients and patients’ age. Neurological indications dominate, with significant changes in spectra of indications. Methods of conducting TPE also changed significantly: there is less use of unfractioned heparin, exchange volumes are larger and use of CVK more frequent. Complications occurred during 10,8 % of TPE. Use of fractionated heparin, fresh frozen plasma resulted in higher percentage of complications. That is also true for procedures done for hematological indications and in chronic program. Use of AV fistula, prophylactic replenishment of potassium and adult patients had smaller percentage of complications. Complications occurred in 7,4 % of LDL apheresis. The complexity of procedure, possible complications and high costs, ask to respect, permanently reviewe and update the guidelines for its use. National apheresis registry would contribute to improvement of the quality and safety of therapeutic apheresis and help in identifying best treatment options.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:979143
Study programmeTitle: Biomedicine and Health Sciences
Study programme type: university
Study level: postgraduate
Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
Type of resourceText
Extent216 str.
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-05-05 07:36:28