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master's thesis
Intenzivistička skrb bolesnika nakon transplantacije srca
Zagreb: University of Zagreb, School of Medicine, 2023. urn:nbn:hr:105:265210
Čepić, Petra
University of Zagreb
School of Medicine
Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities

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

Cite this document

Čepić, P. (2023). Intenzivistička skrb bolesnika nakon transplantacije srca (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:265210

Čepić, Petra. "Intenzivistička skrb bolesnika nakon transplantacije srca." Master's thesis, University of Zagreb, School of Medicine, 2023. https://urn.nsk.hr/urn:nbn:hr:105:265210

Čepić, Petra. "Intenzivistička skrb bolesnika nakon transplantacije srca." Master's thesis, University of Zagreb, School of Medicine, 2023. https://urn.nsk.hr/urn:nbn:hr:105:265210

Čepić, P. (2023). 'Intenzivistička skrb bolesnika nakon transplantacije srca', Master's thesis, University of Zagreb, School of Medicine, accessed 27 April 2024, https://urn.nsk.hr/urn:nbn:hr:105:265210

Čepić P. Intenzivistička skrb bolesnika nakon transplantacije srca [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2023 [cited 2024 April 27] Available at: https://urn.nsk.hr/urn:nbn:hr:105:265210

P. Čepić, "Intenzivistička skrb bolesnika nakon transplantacije srca", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2023. Available at: https://urn.nsk.hr/urn:nbn:hr:105:265210

Metadata
TitleIntenzivistička skrb bolesnika nakon transplantacije srca
Title (english)Intensive care management of patients after heart transplantation
AuthorPetra Čepić
MentorSanja Konosić (mentor)
Committee memberSlobodan Mihaljević (predsjednik povjerenstva)
Committee memberDinko Tonković (član povjerenstva)
Committee memberSanja Konosić (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities)
Zagreb
Defense date and country2023-07-13, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Anesthesiology and Reanimatology
Abstract
Transplantacija srca je metoda liječenja pacijenata s terminalnim srčanim zatajenjem čije je očekivano trajanje života manje od godinu dana. Godišnje se u svijetu transplantira preko 5500 srca, s preživljenjem od 91% u prvoj godini nakon operacije i ukupnim medijanom preživljenja 12 godina (1). Mortalitetni rizik za pacijenta najveći je neposredno nakon transplantacije, za vrijeme boravka u jedinici intenzivne njege. Iako je poslijeoperativna skrb za sve pacijente nakon kardiokirurške operacije slična, postoje određene posebitosti i komplikacije kod zbrinjavanja primaoca srčanog presatka. Nakon transplantacije srca očekivana je određena mjera hemodinamske nestabilnosti. Nužna je optimizacija pacijentovog predopterećenja, naknadnog opterećenja i kontraktilnosti kako bi se postigla optimalna srčana funkcija i izbjeglo primarno zatajenje presatka. Farmakološka potpora uključuje inotrope za održavanje kontraktilnosti i funkcije miokarda, koloidnu i kristaloidnu nadoknadu volumena, optimizaciju diureze i vazopresore za podizanje naknadnog opterećenja i održavanje srednjeg arterijskog tlaka u fiziološkom rasponu. U ovom radu opisane su navedene smjernice za održavanje funkcije presađenog srca, strategije imunosupresije, te osvrt na najčešće komplikacije za vrijeme boravka u jedinici intenzivne njege.
Abstract (english)
Heart transplantation is a therapy method for patients with end-stage heart failure whose life expectancy is less than one year. Over 5,500 hearts are transplanted annually in the world, with a survival rate of 91% in the first year after surgery and an overall median survival of 12 years (1). The main mortality risk for the patient is immediately after transplantation, during the stay in the intensive care unit. Although postoperative care for all patients after cardiac surgery is similar, there are certain peculiarities and complications in the care of post-transplant patients. Certain measure of hemodynamic instability is expected after heart transplantation. Optimization of the patient's preload, afterload, and contractility is necessary to achieve optimal cardiac function and avoid primary graft failure. Pharmacological support includes inotropes to maintain myocardial contractility and function, colloidal and crystalloid volume replacement, diuresis optimization, and vasopressors to increase afterload and maintain mean arterial pressure in the physiological range. This paper describes the guidelines for maintaining the function of a transplanted heart, immunosuppression strategies, and a review of the most common complications during a stay in the intensive care unit.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:265210
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-10-23 12:51:06