Zbrinjavanje masivnog krvarenja kod politraume

master's thesis

• Title (english): Management of massive bleeding in polytrauma
• Author: Helena Goršić
• Mentor: Mladen Perić (mentor)
• Committee member: Slobodan Mihaljević (predsjednik povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Committee member: Mladen Perić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Politrauma podrazumijeva istovremene ozljede dvije ili više regija tijela, koje gotovo uvijek predstavljaju životno ugrožavajuće stanje. Najčešći je uzrok smrti u osoba između pete i četrdeset pete godine života i jedan od vodećih uzroka smrti u svijetu. Većina smrti u politraumi događa se unutar 24 sata od ozljede, a jedan od najčešćih uzroka je masivno krvarenje. Masivnim krvarenjem naziva se gubitak cijelog volumena krvi unutar 24 sata s posljedičnim razvitkom hipovolemijskog šoka. Gubitak velikog volumena krvi u kombinaciji s prirodom i težinom ozljeda potiču snažan upalni odgovor ozlijeđenog. Nastale višestruke hormonske, imunosne i metaboličke promjene često izazivaju nepovratnu štetu organa i loš ishod liječenja. Hipovolemijski šok odgovoran je za 40% smrti povezanih s ozljedama prilikom politraume. Rano prepoznavanje masivnog krvarenja i pravovremena i ispravna nadoknada volumena su najbolja prilika za smanjenje ukupnog mortaliteta politraumatiziranih bolesnika. U ovom radu su sažeto opisane osnovne značajke politraume i masivnog krvarenja te su prikazane suvremene spoznaje o zbrinjavanju istih. U drugom dijelu iznesen je prikaz slučaja bolesnika s masivnim krvarenjem kod politraume.

Abstract (english)

Polytrauma includes simultaneous injuries to two or more regions of the body, which almost always represent a life-threatening condition. It is the most common cause of death in people between five and forty-five years of age and one of the leading causes of death in the world. Most of the deaths during polytrauma occur within 24 hours of the injury, and one of the most common causes is massive bleeding. Massive bleeding is a medical term describing the loss of the entire blood volume within 24 hours with the consequent development of hypovolemic shock. The loss of large amounts of blood in combination with the characteristics and severity of the injuries causes a strong inflammatory response. The resulting multiple hormonal, immune and metabolic changes often cause irreversible organ damage and a poor treatment outcome. Hypovolemic shock is responsible for 40% of deaths associated with injuries in polytrauma. Early recognition of massive bleeding and timely and correct volume replacement is the best opportunity to reduce the overall mortality of polytraumatized patients. This paper summarizes the basic features of polytrauma and massive bleeding and presents modern knowledge about how to manage them. In the second part it presents a case report of acute massive bleeding during polytrauma.

• Keywords: politrauma; masivno krvarenje
• Keywords (english): polytrauma; massive bleeding
• Language: croatian
• URN:NBN: urn:nbn:hr:105:474293
• 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
• Created on: 2019-01-02 08:22:48