Ljestvice za procjenu dubine kome

master's thesis

• Title (english): Scales for assessment of coma severity
• Author: Lucija Klobučar
• Mentor: Ante Sekulić (mentor)
• Committee member: Slobodan Mihaljević (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: 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

Poremećaji svijesti česta su pojava kod bolesnika u hitnim službama i jedinicama intenzivnog liječenja. U svakodnevnom se govoru, pojmovi koma i poremećaj svijesti koriste kao istoznačnice, no koma je samo krajnja kategorija u spektru poremećaja svijesti. Osim kome, drugi poremećaji svijesti, koji su detaljnije objašnjeni u ovom radu, su minimalno svjesno stanje (engl. minimally conscious state, MCS), vegetativno stanje (engl. vegetative state, VS) i locked-in sindrom. Radi standardizacije procjene stanja svijesti kod tih bolesnika, olakšanja komunikacije među zdravstvenim osobljem i praćenja neurološkog oporavka bolesnika, razni autori i radne skupine stvaraju ocjenske ljestvice koje pomažu u tim postupcima. Iako su ocjenske ljestvice za procjenu stupnja poremećaja svijesti neizravni način procjene stanja svijesti, još uvijek predstavljaju zlatni standard u svakodnevnom kliničkom radu. Od svih ocjenskih ljestvica za procjenu stupnja poremećaja svijesti, najpoznatija je i najviše korištena Glasgowska ljestvica kome (engl. Glasgow Coma Scale, GCS). Osim nje, u ovom su radu prikazane i Full Outline of UnResponsiveness Score (FOUR), The Swedish Reaction Level Scale-1985 (RLS85), Japanska ljestvica kome (engl. Japan Coma Scale, JCS) i Coma Recovery Scale-Revised (CRS-R). Napretkom tehnologije javljaju se funkcionalne metode oslikavanja mozga kao novi, sofisticirani način procjene stanja svijesti. Njihovo korištenje u ovim indikacijama još je uvijek skupo i zahtijeva daljnja istraživanja, no omogućilo bi precizniju procjenu stanja svijesti, pa čak i mogućnost komunikacije s ovim bolesnicima.

Abstract (english)

Disorders of consciousness are commonly seen in patients in emergency departments and intensive care units. In everyday speech, the terms coma and disorder of consciousness are used interchangeably, but coma is only the final category in the spectrum of these disorders. Besides coma, other consciousness disorders that are presented in this paper are minimally conscious state (MCS), vegetative state (VS) and locked-in syndrome. In order to standardize the approach to evaluation and monitoring of patients with altered levels of consciousness and improve the communication among health workers, different authors and task forces have developed assessment scales for disorders of consciousness. Although these scales present only an indirect method to evaluate the levels of consciousness, they are still the gold standard in everyday clinical work. Among all assessment scales for disorders of consciousness, the best known and the most used one is the Glasgow Coma Scale (GCS). In addition to the GCS, this paper includes explanations of Full Outline of UnResponsiveness Score (FOUR), The Swedish Reaction Level Scale-1985 (RLS85), Japan Coma Scale (JCS) and Coma Recovery Scale-Revised (CRS-R). Improvement of technology leads to development of neuroimaging techniques which present new, sophisticated methods for the assessment of consciousness. Their use in these indications is still expensive and requires further research, but in the future it could also provide more precise ways to evaluate the level of consciousness and provide a possibility of communication with the affected patients.

• Keywords: svijest; poremećaji svijesti; koma; ocjenske ljestvice; Glasgow Coma Scale
• Keywords (english): consciousness; consciousness disorder; coma; assessment scales; Glasgow Coma Scale
• Language: croatian
• URN:NBN: urn:nbn:hr:105:519603
• 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: 2019-01-03 13:16:02