Nadoknada krvnih pripravaka u perioperacijskom razdoblju

master's thesis

• Title (english): Blood transfusion in the perioperative period
• Author: Mark Žižak
• Mentor: DINKO TONKOVIĆ (mentor)
• Committee member: Mladen Perić (predsjednik povjerenstva)
• Committee member: Slobodan Mihaljević (član povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Osnovna je funkcija krvi opskrba tkiva kisikom i hranjivim tvarima, kao i odstranjivanje ugljičnog dioksida i svih metaboličkih produkata. Transfuzija krvi je proces prenošenja krvi ili krvnih produkata iz krvnog sustava jedne osobe u krvni sustav druge osobe. Puna krv se danas rijetko upotrebljava za transfuziju, a pacijentima se daju samo oni krvni sastojci koji im nedostaju kao npr. koncentrat eritrocita ili trombocita. Transfuzijsko liječenje preduvjet je mnogih medicinskih intervencija i kirurških zahvata u liječenju i spašavanju života. Iako je transfuzija ponekad neophodna, ona može uzrokovati ozbiljne nuspojave. Najznačajnije su imunološke reakcije i infekcije. Stoga bi transfuzija krvi i krvnih pripravaka trebala biti optimalna i učinkovita. Glavni razlozi za transfuziju krvi u perioperacijskom razdoblju su ispravak anemije i poboljšanje tkivne oksigenacije. Pojam transfuzijskog okidača odnosi se na laboratorijske vrijednosti hemoglobina ili hematokrita pri kojima je u većine pacijenata potrebna transfuzija koncentriranih eritrocita. Restriktivan pristup transfuzije koncentrata eritorocita pokazao se sigurnim u raznim vrstama operacija te u pacijenata na intenzivnom liječenju. Izbjegavanje nepotrebnih i neadekvatnih transfuzija bitno je zbog zaštite pacijenata ali i racionalne uporabe smanjenih zaliha krvi koje moraju zadovoljiti rastuće potrebe sve starije populacije. Klinička procjena, a ne samo laboratorijske vrijednosti krvnih parametara, trebala bi biti najvažniji faktor u odluci o transfuzijskom liječenju.

Abstract (english)

The primary function of blood is to deliver oxygen and nutrients and remove carbon dioxide and metabolic wastes from the body cells. Blood transfusion is the transfer of blood or blood components from one person who is the donor into the bloodstream of another person who is the recipient. Whole blood is now rarely used for transfusion and patients are given only specific blood components they require, such as red blood cells or platelets. Blood transfusion can be lifesaving and is a key component of many modern surgical and medical interventions. Although blood transfusion is sometimes inevitable, it can cause serious side effects. Most important are immunological reactions and infections. Therefore, transfusion of blood and blood components should be optimal and effective. Main indications for blood transfusion in the perioperative period are correction of anemia and improvement of tissue oxygenation. Transfusion trigger refers to hemoglobin or hematocrit laboratory levels at which most patients require red blood cell transfusion. Restrictive red cell transfusion strategies are safe in a wide variety of surgeries and in critical care patients. Avoiding unnecessary and inappropriate transfusions is both good for patients and essential to ensure blood supplies meet the increasing demands of an ageing population. Clinical assessment, rather than laboratory test results, should be the most important factor in the decision to transfuse.

• Keywords: transfuzija; krvni pripravci; hemoglobin; transfuzijski okidači
• Keywords (english): transfusion; blood components; hemoglobin; transfusion triggers
• Language: croatian
• URN:NBN: urn:nbn:hr:105:432722
• 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: 2020-04-29 12:17:19