Mehanička ventilacijska potpora tijekom transporta bolesnika

master's thesis

• Title (english): Mechanical ventilation support during patient transport
• Author: Tara Golubić
• Mentor: Daniela Bandić Pavlović (mentor)
• Committee member: Slobodan Mihaljević (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Daniela Bandić Pavlović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2020-07-17, 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; Emergency Medicine

Abstract

Mehanička ventilacija medicinski je postupak kojim se omogućuje umjetna izmjena plinova u plućima kod pacijenata koji ne mogu samostalno održavati zadovoljavajuću ventilaciju i oksigenaciju. Suvremeni mehanički ventilatori rade na principu generiranja pozitivnog tlaka, a omogućuju tlačno ili volumno kontroliranu ventilaciju. Razlikujemo stacionarne ventilatore koji se nalaze u operacijskim dvoranama i JIL te transportne ventilatore koji se koriste za potrebe hitne medicinske službe. Mehanička ventilacijska potpora može se primijeniti neizvazivno pomoću kanila, maski ili respiratornih kaciga te invazivno uz postavljanje umjetnog dišnog puta. Indikacije za primjenu mehaničke ventilacije uključuju apneju, akutnu respiracijsku insuficijenciju, GCS ≤ 8, teške opekline glave i vrata te traumatsku ozljedu mozga. Pacijenti s navedenim stanjima često se inicijalno zbrinjavaju putem izvanbolničke hitne službe. Primjena transportnih ventilatora u takvih pacijenata omogućuje potporu disanju tijekom transporta, stabilizaciju vitalnih parametara i sprječavanje pogoršanja postojećeg stanja do konačnog zbrinjavanja u bolnici. Unutar bolnice, prijenosni ventilatori omogućuju transport vitalno ugroženih pacijenata na dodatne dijagnostičke pretrage. Mehanička ventilacija utječe na različite organske sustave i može dovesti do brojnih neželjenih posljedica, stoga je razumijevanje patofiziologije pojedinih bolesti i odabir modaliteta ventilacije ključno za sprječavanje komplikacija povezanih uz ventilaciju pozitivnim tlakom.

Abstract (english)

Mechanical ventilation is a medical procedure which enables artificial gas exchange in patients who cannot sustain adequate minute ventilation and oxygenation. Modern mechanical ventilators work by generating possitive pressure in the lungs during pressure or volume controlled ventilation. Stationary mechanical ventilators are used in operating rooms and intensive care units whereas portable mehcanical ventilators are used by prehospital emergency medicine providers. Mechanical respiratory support can be provided non-invasively via cannulas, masks or helmets or invasively by placing an artificial airway. Indications for mechanical ventilation support include apnea, acute respiratory failure, GCS ≤ 8, severe head and neck burns and traumatic brain injury. Such patients are often managed by prehospital emergency team first. Placing these patients on a portable ventilator enables respiratory support during transport, stabilization of vital parameters and prevention of further deterioration during transport until final care is provided in a hospital. Portable ventilators are used during intrahospital transport of a critically ill patient undergoing further diagnostic procedures. Mechanical ventilation affects different organ systems which can result in numerous complications. Understanding patophysiology behind every disease and selecting appropriate mode of ventilation for each patient can prevent or result in less complications associated with positive pressure ventilation.

• Keywords: mehanička ventilacija; transport; izvanbolnička hitna služba; akutna respiracijska insuficijencija; modaliteti ventilacije
• Keywords (english): mechanical ventilation; transport; prehospital emergency; acute respiratory failure; modes of ventilation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:656179
• 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: 2021-09-01 09:27:18