Komplikacije strojne ventilacije pluća u neurokirurških bolesnika

master's thesis

• Title (english): Complications of mechanical lung ventilation in neurosurgical patients
• Author: Ana Herceg
• 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: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Strojna ventilacija pluća medicinski je postupak čija primjena je indicirana kod svih bolesnika koji nisu u mogućnosti samostalno disati i time osigurati adekvatnu izmjenu plinova. Ovisno o prisutnosti endotrahealnog tubusa, strojnu ventilaciju pluća dijelimo na
neinvazivnu i invazivnu, dok se prema načinu prizvodnje inspiracijske sile dijeli na ventilaciju negativnim tlakom i ventilaciju pozitivnim tlakom. Iako se strojna ventilacija primjenjuje u kirurških i nekirurških bolesnika, otprilike 20% bolesnika kod kojih postoji potreba za umjetnom potporom disanju boluje od neuroloških ili neurokirurških bolesti. Činjenica je da strojna ventilacija pluća spašava život nekirurškim pacijentima u akutnoj respiratornoj insuficijenciji, ali istovremeno nosi sa sobom i brojne komplikacije, koje mogu dodatno narušiti stanje tih pacijenata, a time i povećati vjerojatnost smrtnog ishoda. Uz značajan utjecaj na pluća i mogućnost razvoja akutne ozljede pluća poznate pod skraćenicom VILI (eng. Ventilator Induced Lung Injury), ali i drugih plućnih komplikacija poput ventilatorom uzrokovane pneumonije, strojna ventilacija utječe i na druge organske sustave te povećava sklonost krvarenju iz gastrointestinalnog trakta, uzrokuje pad srčanog minutnog volumena, smanjuje produkciju urina, dovodi do promjena u acidobaznoj ravnoteži i dr. Nadalje, kod neurokirurških pacijenata značajan je utjecaj strojne ventilacije na perfuziju mozga, na promjene u intrakranijalnom tlaku, pa i utjecaju na kognitivne promjene. Iako su brojne, komplikacije strojne ventilacije pluća važno je poznavati i na vrijeme prepoznati jer su potencijalno preventabilne i lječive.

Abstract (english)

Mechanical ventilation is a medical intervention indicated in patients who are not able to breathe on their own and maintain adequate gas exchange in the lungs. Mechanical ventilation can be non-invasive or invasive, depending on whether or not endotracheal tube is used,while according to the pressure used to deliver air into the lungs can be divided into negative pressure ventilation and positive pressure ventilation. Although mechanical ventilation is used in both, nonsurgical and surgical patients, approximately 20% of all patients requiring mechanical ventilation suffer from neurological or neurosurgical conditions. Mechanical ventilation is a lifesaving procedure for nonsurgical patients with acute respiratory failure, but it can also lead to numerous complications that can worsen patient’s condition and also increase the mortality rate. Acute lung injury known as ventilator induced lung injury (VILI) is a common lung complication of mechanical ventilation. However, there are a lot more, such as ventilator associated pneumonia, etc. Mechanical ventilation can also affect other organ systems and lead to greater risk for gastrointestinal bleeding, decrease in cardiac output, decrease in urine output as well as acid base disorders. Moreover, in neurosurgical patients, mechanical ventilation has an impact on brain perfusion, changes of intracranial pressure and even on cognitive functions. It is important be aware of complications of mechanical ventilation and recognize them, since
they are potentially preventable and treatable.

• Keywords: strojna ventilacija; respiratorna insuficijencija; neurokirurški bolesnici; komplikacije strojne ventilacije
• Keywords (english): mechanical ventilation; respiratory insufficiency; neurosurgical patients; complications of mechanical ventilation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:995133
• 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: 2022-02-03 13:29:42