Skrb nakon reanimacijskog postupka kod kardiokirurških bolesnika

master's thesis

• Title (english): Post-resuscitation care in cardiac patients
• Author: Andrea Vukša
• Mentor: Bojan Biočina (mentor)
• Committee member: Višnja Ivančan (predsjednik povjerenstva)
• Committee member: Hrvoje Gašparović (član povjerenstva)
• Committee member: Bojan Biočina (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2020-11-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Kardiovaskularne bolesti, kao vodeći uzrok smrtnosti u svijetu, često zahtjevaju kirurško
liječenje i dovode do kritičnih stanja kardijalnog aresta i reanimacije. Temeljni postupci
oživljavanja imaju jasne smjernice i algoritme verficirane od strane Europskog vijeća za
reanimaciju. One uključuju provjeru stanja svijesti, otvaranje dišnog puta i umjetno disanje,
vanjsku masaža srca te korištenje defibrilatora ili automatskog vanjskog defibrilatora. Za
uspješan ishod liječenja kod reanimacijskog postupka bitno je rano prepoznati i pozvati pomoć,
rano započeti kardiopulmonalnu reanimaciju, rano izvršiti defibrilaciju ukoliko je potrebno, te
kvalitetno obaviti postreanimacijsku skrb. Liječenje kardijalnog aresta nakon operacije srca traži
poseban, individualizirani pristup. Ključne razlike su izbjegavanje vanjskih kompresija prsnog
koša, doza adrenalina nakon tri šoka defibrilatorom i potreba za hitnom resternotomijom. Kod
bolesnika nakon velikog zahvata na srcu ključ uspješne reanimacije jest prepoznavanje potrebe
za hitnom resternotomijom, osobito u kontekstu tamponade ili krvarenja. Reanimacija, osim što
je jedno od stresnih stanja u medicini, ima i svoje etičke dileme koje je važno poštovati.
Postreanimacijska skrb za bolesnika podrazumjeva njegu u jedinici intenzivnog liječenja, te
zahtjeva dijagnostiku i terapiju. Stručni multidisciplinarni pristup te zdravstveno osoblje koje je
visoko educirano o naprednom održavanju života znači visoku kvalitetu zdravstvene njege i
skrbi za kritičnog bolesnika.

Abstract (english)

Cardiovasular diesases, as main cause of mortality in the world, often require surgical treatment
and lead to critical conditions of cardiac arrest and resuscitation. Basic life support procedures
have clear guidelines and algorithms verifed by European resuscitation council. They include
assessing the level of consciousness, opening up airways, providing artificial ventilation and
outside chest compressions and using a defibrillator or automatic external defibrillator. For a
successful outcome in resuscitation is important to early recognition and recall of a resuscitation
team, early cardiopulmonary resuscitation, early defibrillation if it's necessary and do quality
post-resuscitation care. Treatment of cardiac arrest after heart surgery requires a special,
individualized approach. The key differences are the avoidance of external chest compressions,
the dose of adrenaline after three defibrillator shocks, and the need for emergency resternotomy.
In patients after major heart surgery, the key to successful resuscitation is to recognize the need
for emergency resternotomy, especially in the context of tamponade or bleeding. Resuscitation,
in addition to being one of the stressful conditions in medicine, also has its ethical dilemmas,
which are important to respect. Post-resuscitation care for the patient implies care in the
intensive care unit, and requires diagnosis and therapy. A professional multidisciplinary
approach and health care staff who are highly educated on advanced life support means a high
quality of health care and care for the critical patient.

• Keywords: postreanimacijska skrb; kardijalni arest; kardiopulmonalna reanimacija; kardiokirurški bolesnik; intenzivna njega
• Keywords (english): post-resuscitation care; cardiac arrest; cardiopulmonary resuscitation; cardiac patient; intensive care
• Language: croatian
• URN:NBN: urn:nbn:hr:105:310011
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-14 14:22:53