Title Hitna stanja u pulmologiji Title (english) Pulmonary emergencies Author Martina Gasparini Mentor Marija Gomerčić Palčić (mentor)Committee member Mateja Janković Makek (predsjednik povjerenstva)Committee member Marko Jakopović (član povjerenstva)Committee member Marija Gomerčić Palčić (član povjerenstva)Granter University of Zagreb Defense date and country 2022-07-15, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Najčešća hitna, životno ugrožavajuća stanja u pulmologiji su: egzacerbacija kronične opstruktivne plućne bolesti, egzacerbacija astme, plućna embolija, pleuralni izljev i pneumotoraks. Iako su im patogenetski mehanizmi, uzroci i modaliteti liječenja različiti svi se mogu prezentirati naglo nastalom zaduhom odnosno respiratornom insuficijencijom koja zahtijeva promptno postavljanje dijagnoze i liječenje jer u protivnom može doći do smrti.
Egzacerbacija kronične opstruktivne plućne bolesti je često hitno stanje, a definira se kao pogoršanje respiratornih simptoma koje zahtijeva dodatnu terapiju koja uključuje oksigenoterapiju, bronhodilatatore, sistemske kortikosteroide i antibiotike ako postoji indikacija. Cilj liječenja je prevencija egzacerbacija čiji su najčešći uzrok respiratorne infekcije. Težina egzacerbacije varira od blage do teške, a svaka dovodi do dodatnog narušavanja plućne funkcije i povećanja rizika od recidiva.
Egzacerbaciju astme karakterizira brzo i progresivno pogoršanje simptoma bolesti, a težina egzacerbacije varira od blage do životno ugrožavajuće. Ona zahtijeva hitnu intervenciju koja podrazumijeva ponavljanu primjenu inhalacijskih bronhodilatatora brzog djelovanja i sistemskih kortikosteroida uz kontroliranu oksigenoterapiju, a cilj liječenja je ublažiti stupanj bronhoopstrukcije i korigirati hipoksemiju u što kraćem vremenskom periodu.
Plućna embolija uglavnom nastaje kao posljedica embolizacije tromba iz duboke vene donjeg ekstremiteta koji dospije u plućnu cirkulaciju. Terapijske opcije su brojne, ali temelj je antikoagulantna terapija.
Pleuralni izljev je stanje koje može uzrokovati postepeno ili naglo nastalu zaduhu s posljedičnom respiratornom insuficijencijom čime je indicirana neodgodiva torakodrenaža koja može biti jednokratna ili dugotrajna putem torakalnog drena.
Pneumotoraks je naziv za stanje kojem je u podlozi zrak u pleuralnom prostoru nastao spontano zbog rupture bule, kao komplikacija druge plućne bolesti, medicinskih zahvata ili traumatski. Postoji više terapijskih pristupa i metoda liječenja, ali temelj je torakodrenaža nakupine zraka sa ciljem olakšavanja simptoma i promptnog rješavanja respiracijske insuficijencije.
Abstract (english) The most common, potentially life-threatening pulmonary emergencies are: exacerbation of chronic obstructive pulmonary disease, asthma exacerbation, pulmonary embolism, pleural effusion and pneumothorax. Although their pathogenetic mechanisms, causes and treatment modalities are different, they can all present by sudden onset of dyspnea or respiratory failure, which requires prompt diagnosis and treatment to prevent lethal outcome.
An exacerbation of chronic obstructive lung disease is a common emergency and is defined as an acute worsening of respiratory symptoms which requires additional therapy including supportive oxygen therapy, bronchodilators, inhaled or intravenous corticosteroids and antibiotics if indicated. The goal of treatment is to prevent exacerbations that are mostly induced by infections. The severity of the exacerbation varies from mild to severe, and every exacerbation leads to additional lung function impairment and increased risk of recurrence.
Asthma exacerbations are characterized by a progressive increase of symptoms, and the severity of exacerbation varies from mild to life-threatening. It requires prompt intervention with the repeated doses of short-acting inhaled bronchodilators, systemic corticosteroids and controlled oxygen therapy. The aim of asthma exacerbation management is to rapidly relieve airway obstruction and hypoxemia.
Pulmonary embolism is usually caused by thrombus embolization from the deep vein of the lower limb that enters the pulmonary circulation. There are many treatment options, but the main one is anticoagulant therapy.
Pleural effusion is a condition that can cause gradual or sudden dyspnea with consequent respiratory failure indicating immediate thoracic drainage which may be short-term or long-term via chest tube/catheter thoracostomy.
Pneumothorax is defined as a gas in the pleural space derived from the spontaneous bulla rupture, due to a complication of underlying lung disease, medical procedures, or a chest trauma. There are many therapeutic approaches and treatment methods, but the most important one is chest drainage with the aim of symptoms improvement and prompt respiratory failure resolving.
Keywords
egzacerbacija kronične opstruktivne plućne bolesti
egzacerbacija astme
plućna embolija
pleuralni izljev
pneumotoraks
Keywords (english)
exacerbation of chronic obstructive lung disease
asthma exacerbation
pulmonary embolism
pleural effusion
pneumothorax
Language croatian URN:NBN urn:nbn:hr:105:035885 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-01-09 08:42:00
