Anesteziološki pristup traumatskoj ozljedi mozga

master's thesis

• Title (english): Anesthesiological approach to traumatic brain injury
• Author: Hrvoje Jambrešić
• Mentor: Dinko Tonković (mentor)
• Committee member: Slobodan Mihaljević (predsjednik povjerenstva)
• Committee member: Daniela Bandić Pavlović (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: 2022-09-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Traumatska ozljeda mozga predstavlja izazovan problem za zdravstvo. Sama bolest
je još nedovoljno istražena, što otežava zbrinjavanje. Uz to, posljedice bolesti
pokazuju značajnu varijabilnost, od potpunog oporavka, preko dugotrajnih
posljedica, pa sve do smrtnog ishoda. Ukoliko dođe do kroničnih posljedica, sam
zdravstveni sustav se dodatno opterećuje troškovima dugotrajnog praćenja i
zbrinjavanja. Zbog toga je bitno da algoritmi zbrinjavanja budu što kvalitetniji, kako bi
ishodi liječenja traumatske ozljede mozga bili što je moguće bolji. Neki iskoraci su
već postignuti pomoću regulacije intrakranijalnog tlaka (ICP), što posljedično
povoljno utječe na cerebralni protok krvi (CBF) koji ima djelovanje na cerebralni
perfuzijski tlak (CPP) i u krajnjoj liniji na homeostazu mozga. Regulacije
intrakranijalnog tlaka se ostvaruje kroz više terapijskih postupaka koji se mogu
podijeliti na farmakološke, nefarmakološke, i kirurške. Farmakološki postupci se
sastoje od hiperosmolarne terapije, uporabe anestetika, analgetika i sedativa, te
profilakse infekcija, duboke venske tromboze i epileptičkih napadaja.
Nefarmakološke metode uključuju profilaktičku hipotermiju, drenažu cerebrospinalne
tekućine, ventilacijsku terapiju, te adekvatnu nutritivnu podršku. Kirurška terapija se
trenutno bazira na dekompresivnoj kraniektomiji. Sva ova područja su još uvijek
predmet rasprave i aktivnog istraživanja što daje nadu da će doći do novih otkrića i
poboljšanja terapije za pacijente.

Abstract (english)

Traumatic brain injury presents a challenging problem for healthcare. The disease
itself is still insufficiently researched, which makes treatment difficult. In addition, the
consequences of the disease show significant variability, from complete recovery,
through long-term consequences, and even death. If there are chronic
consequences, the healthcare system itself is additionally burdened with the costs of
long-term monitoring and treatment. For this reason, it is important that the care
algorithms are of the highest quality, so that the outcomes of the treatment of
traumatic brain injury are as good as possible. Some progress has already been
achieved by regulating intracranial pressure (ICP), which consequently favourably
affects cerebral blood flow (CBF) which has an effect on cerebral perfusion pressure
(CPP) and ultimately brain homeostasis. Regulation of intracranial pressure is
achieved through several therapeutic procedures that can be divided into
pharmacological, non-pharmacological and surgical. Pharmacological procedures
consist of hyperosmolar therapy, the use of anaesthetics, analgesics and sedatives,
as well as prophylaxis of infections, deep vein thrombosis and epileptic seizures.
Non-pharmacological methods include prophylactic hypothermia, cerebrospinal fluid
drainage, ventilation therapy, and adequate nutritional support. Surgical therapy is
currently based on decompressive craniectomy. All these areas are still the subject
of debate and active research, which gives hope for new discoveries and
improvements in therapy for patients.

• Keywords: TBI; CBF; CPP; ICP
• Keywords (english): TBI; CBF; CPP; ICP
• Language: croatian
• URN:NBN: urn:nbn:hr:105:550784
• 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: 2023-01-10 12:47:51