Procjena prijeanestezijskog rizika u djece

master's thesis

• Title (english): Assessment of preoperative risk in children
• Author: Ivana Bureš
• Mentor: Ljiljana Popović (mentor)
• Committee member: Božidar Župančić (predsjednik povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Committee member: Ljiljana Popović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Prijeoperacijska procjena zdravstvenog stanja bolesnika neizostavni je dio planiranja svakog zahvata pri kojemu se bolesnik podvrgava anesteziji. Klasifikacija fizikalnog statusa bolesnika Američkog društva anesteziologa - poznata kao ASA klasifikacija, danas se rutinski rabi za procjenu rizika anestezije i perioperacijske smrtnosti bolesnika predviđenih za operacijski zahvat. S obzirom na nedostatke ASA statusa kao prediktora perioperacijskog rizika u djece, postoje pokušaji razvoja novih sustava procjene rizika i smjernica prijeanestezijske obrade specifičnih u djece. Ukratko su prikazana dva nova alata za procjenu prijeanestezijskog rizika u djece: „PRAm“ bodovni sustav (Pediatric Risk Assessment score) i sustav „NARCO-SS“ (engl. neurological, airway, respiratory, cardiovascular, other-surgical severity). Već u prvim evaluacijama „NARCO-SS“ sustav pokazao se kao preciznija mjera procjene perioperacijskog rizika u djece u odnosu na ASA status. Cilj rada je bio utemeljiti vrijednost postojećih smjernica u djece. Prikazan je algoritam i posebnosti anesteziološkog pregleda u djece s naglaskom na identifikaciju rizičnih čimbenika koji bi mogli utjecati na komplikacije tijekom anestezije i neposredno nakon nje. Pažljiva procjena rizika temelj je za oblikovanje plana intraoperacijske skrbi o djetetu, oporavka nakon anestezije i kontrole boli u perioperacijskom periodu. O dobroj prijeoperacijskoj procjeni rizika ovisi sigurnost i uspjeh anesteziološkog postupka.

Abstract (english)

The preoperative assessment of the patient's health status is an indispensable part of planning any procedure where the patient is undergoing anesthesia. The American Society of Anesthesiologists' Physical Status classification – known as ASA PS classification - is routinely used today to assess the risks of anesthesia and perioperative mortality of patients undergoing surgery. Given the imperfections of ASA status as a predictor of perioperative risk in children, there are attempts to develop new risk assessment systems and guidelines specific to children. Two novel tools for assessing the preanesthetic risk in children are briefly presented: Pediatric Risk Assessment (PRAm) score and ''NARCO-SS'' (neurological, airway, respiratory, cardiovascular, other – surgical severity) score. Already in the first evaluations, the "NARCO-SS" system has proven to be a more precise measure of perioperative risk in children compared to the ASA status. Finally, the aim of this paper was to establish the value of the current guidelines in assessing the preoperative risk in children. The algorithm and the specificity of the preanesthesia evaluation process in children with an emphasis on identifying risk factors that could affect complications during and immediately after anesthesia are presented. Careful risk assessment is the basis for designing a plan for intraoperative child care, recovery after anesthesia, and perioperative pain management. Safety and success of the anesthetic procedure depends on valid preoperative risk assessment.

• Keywords: dječja anesteziologija; anesteziološki pregled; procjena rizika; djeca
• Keywords (english): pediatric anesthesia; preanesthesia evaluation; risk assessment; children
• Language: croatian
• URN:NBN: urn:nbn:hr:105:477972
• 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: 2017-11-13 09:01:45