Intenzivno liječenje pacijenta s ozljedom mozga

master's thesis

• Title (english): ICU treatment of patients with brain injury
• Author: Daria Sarić
• 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: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Traumatska ozljeda mozga (TOM) jedan je od važnijih zdravstvenih problema u Hrvatskoj. TOM nastaje djelovanjem mehaničke sile, najčešće kao posljedica pada, prometne nesreće, nasilja ili sportske ozljede. Godišnje u Europi od TOM-a strada više od 1.5 milijuna ljudi, a umre ih oko 57000. U Hrvatskoj strada otprilike 8700 ljudi, a umre ih oko 560. Pogođeni su uglavnom mlađi muškarci, ali sve više stradavaju i starije osobe. Oštećenje koje nastaje kao posljedica TOM-a dijeli se na primarnu i sekundarnu ozljedu. Primarna ozljeda nastaje kada zbog sila akceleracije i deceleracije dolazi do samog fizičkog oštećenja mozga. Puno veću štetu uzrokuje sekundarna ozljeda kada se razvijaju brojni patofiziološki mehanizmi koji dodatno uzrokuju oštećenje moždanog tkiva. Sekundarna ozljeda se može razviti i do nekoliko dana nakon ozljede i cilj liječenja je spriječavanje njenog nastanka. Liječenje započinje ranom procjenom općeg i neurološkog statusa. Zbrinjavanje pacijenta najprije treba usmjeriti zbrinjavanju stanja opasnih po život, poput prohodnosti dišnog puta te potpore disanju i cirkulaciji. Nakon početnog zbrinjavanja potrebno je poduzeti specifične mjere liječenja, posebice za smanjenje intrakranijskog tlaka, kako bi se spriječio nastanak neželjenih komplikacija. Djelovanje liječenja trebalo bi pratiti cijelo vrijeme korištenjem metoda neuromonitoringa. Uz smjernicama propisane postupke, nova istraživanja svakodnevno predlažu nove metode liječenja pacijenata s traumatskom ozljedom mozga. Kako njihovo djelovanje još nije u potpunosti istraženo, zasada se koriste samo kao eksperimentalne metode koje bi mogle ući u uporabu u budućnosti, ako se uistinu pokažu korisnima.

Abstract (english)

Traumatic brain injury (TBI) is one of the more important health issues in Croatia. TBI develops as a result of a mechanical force trauma, usually caused by a fall, traffic accident, assault or a sports injury. More than 1.5 million people are affected by TBI in Europe on a yearly basis, and around 57000 die from it. In Croatia, around 8700 suffer from TBI, and some 560 die from it in one year. TBI usually affects young men, even though more and more elderly people are becoming a victim of it. The resulting damage of a TBI can be divided into primary and secondary injury. Primary injury is defined as physical damage of brain tissue caused by acceleration and deceleration forces. Numerous pathophysiological processes develop as a result of secondary injury and can cause additional damage to the brain. Secondary injury can occur minutes, hours or even days after the trauma so the main goal of treatment is to prevent it from happening. The treatment of TBI begins with the early assessment of the patient's general and neurological condition. Early treatment should be aimed towards taking care of life threatening conditions, such as airway, breathing and circulation. After the initial resuscitation management goals should be immediate treatment of secondary injury, especially increased intracranial pressure, and prevention of unwanted complications. Treatment results should be continuously assessed by using extensive neuromonitoring methods. New treatment methods are recommended because numerous researches are being conducted on a daily basis. Many of these treatments still have to be proven effective and can so far only be used as an experimental treatment. However, if they are really useful they can become very helpful in the future.

• Keywords: traumatska ozljeda mozga; intenzivno liječenje; neuromonitoring
• Keywords (english): traumatic brain injury; ICU treatment; neuromonitoring
• Language: croatian
• URN:NBN: urn:nbn:hr:105:051042
• 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: 2019-01-16 11:57:04