Hiperoksemija u liječenju teške ozljede mozga

master's thesis

• Title (english): Hyperoxaemia in the treatment of traumatic brain injury
• Author: Ivan Majdandžić
• Mentor: Ante Sekulić (mentor)
• Committee member: Mladen Perić (predsjednik povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Committee member: Ante Sekulić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Traumatska ozljeda mozga je tjelesna ozljeda moždanog tkiva koja privremeno ili trajno oštećuje moždanu funkciju. Traume mozga imaju relativno lošu prognozu i takvi pacijenti često imaju smanjenu radnu sposobnost te mogu ostati privremeno ili trajno onesposobljeni. Takve ozljede predstavljaju značajan javnozdravstveni problem jer čak i lakše ozljede mozga mogu dovesti do trajnih neuropsiholoških poremećaja koji će potencijalno utjecati na radnu sposobnost i kvalitetu života. Traumatska ozljeda mozga se može podijeliti u dvije faze, primarnu i sekundarnu. Primarna ozljeda rezultat je neposrednog djelovanja mehaničke sile na glavu i moždane strukture. Razvoj sekundarne ozljede počinje nakon nastanka primarne i traje nekoliko dana. Kroz taj period se oštećenje povećava te je od vitalne važnosti pokušati smanjiti opseg zahvaćenog tkiva. Hiperoksija je veća količina kisika u tkivima od uobičajne, uzrokovana povećanom opskrbom ili povećanim sadržajem kisika u arterijskog krvi. Može se postići u normobaričnim i hiperbaričnim uvjetima. Normobarična hiperoksija se ostvaruje u uvjetima atmosferskog, a hiperbarična se postiže pri tlaka koji je veći od atmosferskog. U liječenju traumatske ozljede mozga su glavni ciljevi očuvanje funkcije mozga i smanjenje opsega oštećenja tkiva. Najveću važnost, uz kontrolu ICP-a, ima održavanje odgovarajuće perfuzije tkiva i osiguravanje aerobnog metabolizma. Istraživanja su pokazala da hiperoksija dovodi do poboljšane oksigenacije i povećanja aerobnog metabolizma ozlijeđenog tkiva. Potrebna su daljnja istraživanja ovog područja kako bi se jasno odredile skupine pacijenata kod kojih se preporuča terapija hiperoksijom.

Abstract (english)

Traumatic brain injury is an injury which can temporarily or permanently damage the brain function. Brain trauma has a relatively poor prognosis and such patients will often have reduced work ability and a high possibility to stay temporarily or permanently disabled. That is why such injuries are a major public health issue since even less severe brain injuries can result in permanent neuropsychological disorders that affect work ability and quality of life. Traumatic injury can be divided into two phases, primary and secondary. Primary injury is the result of the mechanical force that acts upon the head and brain structures. The development of secondary injury begins after the emergence of the primary and lasts for several days. During this period the damage increases and it is of vital importance to try to reduce the extent of the damage to the affected tissue. Hyperoxia is defined as a greater than normal oxygen percent in the tissues and organs, caused by increased delivery of oxygen or increased percentage o fit in the arterial blood. It can be achieved in normobaric and hyperbaric conditions. Normobaric hyperoxia is achieved under atmospheric conditions, whereas hyperbaric is achieved at pressures higher than atmospheric.
In the treatment of traumatic brain injury, the main goal is to preserve brain function and reduce the extent of tissue damage. Most important thing is, except ICP control, to maintain proper tissue perfusion and to provide aerobic metabolism. Studies have shown that hyperoxia leads to improved oxygenation and increased aerobic metabolism of injured tissue. In conclusion, further research in this area is needed in order to clearly identify groups of patients that should be recommended for hyperoxia treatment.

• Keywords: hiperoksija; neuroanestezija; traumatska ozljeda mozga; neurokirurgija
• Keywords (english): hyperoxia; neuroanesthesia; traumatic brain injury; neurosurgery
• Language: croatian
• URN:NBN: urn:nbn:hr:105:811481
• 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: 2020-01-27 14:50:07