Imunizacija djece s kongenitalnim srčanim grješkama – klinički i kritički osvrt

Professional paper - Professional paper

• Title (english): Immunisation of children with congenital heart defects – clinical and critical overview
• Author: Matej Katavić
• Author: Daniel Dilber
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Numeruous scientific articles indicate the benefit of immunisation when dealing with children with congenital heart defects. High possibility of gaining infections can be related to compromised cardiopulmonary status, changed pressures in pulmonary circulation (including pulmonary hypertension) as well as ventilation-perfusion mismatch. Many children with heart anomalies within heterotaxy syndrome have functional hyposplenism with high susceptibilty to infections. Children with chromosomopathies and many other syndromes have a high frequency of immunodeficiency states of various intensity, alongside hemodynamically significant, often complex heart defects and numerous anomalies of other organs. Cardiopulmonary bypass and ECMO device are inevitably used for operative corrections and palliative procedures, however, main issue is their tendency to decrease the circulating antibodies that have occurred during active immunisation, thereby compromising the acquired immune system. Protecting such patients by systematic immunisation of children and their family members should be the main interest of scientific community. This paper gives a systematic overview of the above mentioned controversy.

Abstract (croatian)

Brojni znanstveni radovi upućuju na dobrobit cijepljenja djece s prirođenim srčanim grješkama. Povišen rizik od razvoja infekcija povezuje se s kompromitiranim kardiopulmonalnim statusom, promijenjenim tlakovima u plućnoj cirkulaciji (uključujući plućnu hipertenziju) te poremećajima ventilacije i perfuzije. Brojne srčane malformacije u sklopu sindroma heterotaksije u svojoj osnovi imaju funkcionalnu hipospleniju s pojačanom sklonošću za razvoj infekcija. Kromosomopatije, genomopatije i genopatije često su udružene s hemodinamski važnim srčanim grješkama i prirođenim poremećajima imunosti i/ili malformacijama drugih organa koje pogoduju nastanku infektivnih bolesti. Velik dio prirođenih srčanih grješaka nalaže kardiokirurško liječenje operacijom na otvorenom srcu uz uporabu ekstrakorporalne cirkulacije ili je ona nužna za liječenje sindroma smanjenoga srčanog izbačaja, čime se snižava razina cirkulirajućih protutijela prije nastalih tijekom aktivne imunizacije. Slijedom navedenoga, u današnjoj medicinskoj znanosti nezaobilaznu ulogu u zaštiti takvih bolesnika ima sustavno procjepljivanje dodatnim cjepivima i oboljele djece i članova njihovih obitelji. Ovaj rad daje sustavni pregled navedene problematike.

• Language: croatian
• Publication type: Professional paper - Professional paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Liječnički vjesnik
• Numbering: vol. 140, no. 1-2, pp. 24-34
• p-ISSN: 0024-3477
• DOI: https://doi.org/10.26800/LV-140-1-2-4
• URN:NBN: urn:nbn:hr:105:349718
• Publication: 2018-01
• Document URL: https://hrcak.srce.hr/file/296018
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 09:44:13