Intenzivno liječenje djeteta nakon kardiokirurškog zahvata

master's thesis

• Title (english): Intensive care of a child following cardiac surgery
• Author: David Miklenić
• Mentor: Sanja Konosić (mentor)
• Committee member: Slobodan Mihaljević (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Sanja Konosić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Prirođene bolesti srca (eng. congenital heart defect – CHD) obuhvaćaju poremećaje u građi i funkciji srca i velikih krvnih žila koji nastaju tijekom fetalnog razvoja. Radi se o jednim od najčešćih prirođenih defekata uopće. Procjenjuje se da je učestalost CHD-a oko 1 na 100 živorođene djece. Prirođene bolesti srca mogu promijeniti put i način kojim krv teče kroz srce, što značajno može narušiti hemodinamsku stabilnost djeteta već u najranijem razdoblju života. CHD mogu varirati od manjih i klinički beznačajnih pa sve do teških i životno ugrožavajućih poremećaja i defekata, a važnost toga naglašava činjenica da u prosjeku 1 od 4 djece s prirođenim srčanim greškama, ima takozvanu kritičnu prirođenu srčanu bolest (eng. critical congenital heart disease). Tijekom proteklih dvadeset godina, poslijeoperacijsko intenzivno liječenje pedijatrijskih kardijalnih bolesnika doživjelo je značajan razvoj, što je rezultiralo primjetnim povećanjem stope preživljenja. Ovaj napredak uglavnom je posljedica razvoja dijagnostičkih i kirurških postupaka, tehnika izvantjelesnog krvotoka (ITK), anestezioloških strategija te poslijeoperacijske intenzivne njege, ali i upotreba izvantjelesne mehaničke potpore života (eng. extracorporeal life support – ECLS) u rješavanju poslijeoperacijskog refraktornog šoka također je pridonijela boljim ishodima liječenja. Prijeoperacijska procjena pacijenata s prirođenim bolestima srca ključna je za uspješno perioperacijsko i poslijeoperacijsko zbrnjavanje. Napredak u multidisciplinarnom pristupu, u dijagnostičkim i kirurškim postupcima te optimizacija protokola poslijeoperacijske skrbi, značajno su poboljšali ishode pedijatrijskih pacijenata s prirođenim bolestima srca.

Abstract (english)

Congenital heart defects (CHDs) encompass structural and functional abnormalities of the heart and major blood vessels that occur during fetal development. They represent one of the most common congenital defects overall. Estimated frequency of CHDs is approximately 1 in 100 live births. These conditions can alter the path and manner in which blood flows through the heart, significantly compromising the hemodynamic stability of the child even in the earliest stages of life. CHDs can range from minor and clinically insignificant to severe and life-threatening disorders and defects. The importance of this is underscored by the fact that on average, 1 in 4 children with congenital heart defects has a critical congenital heart disease. Over the past two decades, postoperative intensive care for pediatric cardiac patients has undergone significant development, resulting in a noticeable increase in survival rates. This progress is largely attributed to advancements in diagnostic and surgical procedures, techniques of cardiopulmonary bypass (ITK), anesthetic strategies, and postoperative intensive care. Additionally, the use of extracorporeal life support (ECLS) in managing postoperative refractory shock has also contributed to improved treatment outcomes. Preoperative assessment of patients with congenital heart defects is crucial for successful perioperative and postoperative management. Progress in multidisciplinary approaches, diagnostic and surgical procedures, and optimization of postoperative care protocols have significantly improved outcomes for pediatric patients with congenital heart defects.

• Keywords: prirođene bolesti srca; poslijeoperacijsko intenzivno liječenje; izvantjelesna mehanička potpora života; hemodinamska stabilnost
• Keywords (english): congenital heart defects; postoperative intensive care; extracorporeal life support; hemodynamic stability
• Language: croatian
• URN:NBN: urn:nbn:hr:105:231323
• 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: 2024-07-02 17:38:23