National Repository of Grey Literature 3 records found  Search took 0.00 seconds. 
New trends in perioperative monitoring and glycaemic control.
Lipš, Michal ; Kunstýř, Jan (advisor) ; Bešík, Josef (referee) ; Beneš, Jan (referee)
Glycaemic control in critically ill patients has been a topic of considerable attention for the past 20 years. In literature and at scientific meetings, there have been ongoing debates regarding the efficacy of glycaemic control in these patients with frequently entirely opposite opinions. These range from a strict invasive approach with target glycaemia 4-6 mmol/l to a liberal approach tolerating even values higher than 12 mmol/l. In the preview of this PhD thesis we have analysed so far published literature and describe the reasons for this inconsistency. According to the results of recent studies, the most significant efficacy of tight glycaemic control has been observed in cardiac surgical patients. If we consider the concept of tight glycaemic control as efficient strategy, there are three important questions remaining unanswered as follow. Does the specific algorithm-protocol play a key part in the concept of tight glycaemic control alongside the knowledge and skills of nursing staff in safe and efficient blood glucose control? What is the ideal timing of starting the strategy of tight glycaemic control (TGC) in cardiac surgical patient? And is there any benefit in outcome respect to mortality or morbidity? Do we have any more safe and efficient option or add-on to standard perioperative...
Regional flow and number of microembolisms in the common carotid artery at different levels of hemodynamics controlled by VA-ECMO.
Janák, David ; Kittnar, Otomar (advisor) ; Danzig, Vilém (referee) ; Bešík, Josef (referee)
Extracorporeal membrane oxygenation (ECMO) is a method that allows extracorporeal life support in potentially reversible life-threatening conditions affecting the heart or lungs which are refractory to conventional treatment. Depending on the parameters of its setting, this method affects the haemodynamics of the cardiovascular system and the perfusion of the target organ. From the point of view of its character, the necessity for invasive application, and the function thereof in the conditions of the cardiovascular system, ECMO is regarded as a risky method accompanied by a number of complications. Among the critical complications are thromboembolic complications affecting the central nervous system (CNS) and haemorrhagic complications. The goal of this paper is to present and verify the prerequisites for the formation of periprocedural embolisms affecting the CNS and to evaluate the regional haemodynamics of the CNS. This is done by analysing the presence of embolisms and by analysing the parameters of blood flow rates in the right common carotid artery (arteria carotis communis-ACC) and the corresponding oxygenation of the brain tissue during various flow rate parameters generated by the ECMO support on induced heart failure in a biological porcine model. In the first section of the paper, 8...
Tolerance to acute ischemia in hypertrophic myocardium
Bešík, Josef ; Pirk, Jan (advisor) ; Šamánek, Milan (referee) ; Herget, Jan (referee)
Background: The degree of ischemic injury of the heart muscle depends not only on the intensity and duration of the ischemic insult, but also on the cardiac tolerance to oxygen deprivation. Cardiac tolerance to ischemia changes significantly during ontogenetic development neonates are more resistant to ischemia then adults. Moreover, cardiac tolerance to ischemia/reperfusion injury in adults is sex-dependent males are less tolerant than females. Individually the tolerance to ischemia decreases in certain pathological conditions, particularly in heart muscle hypertrophy. Aim: 1. The aim of this study was to answer the question whether the degree of tolerance to oxygen deprivation in hearts of spontaneously hypertensive rats (SHR) is sex-dependent and to verify the hypothesis whether cardiac tolerance of the normal neonatal heart differs from that of hypertensive rats. 2. To determine whether a higher resistence of the female hypertrophied myocardium to ischemia/reperfusion injury can be seen in clinical medicine. (...) Conclusions: We can conclude, that male and female hearts differ significantly in many parameters. Detailed mechanisms of these differences are still unknown but it is clear that they are so important that they deserve serious consideration in clinical practice and in the search for proper...

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