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Acute kidney injury in sepsis: phatophysiological and therapeutical aspects
Chvojka, Jiří ; Matějovič, Martin (advisor) ; Kasal, Eduard (referee) ; Maňák, Jan (referee) ; Balík, Martin (referee)
Sepsis and septic shock remain major cause of mortality in non-coronary intenisve care units. Prognosis of septic patiens worsens further in case of concomitant acute kidney injury. Pathophysiological pathways leading to renal dysfunction in sepsis remain unclear despite of enormous experimental and clinical research. Similarly, the role of extracorporeal blood purification techniques as an adjunctive treatment in sepsis is highly controversial. The aim of our study was to dynamically assess renal haemodynamic, microvascular and metabolic responses in a porcine clinically relevant model of septic shock. The same experimental model was used in experiments elucidating potential benefit effects of two distinct haemopurification methods on different biological responses to infectious insult.
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The Care of Patient with Extra-corporeal Membrane Oxygenation
Vagnerová, Zuzana ; Tomanová, Alena (advisor) ; Balík, Martin (referee)
The theme of this diploma work is the Extra-Corporeal Membrane Oxygenation for adult patients. In those papers is describing history, development and current using this method in the world. The part of this work is the pilot development aimed for occurrence of complications of patients from the look of a nurse. For the visual demonstration, two nursing case reports are the part of this work. The finish of this work is completed about the recommended introduction for nurses, who will care about patients on ECMO.
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Sepsis and Sepsis-associated Acute Kidney Injury: Molecular Mechanism and Lovel Aspects of Treatment
Horák, Jan ; Matějovič, Martin (advisor) ; Šrámek, Vladimír (referee) ; Balík, Martin (referee)
Sepsis is the most common cause of death in the intensive care units worldwide. Despite the undeniable progress in pre- and clinical research, the effective causal therapeutic strategy still does not exist. Given to extremely complex and heterogenic host response to presence of infection, the paradigm "one disease, one drug" is obviously flawed and combination of multiple targets that involves early immunomodulation and cellular protection are needed. Cellular therapy using mesenchymal stem cells represents strategy that brought positive results in experiments with rodent septic models. Part of this thesis is dedicated to evaluation of safety and efficacy of stem cells intravenous administration to well-established large animal model of progressive peritoneal sepsis. Affecting of the neuroinflammatory reflex through the vagus nerve stimulation showed potential to attenuate sepsis in rodents. Rest of the text is dedicated to evaluation of vagus nerve stimulation effectivity in our model. KEYWORDS Sepsis, sepsis-associated acute kidney injury, mesenchymal stem cells, vagus nerve stimulation
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Acute kidney injury in sepsis: phatophysiological and therapeutical aspects
Chvojka, Jiří ; Matějovič, Martin (advisor) ; Kasal, Eduard (referee) ; Maňák, Jan (referee) ; Balík, Martin (referee)
Sepsis and septic shock remain major cause of mortality in non-coronary intenisve care units. Prognosis of septic patiens worsens further in case of concomitant acute kidney injury. Pathophysiological pathways leading to renal dysfunction in sepsis remain unclear despite of enormous experimental and clinical research. Similarly, the role of extracorporeal blood purification techniques as an adjunctive treatment in sepsis is highly controversial. The aim of our study was to dynamically assess renal haemodynamic, microvascular and metabolic responses in a porcine clinically relevant model of septic shock. The same experimental model was used in experiments elucidating potential benefit effects of two distinct haemopurification methods on different biological responses to infectious insult.
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The Care of Patient with Extra-corporeal Membrane Oxygenation
Vagnerová, Zuzana ; Tomanová, Alena (advisor) ; Balík, Martin (referee)
The theme of this diploma work is the Extra-Corporeal Membrane Oxygenation for adult patients. In those papers is describing history, development and current using this method in the world. The part of this work is the pilot development aimed for occurrence of complications of patients from the look of a nurse. For the visual demonstration, two nursing case reports are the part of this work. The finish of this work is completed about the recommended introduction for nurses, who will care about patients on ECMO.
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Biochemical diagnosis and monitoring of disorders of renal functions in critically ill patients
Balík, Martin ; Kazda, Antonín (advisor) ; Tesař, Vladimír (referee) ; Schück, Otto (referee)
Aims: A systematic approach to renal function monitoring using information taken by means of renal function tests calculated from serum and urine specimen has not been comprehensively explored. The application of analysis of natriuretic peptides and low molecular weight proteins in diagnosis of advanced renal failure has not been tested in critical ill patients. The performance of continuous renal replacement therapy depends on adequate anticoagulation of the extracorporeal circuit. Prostacyclin as one of the newer agents has not been compared to citrate which may be considered a standart agent in many intensive care units. Changes of distribution volume of antibiotics have been a matter of debate in terms of dosage alteration but have not been assessed clinically at the bedside using other tools than a pharmacokinetic model. Methods: Establishing computer programme calculating various renal function tests allowed us to monitor the effects of diuretics, osmolality shifts, disorders of urine acidification and progression of renal insufficiency towards acute renal failure. Creating a functional model of acute renal failure serves as a tool for further studies on renal replacement therapy. A relationship between residual diuresis and levels of natriuretic peptides and cystatin C were studied before and...
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