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Endothelial Glycocalyx - Diagnostic Approach and Intervention Assesment
Pouska, Jiří ; Beneš, Jan (advisor) ; Málek, Jiří (referee) ; Štourač, Petr (referee)
UNIVERZITA KARLOVA Lékařská fakulta v Plzni Dizertační práce Endothelial glycocalyx - diagnostic approach and intervention assessment MUDr.Jiří Pouska ABSTRACT Endothelial glycocalyx (EG) is fine structure on the surface of endothelium. After extensive research in past years, revisited Starling principle was finally formulated. It describes fluid physiology in capillaries precisely. EG has pivotal role in keeping endothelium semipermeable and thus avoiding extensive filtration of fluids to interstitium. Assessment of EG is clinically difficult. Many pathological conditions lead to damage of EG (sepsis etc.). Intravenous fluid therapy is mainstay of treatment of such conditions. Our aim was to determine the changes of EG integrity depending on the choice of intravenous fluid and its infusion time in physiological and pathological conditions. Key words: Endothelial glycocalyx, infusion therapy, anaesthesia, sepsis, microcirculation.
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Nursing care in anestesiology for a patient undergoing endarterectomy
Mocková, Karolína ; Di Cara, Veronika (advisor) ; Pucholtová, Romana (referee)
The subject of my bachelor thesis is a description of nursing process for the patients in anesthesia during the endarterectomy. By myself, I find this topic very interesting, because the disease of the cerebrovascular system is currently the most frequent disease. Stenosis of carotids is responsible for the one-third cases of stroke. In most cases is asymptomatic. Stenosis of carotids is more frequent in the age of 60 and higher. The goal of my bachelor thesis is to describe the nursing process on the operating theatre during the endarterectomy and the differences in the nursing process for the patients in a general anesthesia and locoregional anesthesia. Point out the importance of the cooperation between anesthesiology team and surgical team. In my bachelor thesis, I used the method of the case study of the patient on the operating theatre in the county hospital. For my thesis I have used following sources: Czech or foreign professional literature, Czech or foreign scientific articles, my own observations and providing professional nursing care, interview with the patient, information from health care personnel and patient's medical documentation. Analyzing of the nursing care I found that the healthcare professionals follow the nursing standards and recommended procedures. I found also the...
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Nursing process for client Stenosis of the internal carotid artery
Duštírová, Monika ; Kordulová, Pavla (advisor) ; Trávníčková, Ivana (referee)
Tématem bakalářské práce "Ošetřovatelský proces u klienta se stenózou arteria carotis interna" přibližuji problematiku a specifika pooperační péče u pacientů s touto diagnózou. Zúžení krční tepny na podkladě vytvoření aterosklerotického plátu je nejčastější příčinou cévní mozkové příhody. Nedostatečné prokrvení některých částí mozku může způsobit jeho poškození a vést k nezvratným změnám. Odstranění zúžení krční tepny patří k nejčastěji prováděným cévním operacím, v ČR je ročně odoperováno přibližně 1500 pacientů. V teoretické části mé závěrečné práce se zaměřuji na anatomii a fyziologii cévního řečiště mozku a tepenného systému. Zabývám se zde zúžením krční tepny, včasnou diagnostikou a bezpečnou léčbou, především chirurgickou. Podklady pro vypracování práce jsem získala vyhledáváním v databázích NLK, PubMed, Embase, Medvik a CINAHL apod. Dále jsem čerpala z internetových zdrojů profesních organizací a společností zabývající se touto problematikou. Zahrnuta byla i doporučení profesních organizací jako je ESVS - European Society for Vascular Surgery, SVN - Society of Vascular Nursing. METODIKA: Pro vypracování bakalářské práce jsem zvolila případovou studii pacienta se stenózou arteria carotis interna po chirurgickém operačním výkonu endarterektomii. Informace k vypracování bakalářské práce byly...
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Monitoring quality indikators of anesthesilogy care
Šimonová, Petra ; Jeřábková, Lenka (advisor) ; Dynáková, Šárka (referee)
Safety and quality of care are considered to be one of the main priorities in anaesthesia and their management and monitoring should be continuous and systematic. Quality indicators in anaesthesia must be frequently evaluated. Their evidence and evaluation create not only safe environment for patients but also continuously improve quality of anaesthesiologic care. The main objective of this diploma thesis was to evaluate patient's satisfaction with provided anaesthesiologic care, one of the main quality indicators in anaesthesia. Other objectives were research of quality indicators recommended in the Czech Republic and quality indicators recommended by foreign medical societies. The last partial objective was to create quality indicators checklist tailored for specific department of anaesthesiology based on collected data. Quantitative method research was conducted, using unstandardised questionnaire for patients, hospitalized and anaesthetised. 140 questionnaires were distributed of which 117 questionnaires returned. Based on objective the author of diploma thesis found out that Czech society of anaesthesia, resuscitation and intensive care determines quality indicators monitored in the Czech Republic. Quality indicators in foreign countries are in form of criteria that are necessary to adhere to....
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Test of exposiv partitions in anestetic praxis.
Klimešová, Marie ; Dvořák, Miroslav (referee) ; Jehlička, Karel (advisor)
On anesteziologic workplace are workers meet with various substances and materials every day. Are they put at risk of outbreak of fire or explosion? I´m going to put mind to this issue in my work, which is aimed at monitoring concentrations of explosive substances used in anesthesia. A related study of gases and vapors of volatile liquids concentration, explosiveness, flammability and other properties. I'm interesting in security and the timely identification of gases and vapors of volatile substances of the leak of anesthetic workplace, then studying the detection system and the detectors themselves. I meet with gas analyzers of company Brűel & Kjaer.
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Skull Trepanation in Prehistory of the Europe: The Oldest Surgical Procedures
Moravec, Tomáš ; Komárek, Stanislav (advisor) ; Pankowská, Anna (referee)
The main aim of the thesis is to provide a comprehensive overview of trepanations in the prehistory of Europe and to compile a brief overview of the oldest findings in Europe and closer in the Czech Republic. At first, the thesis deals with the types of trepanations according to their execution and the problems with trepanation diagnosis, where the work focuses on various groups of defects created by different mechanisms, which can be incorrectly diagnosed as trepanations. Further, the thesis deals with the reasons for trepanation and the description of the trepanations tools and techniques used in the prehistory. It also briefly mentions the first references to surgical interventions and the origin of anesthesia. Additionally, the thesis deals with the overview of the oldest findings in Europe and the Czech Republic and their brief description. And finally, there is a mention of trepanations at the present time.
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Hemodynamic optimalization in hepatic recection
Zatloukal, Jan ; Pradl, Richard (advisor) ; Cvachovec, Karel (referee) ; Málek, Jiří (referee)
Lowering of central venous pressure in hepatic surgery is nowadays widely recommended and used procedure. Low central venous pressure anesthesia is associated with decreased blood loss and improved clinical outcome. There are several approaches how to reach low central venous pressure. Till now none of them is recommended as superior in terms of patient safety and clinical outcome. Concurrently there is still debate if to use the low central venous pressure anesthesia principle or if it could be replaced with a principle of anesthesia with high stroke volume variation (or another dynamic preload parameter) with the use of a more sophisticated hemodynamic monitoring method. Results of our study didn't show any significant difference between two approaches used for reduction of central venous pressure, but suggest that the principle of low central venous pressure anesthesia could be possibly replaced by the principle of high stroke volume variation anesthesia which presumes the use of advanced hemodynamic monitoring. KEYWORDS Hepatic resection, central venous pressure, Pringle maneuver, hemodynamics, hemodynamic monitoring, fluid therapy, anesthesia
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Skull trepanation in archaic ethnics
Moravec, Tomáš ; Komárek, Stanislav (advisor) ; Hroníková, Linda (referee)
This thesis is focused on skull trepanation in archaic ethnics. Trepanation has been used since the Stone Age almost all around the world and since that time have occured the constantly improved tools, trepanation techniques and used anesthesia. However to the present time we are not sure, what exactly was the motivation of then primitive nations to perform such a dangerous procedure. Trepanation has been the subject of many researches since the 19th century, which has been tasked with bringing closer knowledge about the procedure and what was the reason for doing it. This work should provide general knowledge about the topic of trepanations.
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The role of nurses in patient education prior to anesthesia for surgical procedures in orthopedics
Slouková, Michaela ; Di Cara, Veronika (advisor) ; Hakenová, Renata (referee)
The thesis is focused on the role of nurse in patient education prior anaesthesia in surgical procedures in orthopaedic. Description of this role is based on the experience at the orthopaedic clinic and problems related to it are seen in the results of survey. The aim was to assess the level and effectiveness of patient education done by nurse before anaesthesia, measure the level of satisfaction and patient awareness before surgery, assess the quality and content of education provided by nurse and identify the current competencies of nurses in patient education before anaesthesia. Data for the research survey were obtained through two questionnaires designed for nurses working at the orthopaedic clinic and for patients who have undergone scheduled intervention in this clinic. The most important finding of the research results was crossing the competencies of nurses in the preoperative patient education because the lack of visits by anaesthesiologist. Based on what I studied in the available literature and the research results, in the discussion I am presenting proposals for solutions of this situation and I suggest active offering of the information material to patient during admission, the creation of improved education material for preoperative preparation, using of different teaching methods...
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Education of patients before anesthesia.
Vizinová, Gabriela ; Kulhavá, Miluše (advisor) ; Hladká, Petra (referee)
The present diploma thesis is engaged in the education of patients prior to the application of anaesthesia. The theoretical part studies the area of education. For a comprehensive overview of the problems at issue, the theoretical part delves in the area of anaesthesia. The thesis examines the contribution of education provided to patients prior to the application of anaesthesia. The target group of respondents is composed by patients who underwent a procedure requiring an anaesthesiology care. Patients suitable for data collection were selected using the purposeful sampling method on the basis of collaboration with head nurses of the given hospital wards. The research was conducted by a quantitative method, using the author's own questionnaire. The total of 69 questionnaires was distributed. The results of the research investigation conducted that patients are provided advice as to anaesthesiology care in more than one half of all cases. The greatest share in providing advice and education to patients in anaesthesiology care is taken up by physicians - anaesthesiologists. Most often, advice is provided in form of an informed consent, including oral advice. A vast majority of the patients questioned observe the recommendations and measures that they have been informed of. The results further imply...
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