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Options preventing catheter-related sepsis during hospitalization
Slavkovská, Jana ; Heczková, Jana (advisor) ; Mrákava, Vlastimil (referee)
The thesis is focused on the assessment of nurse's knowledge in the prevention of catheter sepsis. The aim of the study was to expertise knowledge in the prevention of catheter sepsis among nurses working in intensive care units. Map out the latest theoretical and practical possibilities of nurses working in intensive care units in the prevention of catheter-related sepsis of hospitalized patients. The work is divided into theoretical and practical part. The theoretical part consists of three chapters. In the first chapter, we focused on a theoretical overview of nosocomial and bloodstream infections. The second chapter is focused on an overview of invasive inputs. The third chapter focuses on prevention of catheter sepsis. Practical part was divided into two chapters. In the first section of the empirical part of the diploma thesis, which is the fourth chapter, we characterized the survey sample, the evaluation of the survey data that have been collected through the questionnaire. Practical part was divided into two chapters. The fifth chapter consists of discussion and suggestions. Key words: sepsis, prevention, nursing, catheter, nurse, hospitalization.
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Significance of prolactin as peripheral cytokine in dysbalance of immune system
Janatová, Kateřina ; Černá, Marie (advisor) ; Holáň, Vladimír (referee)
Background: Interactions between the neuroendocrine and immune system play an importatnt role in maintaining homeostasis. This communication is mediated by cytokines, neurotransmiters and hormones through endocrine, paracrine and autocrine signaling. Prolactin (PRL), hormone of anterior pituitary, is produced by a number of other tissues and cells of immune system. On periphery, PRL is cytokine. Sepsis is an inflamatory response of the organism to severe infection, Th1 immune response is activated and PRL could participate in it. Toll-like receptors (TLR) play a key role in a recognition of bacteial components and mediate a systemic response (with PRL secretion) during infection. It is supposed that activated immune system leads to increasing of PRL, TLR2 and TLR4 gene expression. We detected PRL, TLR2 a TLR4 mRNA levels in monocytes from patiens with system inflammation. We studied influence of single nucleotide polymorphism (SNP -1149 G/T) in PRL gene promotor, it supposed that G allele increases PRL expression. Materials and Methods: For the pilot study 30 patients diagnose with severe infectious event. Collectoin of patiens blood samples was performed consequently three times. Control group comprised 40 healthy individuals. One blood sample was taken from each healthy subject. For testing of...
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Thrombophilia and thrombotic complications in severe septic patients
Zenáhlíková, Zuzana ; Kvasnička, Jan (advisor) ; Maruna, Pavel (referee) ; Malý, Jaroslav (referee)
Introduction: Thrombotic events are among the most serious complications of sepsis and also the most frequent causes of morbidity and mortality in patients with sepsis. Currently, the administration of low molecular weight heparins (LMWH) is recommended in patients with severe sepsis for prophylaxis of these complications. However, this prophylaxis often fails. Objectives of the study: One of the objectives of our study was to examine changes in haemostasis in relation to the inflammatory response during 15 days of severe sepsis. The next objective was to determine whether a prophylactic inhibition of F Xa in the range from 0.2 to 0.4 IU/mL is achieved in these patients, if they receive the recommended prophylaxis with LMWH. We also recorded the dynamics of changes in the F Xa inhibition during the entire study period. Moreover, we tried to identify the factors that may affect the antithrombotic efficacy of the subcutaneously administered enoxaparin. Patient population and methods: A total of 35 ICU patients meeting the criteria of severe sepsis were enrolled in the study. Only 16 of these patients could be followed throughout the entire 15-day period. Patients were treated according to the current guidelines, including LMWH prophylaxis; enoxaparin (40 mg sc per day) was used in this study....
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Aktivita antioxidačních enzymů za různých patofyziologických stavů.
Vávrová, Lucie ; Tvrzická, Eva (advisor) ; Borovanský, Jan (referee) ; Oliyarnyk, Olena (referee)
Background: Oxidative stress is supposed to be implicated in the pathogenesis of several diseases which are connected with increased formation of reactive oxygen and nitrogen species (RONS). Oxidative stress could play an important role in the pathogenesis of inflammation and sepsis, acute and chronic pancreatitis or in the development of cancer. Organisms are protected against RONS from antioxidant system that is composed of antioxidant enzymes and non-enzymatic antioxidants. To the most important antioxidant enzymes belong superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase, glutathione reductase and paraoxonase (PON). The aim of this Doctoral Thesis was to investigate the behaviour of three of these antioxidant enzymes - CuZnSOD, CAT and PON1 in different pathophysiological states. Materials and methods: The activities of CuZnSOD, CAT and PON1 were measured in six different pathophysiological states. Forty patients with metabolic syndrome (MetS), 35 women with depressive disorder (DD), 30 septic patients (SP), 50 patients with pancreatic cancer (PC), 50 patients with chronic pancreatitis (CP) and 13 patients with acute pancreatitis (AP) were included in different studies together with sex- and age-matched healthy controls (CON). Patients with AP and SP were observed in the course...
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Methods for detection of impaired immune response in cardiac-surgical patients
Kormundová, Nikola ; Koláčková, Martina (advisor) ; Hrdý, Jiří (referee)
In patients after cardiac surgery, there is an increase in the level of molecules with both pro-inflammatory and anti-inflammatory effects. This increase is influenced by the patient's clinical condition, but also by the nature of the operation itself, which uses conventional extracorporeal circulation. This technique leads to damage to blood elements by direct contact with air and parts of the extracorporeal circulation, as well as to ischemia-reperfusion injury. The specifics of cardiac surgery then affect possible postoperative complications such as multiorgan failure or septic shock. The diploma thesis is divided into a theoretical and a practical part. The theoretical part describes the principle and influence of cardiopulmonary bypass on the human body and the complications that are associated with its use. Furthermore, IFN-γ is described herein as a potential marker of septic conditions that could reflect the clinical postoperative condition of patients. The practical part of the diploma thesis monitored the percentage change of selected cell populations and the production of IFN-γ in the peripheral blood of patients before and after cardiac surgery. Furthermore, the response of individual isolated populations of healthy volunteers to selected stimulators was investigated. The percentage of...
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Analysis and identification of proteins in organ dysfunction using proteomic methods
Tůma, Zdeněk ; Matějovič, Martin (advisor) ; Lopot, František (referee) ; Hernychová, Lenka (referee)
Proteomics is the large-scale study of proteins, particularly their structures and functions. Proteomics has been utilized in medicine for investigation of disease mechanisms and biomarker discovery. Instrumental methods cover sample preparation, protein and peptide separation and mass spectrometry. At present, there is no proteomic method that can be used as universal for every sample. Analytical methods need to be adapted and optimized for certain samples. The aim of this work was to create methodic procedures and to interpret results of experimental and clinical research. The first part of the thesis includes experiments utilizing proteomics to study changes in the plasma proteome clinically relevant porcine model of sepsis-induced peritonitis. Proteomic analyzes were also starting methodological strategies in experiments aimed at kidney physiology and pathophysiology of acute kidney injury during sepsis. Renal biopsies were analyzed in order to study the time course of proteome changes caused by sepsis and surgery. The second part of the thesis contains experiments studying biocompatibility. A method for elution of proteins interacting with adsorbents used in extracorporeal liver support system and with hemodialyzer capillaries was prepared. Analysis of proteins adsorbed to polysulfone...
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Hemo elimination method in the treatment of sepsis and early multi-organ dysfunction
Sýkora, Roman ; Matějovič, Martin (advisor) ; Chytra, Ivan (referee) ; Maňák, Jan (referee) ; Šrámek, Vladimír (referee)
The most common cause of death in patients with sepsis/septic shock is deterioration of the function of multiple organs, termed multiple organ dysfunction syndrome. Although our understanding of mechanisms involved in the pathophysiology of sepsis-induced tissue damage has improved substantially, therapy of these syndromes still remains largely supportive. The hallmark of sepsis is an overwhelming systemic production of both pro- and anti-inflammatory mediators leading to generalized endothelial and epithelial damage, microcirculatory-mitochondrial distress, altered endocrine and coagulation homeostasis and cellular immune hyporesponsiveness. Therefore, the hypothesis that modulation of this excessive immunological and biological response to infection might improve patient outcome appears reasonable. Hemoelimination techniques represent biologically plausible way to provide non-specific removal of soluble pro- and anti-inflammatory mediators, although the concept of blood purification in sepsis remains a matter of considerable debate. The aim of this thesis was to elucidate effects of 1) high volume hemofiltration (HVHF) and 2) coupled plasma filtration adsorption (CPFA) in a long-term, hyperdynamic porcine septic shock model, which fulfils the criteria for human sepsis. We hypothesized that both HVHF and...
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Septic states
Danielová, Edita ; Vejsová, Marcela (advisor) ; Konečná, Klára (referee)
Background: Septic states are serious conditions that endanger the patient's life. To prevent the patient's death, this condition must be diagnosed in time and appropriate treatment initiated. The aim of this work is to gather findings related to clinical and laboratory signs and diagnosis of sepsis, including recommended procedures, therapy and prevention of sepsis. Main findings: Septic states may have very different laboratory and clinical signs and criteria for the diagnosis are not yet clearly defined. Bacteria are one of the most common causes of septic states; sepsis requires immediate treatment. Bloodstream infections can be diagnosed in many ways, the basis is blood cultivation, but molecular methods have also been developed recently. Conclusions: Informations were found on the issue of septic states and their clinical and laboratory signs, diagnosis and the most common causes, diagnosis of bloodstream infections and recommended procedures in therapy and prevention. The research was mainly focused on laboratory signs of septic states and microbiological diagnosis of bloodstream infections. Keywords: sepsis, bloodstream infections, hemoculture
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Artificial intelligence for predicting sepsis from clinical signals
Šidlo, David ; Chmelík, Jiří (referee) ; Vičar, Tomáš (advisor)
This bachelor thesis deals with the issue of predicting sepsis from clinical data using artificial intelligence methods. In the theoretical part, a literature research is made on the basic principles and functioning of various methods of artificial intelligence. Greater emphasis was placed on recurrent neural networks. The aim of the practical part was to implement a suitable method in the chosen programming environment. The LSTM network and the temporal convolutional network TCN were chosen as suitable methods. The best results of the normalized value of the utility score were achieved by TCN, namely 0.377 and seven-layer LSTM 0.356.
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