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Hemodynamics in the early stages of the critical illness and in the perioperative setting
Beneš, Jan ; Kasal, Eduard (advisor) ; Málek, Jiří (referee) ; Kroužecký, Aleš (referee) ; Adamus, Milan (referee)
Beneš J.: HEMODYNAMIKA V ČASNÉ FÁZI KRITICKÝCH STAVŮ A PERIOPERAČNÍ MEDICÍNĚ - Využití méně invazivních monitorovacích prostředků k cílené hemodynamické péči ABSTRACT Hemodynamic instability occurs very often in critically ill patients and during the perioperative period. Insufficiency in the preload, contractility and afterload contribute in major part to this phenomenon. Hemodynamic monitoring allows clinicians to recognize and to intervene early the underlying cause. Due to new technologies development in recent years it is possible to provide continuous monitoring of hemodynamic parameters with diminished invasivity. Hemodynamic optimization and goal directed therapy show treatment benefit in some groups of critically ill patients and mainly during the perioperative period. Aim of hemodynamic optimizations is to attain the best obtainable hemodynamic conditions with use of fluid loading and inotropic support. In many studies in recent years goal-directed therapy was associated with morbidity and mortality reduction. According to the results of our clinical research hemodynamic optimization using stroke volume variation and minimally invasive device based on the pressure wave analysis is feasible and show the same results as other works with more invasive devices. Key words Hemodynamic monitoring,...
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Alternation of Glycocalyx in Critical Illness and during Major Surgery and Approaches for Glycocalyx Protection
Astapenko, David ; Černý, Vladimír (advisor) ; Cvachovec, Karel (referee) ; Adamus, Milan (referee)
Background: Glycocalyx represents a protective cellular coat on a sugar basis. It serves as a communication medium with outside environment. Glykokalyx also covers the inner apical surface of endothelial cells where it is called the endothelial glycocalyx (EG). Research from last decade declare its pivotal role in physiology and pathophysiology of microcirculation. EG is prone to be damaged in critical conditions but there are more questions than what we actually know about this complex structure. Also, there are new methods being developed for more precise description of EG condition. The aim: The aim of this thesis is to evaluate the level of contemporary evidence about EG and to evaluate methods of its assessment. To describe the condition of EG in experimental model of cardiac arrest (CA) in pig and in experimental model of iatrogenic hypernatremia in rabbit. To describe the influence of different types of anesthesia on EG in patients in perioperative care. To describe the dynamic changes of EG in patients in critical care. To evaluate response of EG to fluid challenge of 500 ml of normal saline in healthy volunteers and the response of EG to administration of lipid emulsion in patients in critical care. To describe the condition of EG in patients with dyslipidemia, with long term home parenteral...
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Hemodynamics in the early stages of the critical illness and in the perioperative setting
Beneš, Jan ; Kasal, Eduard (advisor) ; Málek, Jiří (referee) ; Kroužecký, Aleš (referee) ; Adamus, Milan (referee)
Beneš J.: HEMODYNAMIKA V ČASNÉ FÁZI KRITICKÝCH STAVŮ A PERIOPERAČNÍ MEDICÍNĚ - Využití méně invazivních monitorovacích prostředků k cílené hemodynamické péči ABSTRACT Hemodynamic instability occurs very often in critically ill patients and during the perioperative period. Insufficiency in the preload, contractility and afterload contribute in major part to this phenomenon. Hemodynamic monitoring allows clinicians to recognize and to intervene early the underlying cause. Due to new technologies development in recent years it is possible to provide continuous monitoring of hemodynamic parameters with diminished invasivity. Hemodynamic optimization and goal directed therapy show treatment benefit in some groups of critically ill patients and mainly during the perioperative period. Aim of hemodynamic optimizations is to attain the best obtainable hemodynamic conditions with use of fluid loading and inotropic support. In many studies in recent years goal-directed therapy was associated with morbidity and mortality reduction. According to the results of our clinical research hemodynamic optimization using stroke volume variation and minimally invasive device based on the pressure wave analysis is feasible and show the same results as other works with more invasive devices. Key words Hemodynamic monitoring,...
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