|
|
Haemocoagulation changes caused by cardiopulmonary bypass
Šnircová, Jana ; Vaněk, Tomáš (advisor) ; Kvasnička, Jan (referee) ; Kunstýř, Jan (referee)
The aim of preliminary and experimental prospective, randomized study was to search for thromboelastography signs of fibrinolysis, their impact on postoperative blood loss and need of transfusion in coronary surgery. In preliminary study we had compared results in 20 patients scheduled for coronary surgery (10 patients OPCAB, 10 patients conventional CABG). Completely expressed thromboelastographic signs of hyper-fibrinolysis had been detected in 2 on-pump patients and partial signs of increased fibrinolytic activity had been noticed in other 2 patients originating from the same group, unlike OPCAB group, in which no signs of fibrinolysis had been observed. However, differences between the evaluated groups in that trial had not reached statistical significance due to a small number of study subjects. In experimental study, 65 patients scheduled for coronary surgery were randomized into three groups: A - conventional coronary artery bypass grafting, B - off-pump surgery, C - coronary artery bypass grafting with modified, rheoparin coated ardiopulmonary bypass with the avoidance of re-infusion of cardiotomy blood into the circuit. On the completion of peripheral bypass anastomoses, highly significant inter-group differences were found in the thromboelastographic parameter lysis of set time at 60 min of...
|
|
|
Current Possibilities in Use of a Centrifugal Pump in the Cardiac Sugery
Mlejnský, František ; Lindner, Jaroslav (advisor) ; Lonský, Vladimír (referee) ; Vaněk, Tomáš (referee)
Current Possibilities in Use of a Centrifugal Pump in the Cardiac Sugery Abstract Currently, the most commonly used technical solution for pumping blood during extracorporeal circulation during cardiac surgery, as well as for some types of ECMO (extracorporeal membrane oxygenation) are either a roller pump or centrifugal pump. Due to its advantages the centrifugal pump is mainly used for prolonged extracorporeal circulation in cardiac surgery and as a heart and / or lung support system. In current literature there is a lack of compelling scientific evidence that would clearly support its use in a routine cardiac surgery. The aim of our study was to compare both types of currently used blood pumps in longer cardiac procedures with deep hypothermic circulation arrest. In a randomized clinical study we had selected a group of patients that underwent a pulmonary endarterectomy (PEA) in order to demonstrate the positive effects of the centrifugal pump on the postoperative inflammatory reactions. There were no statistically significant differences between these two pumps when other clinical and laboratory parameters were observed. Based on the hypothesis that significant temperature changes during cardiac procedure with a deep hypothermia can affect sealing pressure of the endotracheal tube cuff, we performed a...
|
|
| |
|
|
Obchod s pivem mezi zeměmi Evropské unie
Vaněk, Tomáš
Thesis is dedicated to quantifying and evaluating the intensity of international beer trade among member states of the European Union. Some international trade intensity indices were selected in order to meet this purpose. First of them being the RCA index, which serves as a tool for revealing and assessing the level of comparative advantages in member states of the EU. The subsequent procedure was aimed to express in numbers and words with help of G-L index the degree of intra-industry trade, which European beer industry reaches. Obtained results suggest notable differences in the levels of countries comparative advantages and also the existence of relatively high degree of intra-industry beer trade. Such outcome results in identification and evaluation of certain business opportunities in the area of intra-EU beer trade.
|
|
|
Determinanty zahraničního obchodu České republiky se zeměmi OECD
Vaněk, Tomáš
The diploma thesis is devoted to determining factors influencing the intensity of two-way trade between the Czech Republic and other member countries of the OECD. In order to fulfil this objective, a model based on principles of the so called gravity equation is constructed. Using a dataset of 35 cross-sectional units (repre-senting the 35 member states of the OECD), observed during the 2007–2016 pe-riod, the impact of the economically relevant variables on the volume of Czech export and import is estimated. Apart from the usual panel data analysis, the vari-ability of the regression parametres within the given time time period is also ex-amined, using cross-sectional approach. Obtained results, among other things, suggest that the impact of the selected explanatory variables on Czech export and import can be considered rather symmetrical.
|
|
|
Influence of crystalloid and colloid solutions on blood coagulation using the rotational thromboelastometry (ROTEM) method
Binterová, Silvie ; Durila, Miroslav (advisor) ; Vaněk, Tomáš (referee) ; Bláha, Jan (referee)
Fluid resuscitation with crystalloid and colloid solutions is a common treatment in perioperative medicine. However, a variety of unbalanced or balanced solutions is used in clinical practice and there is still a vivid debate going on regarding the selection of optimal fluid with minimal negative effect on coagulation. The goal of the dissertation was to investigate the adverse effect of balanced crystalloids and colloids on whole blood coagulation measured by method of rotational thromboelastometry. In the first phase of the work we had assessed the adverse effect of balanced crystalloid, hydroxyethyl starch and gelatin after dilution of blood with the solution in vitro. Parametrs of EXTEM and FIBTEM tests were evaluated by using rotational thromboelastometry. In the second phase of the work we evaluated the negative effect of infusion solution after dilution in vivo. We had obtained blood samples from 30 patients during knee arthroscopy before and after administration of 500 ml of crystalloid or hydroxyethyl starch or gelatin. Parametrs of EXTEM and FIBTEM tests were evaluated by using rotational thromboelastometry.In compliance with the results of the dissertation, hydroxyethyl starch has the most obvious negative effect on clot formation followed by gelatin and finally by crystalloids. Based on...
|
|
|
Aortocoronary bypass surgery with or without heartlung machine in high risk patients.
Hlavička, Jan ; Vaněk, Tomáš (advisor) ; Vojáček, Jan (referee) ; Rohn, Vilém (referee)
This dissertation entitled "Aortocoronary bypass surgery with or without heart-lung machine in high risk patients" is a summary of the findings of two published works by the author: Off-pump Versus On-Pump Coronary Artery Bypass Grafting Surgery in High-Risk Patients: PRAGUE-6 Trial at 30 Days and 1 Year, published in the journal Biomedical Papers in 2015 and Aspirin is insufficient in inhibition of platelet aggregation and thromboxane formation early after coronary artery bypass surgery, published in Journal of Thrombosis and Thrombolysis in 2009. The PRAGUE-6 study, which focused exclusively on patients with very high operative risk according to the EuroSCORE scoring system, confirmed the hypothesis of a higher incidence of combined endpoints up to the 30th day among patients operated with extracorporeal circulation, particularly acute myocardial infarctions. This significant difference was not maintained after one year after the surgery, mainly due to the increase in mortality between the 30th day and the 1st year in patients operated off-pump. The dissertation further discusses similar papers published on the topic in recent years, including the two very last meta- analyzes. The second part of the thesis follows the topic of myocardial revascularization in the field of antiaggregation therapy...
|
|
|
Postoperative delirium in patients after cardiac surgery
Vlk, Robert ; Suchopárová, Štěpánka (advisor) ; Vaněk, Tomáš (referee)
UNIVERZITA KARLOVA V PRAZE 3. LÉKAŘSKÁ FAKULTA Ústav ošetřovatelství Robert Vlk Pooperační delirium u pacientů po kardiochirurgickém výkonu Postoperative delirium in patients after cardiac surgery Bakalářská práce Praha, červen 2018 1 Abstract The aim of this research is to find the predisposing factors of postoperative delirium in cardiac surgery patients, especially due to the use of extracorporeal circulation during cardiac surgery. The delirium itself causes prolongation of the hospitalization of the patient, increases the cost of treatment, and may further endanger the patient's health or life. Delirium also puts higher demands on the medical and nursing care provided to the patient. The ground for the research are 652 patients who were treated in 2016 at the Department of Cardiac Surgery, 3rd Faculty of Medicine, Charles University in Prague, University Hospital Kralovske Vinohrady, Prague. Depending on the occurrence of postoperative delirium, they are divided into two groups. By determining the level of statistical significance, it is determined how the individual factors are important for predicting the occurrence of postoperative delirium. Quite surprising is the finding that the use of extracorporeal circulation alone is not associated with an increased risk of post-operative delirium. However,...
|
|
| |
|
| |
guest ::
