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Gastrointestinal tract dysfunction in critical ill patients
Balihar, Karel ; Matějovič, Martin (advisor) ; Kula, Roman (referee) ; Martínek, Jan (referee)
Multiorgan dysfunction syndrom is the major driving pathophysiological mechanism of morbidity and mortality in critically ill patients. Gastrointestinal dysfunction usually develops as a result critical illness and it is believed to play a key role in the development and progression of multiple organ dysfunction. Moreover, any primary disorder of the gastrointestinal tract, if severe enough, can lead to a critical state and secondary multiorgan dyfunction. Despite intensive experimental and clinical research, reliable tools for monitoring and evaluation of the severity of gastrointestinal dysfunction remain unknown. In the same line, therapy of this complex pathology remains largely supportive. The aim of this thesis was first to explain the severity of the most common and most serious nosocomial infection of the digestive tract, second to elucidate the safety and effectiveness of the endoscopic dual enteral probe insertion in ventilated critically ill patients, and, third to evaluate new diagnostic tools of the gastrointestinal dysfunction. Finally, we present an ongoing project aimed at investigating esophageal dysfunction in mechanically ventilated critically ill patients.
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Transplantation stool in a patient with Clostridium difficile - intervention nurses
PENZKOFER, Jana
This Bachelor's thesis focuses on nursing interventions in a patient with clostridium difficile during fecal microbiota (or stool) transplantation. The main aim of the thesis was to determine nursing interventions during fecal microbiota transplantation in a patient with clostridium difficile. The thesis is divided into two parts. The first part theoretically describes fecal microbiota transplantation and nursing care for a patient with this diagnosis. The second empirical part concentrates on knowledge of nurses and their approaches to this issue. The theoretical part deals with nursing and epidemiology in general and also with principles of barrier nursing care. Next, it describes the anatomy and physiology of the colon, clostridium difficile and the diseases it causes, fecal microbiota transplantation and nursing care for a patient with clostridium difficile. The empirical part is based on research carried out by interviews with nurses working in a teaching hospital and in a general hospital. The interviews were analysed and categorized. The results of the research survey helped to answer the following research questions: What are the specifics of nursing care for a patient with clostridium difficile? What are the specifics of collecting stool from a donor? How can be stool transplanted? How is the patient prepared for the procedure? The results of the research show that the nursing interventions in teaching and general hospital differ in certain categories, especially in the category called "Nursing tasks before and during the procedure". Nurses in the teaching hospital are assisted by doctors during the procedure, while nurses in the general hospital are responsible for preparation of the transplant material and the whole stool transplantation. In conclusion, clostridium difficile is a very dangerous pathogen for humans, especially because its toxins can cause diseases that can put people at risk. It is difficult to treat and affected patients can develop recurrence. However, the bacteria and their toxins can be detected thanks to reliable laboratory methods in order to start early antibiotic treatment and subsequent fecal microbiota transplantation.
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Gastrointestinal tract dysfunction in critical ill patients
Balihar, Karel ; Matějovič, Martin (advisor) ; Kula, Roman (referee) ; Martínek, Jan (referee)
Multiorgan dysfunction syndrom is the major driving pathophysiological mechanism of morbidity and mortality in critically ill patients. Gastrointestinal dysfunction usually develops as a result critical illness and it is believed to play a key role in the development and progression of multiple organ dysfunction. Moreover, any primary disorder of the gastrointestinal tract, if severe enough, can lead to a critical state and secondary multiorgan dyfunction. Despite intensive experimental and clinical research, reliable tools for monitoring and evaluation of the severity of gastrointestinal dysfunction remain unknown. In the same line, therapy of this complex pathology remains largely supportive. The aim of this thesis was first to explain the severity of the most common and most serious nosocomial infection of the digestive tract, second to elucidate the safety and effectiveness of the endoscopic dual enteral probe insertion in ventilated critically ill patients, and, third to evaluate new diagnostic tools of the gastrointestinal dysfunction. Finally, we present an ongoing project aimed at investigating esophageal dysfunction in mechanically ventilated critically ill patients.
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