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Influence of early antibiotic treatment on lower airway microbial colonisation in patients receiving mechanical ventilation
Kroupová, Alžběta ; Duška, František (advisor) ; Kukol, Václav (referee)
AJ Introduction: Ventilator-associated pneumonia (VAP) is a significant source of morbidity and mortality among patients undergoing mechanical ventilation. Its development is preceded by colonization of the lower respiratory tract with pathogenic bacteria. The purpose of this study was to investigate how antibiotic therapy administered for non-pulmonary infections affects the colonization of the lower respiratory tract compared to patients not receiving antibiotics. The hypothesis is that antibiotic treatment reduces colonization of the lower respiratory tract but increases the occurrence of multidrug-resistant bacteria. Methods: This was a retrospective observational cohort study conducted on critically ill patients hospitalized at the Department of Anesthesiology and Resuscitation, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady. This study is part of an ongoing project aimed at improving the quality of care and preventing VAP in intensive care unit patients. Patients had to meet certain criteria: they had to be on mechanical ventilation for more than 48 hours, have no pre-existing pulmonary diseases upon hospital admission, and not be immunocompromised. The primary outcome was the difference in the proportion of patients with positive microbiological...
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Respiratory physiotherapy - part of a comprehensive treatment of Duchenne muscular dystrophy patients
Vargová, Zuzana ; Smolíková, Libuše (advisor) ; Slováčková, Lenka (referee)
Duchenne muscular dystrophy is a progressive muscular disease. This serious disease attacks not only the musculoskeletal system, but also the respiratory system. Respiratory system is one of the most influenced systems. The risks of respiratory problems increase with deteriorating condition of the patient due to muscle weakness. This work is focused on treatment of respiratory system. The aim of treatment is early prevention and solving of complications. These complications include not only scoliosis and cardial problems, but mainly inefficient cough, night hypoventilation, irregular night breathing and failure of respiratory system even during the day. The aim of the respiratory physiotherapy is to keep the right functionality of lungs for the longest time and to choose the correct method of the rehabilitation following the patient's condition deteriorating. Interventions suitable for the patients with the DMD are techniques that leads to increasing lung volume, manual and mechanical techniques of assisted coughing, and noninvasive ventilation. NIV is one of the preferred methods of treating nowadays. Another method is continual invasive ventilation and ventilation with tracheostomy. This treatment includes keeping hygiene of the airways, which is the basis for their throughput. The work also includes...
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Exposure to toxic concentrations of oxygen in ICU patients
Petránková, Eliška ; Bakalář, Bohumil (advisor) ; Jankovcová, Kateřina (referee) ; Hocková, Jana (referee)
Oxygen supplementation has been an important part of respiratory failure treatment in all fields of clinical medicine, especially on intensive care units (hereinafter referred to as ICU). Oxygen therapy is a life-saving measure but indiscriminate administration of oxygen can cause lung and nerve damage and consequently increase morbidity and mortality (1). In clinical practice we often encounter mechanically ventilated patients with high partial pressures of oxygen in arterial blood (5) which should direct our attention to possible consequences and have reliable data how is oxygen treatment managed. This thesis focuses on the exposure to toxic concentrations of oxygen on the resuscitation ward. The aim of this thesis is to determine whether patients are exposed to high concentrations of oxygen. Two other aims of this study are to find out how long are patients in a state of hyperoxemia and whether medical staff reacts to measured partial pressures of oxygen (hereinafter referred to as paO2) values in these patients by reducing oxygen fraction (hereinafter referred to as FiO2) on the ventilator. The research part of this thesis is a quantitative observational retrospective research. The inclusion criteria were hospital admission from 1st July to 1st October 2019, at least two paO2 values greater...
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Respiratory physiotherapy - part of a comprehensive treatment of Duchenne muscular dystrophy patients
Vargová, Zuzana ; Smolíková, Libuše (advisor) ; Slováčková, Lenka (referee)
Duchenne muscular dystrophy is a progressive muscular disease. This serious disease attacks not only the musculoskeletal system, but also the respiratory system. Respiratory system is one of the most influenced systems. The risks of respiratory problems increase with deteriorating condition of the patient due to muscle weakness. This work is focused on treatment of respiratory system. The aim of treatment is early prevention and solving of complications. These complications include not only scoliosis and cardial problems, but mainly inefficient cough, night hypoventilation, irregular night breathing and failure of respiratory system even during the day. The aim of the respiratory physiotherapy is to keep the right functionality of lungs for the longest time and to choose the correct method of the rehabilitation following the patient's condition deteriorating. Interventions suitable for the patients with the DMD are techniques that leads to increasing lung volume, manual and mechanical techniques of assisted coughing, and noninvasive ventilation. NIV is one of the preferred methods of treating nowadays. Another method is continual invasive ventilation and ventilation with tracheostomy. This treatment includes keeping hygiene of the airways, which is the basis for their throughput. The work also includes...
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