20.500.12556/DKUM-40129 SPREMLJANJE PODROČNE NASIČENOSTI MOŽGANOV S KISIKOM PRI ZDRAVLJENJU BOLNIKA S SUBARAHNOIDNO KRVAVITVIJO MONITORING OF REGIONAL CEREBRAL OXYGENATION IN THE TREATMENT OF PATIENTS WITH SUBARACHNOID HAEMORRHAGE V magistrskem delu smo spremljali bližnjo infrardečo spektroskopijo (NIRS) pri bolnikih s subarahnoidno krvavitvijo (SAK). Področna nasičenost možganov s kisikom (rSO2) se pri intervencijah medicinske sestre spreminja. NIRS je ena izmed metod za spremljanje in kvantificiranje teh vrednosti. Metodologija raziskovanja. V raziskovalnem delu smo uporabili kvantitativno metodologijo, v katero je bilo vključenih 30 bolnikov iz Univerzitetnega kliničnega centra Ljubljana. Nadzirali smo jim vrednosti rSO2 obojestransko v možganih (na strani, kjer je SAK, in kjer ga ni). Pri traheobronhialni aspiraciji in obračanju smo te vrednosti spremljali pred, med in po intervenciji ter pri transportu in menjavi senzorja (SomaSensor®, SAFB-SM) pred in po intervenciji. Rezultati raziskave. Pri traheobronhialni aspiraciji je na strani SAK začetna (2 minuti pred aspiracijo) povprečna vrednost rSO2 v možganih 64,82±9,15 % in na strani, kjer ga ni 71,91±9,00 % (p<0,001), 10 minut po aspiraciji pa je na strani SAK vrednost 66,60±8,99 %, in na strani, kjer ga ni 73,45±9,06 % (p<0,001). Pri obračanju opazimo padec rSO2 na strani SAK iz 65,97±9,43 % (2 minuti pred obračanjem) na 62,50±9,17 % (15 minut po obračanju), kar je statistično signifikantno (p<0,001). Po transportu pade povprečna vrednost rSO2 na strani SAK iz 63,13±9,40 % na 61,20±10,37 % (p=0,011). Sklep. Ugotovili smo, da pri izvajanju traheobronhialne aspiracije rSO2 v možganih še 5 minut po njej narašča, nato začne padati, obračanje in transport pa pri bolniku znižata vrednost rSO2 v možganih. Opazili smo tudi, da so po menjavi senzorja vrednosti rSO2 višje kot pred menjavo. Na strani možganov, kjer je SAK, so vrednosti rSO2 nižje kot na strani, kjer ga ni. In this Master's thesis we monitored near infrared spectroscopy (NIRS) in patients with subarachnoid haemorrhage (SAH). Regional cerebral oxygenation (rSO2) is changing during nurse's interventions. NIRS is one of the methods for monitoring and quantifying these values. Research methodology. In this research we used quantitative methodology, involving 30 patients from University clinical centre Ljubljana. We monitored rSO2 in both cerebral hemispheres (on the side with SAH and also on the other). In patient repositioning and tracheobronchial aspiration monitoring was done before, during and after intervention. During patient transport and sensor exchange (SomaSensor, SAFB-SM) we monitored rSO2 values before and after intervention. Results. Beginning average brain rSO2 measured in tracheobronchial aspiration (2 minutes before aspiration) on the side with SAH is 64,82±9,15 % and on the unaffected side 71,91±9,00 % (p<0,001), while 10 minutes after aspiration the value on the SAH side is 66,60±8,99 % and 73,45±9,06 % on the other (p<0,001). A statistically significant drop of rSO2 in cerebral hemisphere with SAH from 65,97±9,43 % to 62,50±9,17 % (15 minutes after reposition) was noticed during patient repositioning, (p<0,001). During patient transportation the average rSO2 on the SAH side drops from 63,13±9,40 % to 61,20±10,37 % (p=0,011). Conclusion. We discovered that during tracheobronchial aspiration rSO2 is rising 5 minutes after intervention before it starts to drop and that patient reposition and transport both lower rSO2. We also noticed that after sensor exchange there is a rise in rSO2. In cerebral hemisphere with SAH there are lower average rSO2 values than in an unaffected side. Bližnja infrardeča spektroskopija subarahnoidna krvavitev traheobronhialna aspiracija obračanje transport bolnik medicinska sestra. Near infrared spectroscopy subarachnoid haemorrhage tracheobronchial aspiration reposition transport patient nurse. true false false Slovenski jezik Angleški jezik Magistrsko delo/naloga 2013-04-10 22:14:44 2013-05-09 15:01:12 2022-05-12 23:27:10 2021-04-23 03:18:53 2013 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.8(043.2) 1898660 URN:SI:UM:DK:TL1VFM1Y MAG_Brgan_Ana_2013.pdf MAG_Brgan_Ana_2013.pdf 1 FBAE654E6311CFD68C4F116C1AC8DBAB 1e10c5e3c4b5ba91262a68df2544c7fbb870714dcb6c73b25b145fce8b2d8aa8 48f4aa84-7c09-11eb-bb7a-00155d0001ca 20.500.12556/dkum/43ddda44-cd2c-4ae9-a8f5-4b13373dbafd https://dk.um.si/Dokument.php?lang=slv&id=54728 Fakulteta za zdravstvene vede 0 0 0