20.500.12556/DKUM-85289 Preprečevanje sekundarnih možganskih okvar pri oskrbi poškodovanca na terenu s povečanim znotrajlobajskim tlakom Prevention of secundary brain damage in the prehospital care of an injured person with increased intracranial pressure Uvod: poškodbe glave oziroma travmatske poškodbe možganov so velik javno zdravstveni problem. S pravilnim ukrepanjem zniževanja znotrajlobanjskega tlaka in z ustreznim transportom lahko precej izboljšamo klinične izide pri takšnih pacientih. Metode: uporabili smo opisno metodo dela in dodatno metodo analize, kompilacije, komparacije ter sinteze. Znanstveno literaturo smo iskali v tujih podatkovnih bazah: PubMed, CINAHL, ScienceDirect in v iskalniku Google Učenjak. Rezultati: v končno analizo smo vključili 16 raziskav. Ugotovili smo, da traneksamična kislina ne vpliva na zmanjšano umrljivost, hipoksija in hipotenzija povečujeta umrljivost, predbolnišnična intubacija v primerjavi z intubacijo v urgentnem centru nima vpliva na umrljivost, ketamin, apliciran v bolusu, zniža znotrajlobanjski tlak, hipertonične raztopine, v primerjavi s fiziološko raztopino ali Ringerjevim laktatom, ne vplivajo na boljše možnosti preživetja, dvig vzglavja za 30° zniža znotrajlobanjski tlak. Razprava in zaključek: traneksamična kislina nima vpliva na boljše preživetje in funkcionalne izide, hipoksija in hipotenzija pomembno vplivata na dodatne poškodbe možganov, predbolnišnična intubacija nima bistvene prednosti pred intubacijo v urgentnem centru, ketamin, apliciran v bolusu, zniža znotrajlobanjski tlak in je varen za uporabo. Trenutni podatki ne dovoljujejo priporočila o tem, kateri vrsti tekočine bi bilo potrebno dati prednost. Dvig vzglavja za 30° pripomore k zmanjšanju sekundarne poškodbe možganov Introduction: Head injuries or traumatic brain injuries are a major public health problem. With proper measures to reduce intracranial pressure and appropriate transport, clinical outcomes in such patients can be significantly improved. Methods: We used a descriptive method of work and an additional method of analysis, compilation, comparison and synthesis. We searched scientific literature in foreign databases: PubMed, CINAHL, ScienceDirect and in the Google Scholar search engine. Results: tranexamic acid has no effect on reduced mortality, hypoxia and hypotension increase mortality, prehospital intubation compared with intubation in the emergency center has no effect on mortality, bolus ketamine lowers intracranial pressure, hypertonic solutions have no effect compared with saline or Ringer's lactate to better chances of survival, raising the head by 30° lowers intracranial pressure. Discussion and conclusion: tranexamic acid has no effect on better survival and functional outcomes, hypoxia and hypotension have a significant effect on additional brain damage, prehospital intubation has no significant advantage over intubation in the emergency center, bolus ketamine lowers intracranial pressure and is safe to use, current data do not allow a recommendation as to which type of fluid should be preferred. 30° head elevation can reduce secondary brain injury. znotrajlobanjski tlak predbolnišnična oskrba poškodba glave sekundarna poškodba možganov intracranial pressure prehospital intervention traumatic brain injury secondary brain injury true true false [Ž. Sirk] Slovenski jezik Angleški jezik Diplomsko delo/naloga 2023-08-24 15:02:34 2023-10-27 12:02:14 2024-01-04 16:05:49 0000-00-00 00:00:00 2023 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.714-001:616-083.98(043.2) 170213635 VS_Sirk_Ziga_2023.pdf VS_Sirk_Ziga_2023.pdf 1 8F092DE71ED2703064FB429D514ACC2A 8a38f2e0ae03b53e5e03b4c68856e678cdafe4d201629cbe1d96d871d8c3a919 b32cd788-427f-11ee-ac23-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=170303 Fakulteta za zdravstvene vede 0 0 0