Učinkovitost avtotransfuzije sistemske cirkulacije spodnjih okončin med simulacijo sinkope

Kaučič, Ivo

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Title:	Učinkovitost avtotransfuzije sistemske cirkulacije spodnjih okončin med simulacijo sinkope
Authors:	ID Kaučič, Ivo (Author) ID Križmarić, Miljenko (Mentor) More about this mentor...
Files:	MAG_Kaucic_Ivo_2017.pdf (2,10 MB) MD5: 72EE050C0AF84ABCCB2AEDA1169DD790
Language:	Slovenian
Work type:	Master's thesis/paper
Typology:	2.09 - Master's Thesis
Organization:	FZV - Faculty of Health Sciences
Abstract:	Uvod: Dvig nog je pogost in enostaven manever, ki se ga kot prva pomoč nudi osebi s kratkotrajno izgubo zavesti (sinkopi). Na ta način z gravitacijo povzročimo prenos krvi iz sistemske cirkulacije spodnjih okončin v srce (avtotransfuzijo), kjer se zaradi višjega pritoka krvi poveča iztis srca. Namen raziskave je bil ugotoviti razlike, ki se pojavljajo v hemodinamičnih spremenljivkah pri dvigu nog na različne naklone. Metode: V eksperimentalni študiji smo s pomočjo hemodinamičnega Task Force® monitorja na zdravih prostovoljcih simulirali sinkopo in ugotavljali iztis srca pri mirovanju (0°) ter naklonih nog 30°, 45° in 90°. Razlike smo ugotavljali s pomočjo Friedmanovega testa, post hoc pa s parnim Wilcoxonovim testom predznačenih rangov (z Bonferronijevo korekcijo) v programskem orodju IBM SPSS 22. Rezultati: Pri dvigu nog iz položaja 30° v 90° se je minutni iztis srca signifikantno dvignil za 0,5±0,6 l/min, kar je znašalo 7,56 % (Z = -2,417; p = 0,016). Statističnih razlik med položajema dvig 45° in 90° ni bilo, čeprav se je minutni iztis srca dvignil za 0,4±0,6 l/min (+5,97 %). Prav tako nismo ugotovili statističnih razlik pri primerjavi vrednosti frekvence srca oziroma iztisa srca pri različnih naklonih nog. Diskusija: Povečanje količine krvi v srcu povzroči povečanje iztisa, posledično pa se poveča tudi krvni tlak in prekrvavitev organov. V povprečju dosežemo najvišje povečanje minutnega iztisa srca, frekvence srca ter iztisa srca z dvigom nog na 90°, vendar lahko statistične razlike med dvigi nog lahko v tem trenutku potrdimo le v primeru minutnega iztisa srca pri dvigu nog na 30° in 90
Keywords:	omedlevica, dvig nog, hemodinamika, minutni iztis srca, frekvenca srca
Place of publishing:	Maribor
Publisher:	[I. Kaučič]
Year of publishing:	2017
PID:	20.500.12556/DKUM-66002
UDC:	612.178:004.358(043.2)
COBISS.SI-ID:	2349732
NUK URN:	URN:SI:UM:DK:RQBBW7GR
Publication date in DKUM:	30.08.2017
Views:	1953
Downloads:	136
Metadata:
Categories:	FZV
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Secondary language

Language:	English
Title:	The effectiveness of a systemic circulation autotransfusion from the lower limbs during a syncope simulation
Abstract:	Introduction: The leg raise maneuver is a simple and basic way to provide first aid to a person with short-term loss of consciousness (syncope). Gravity causes the transfer of blood from the systemic circulation of the lower extremities to the heart. The increased blood flow consequently increases the cardiac output. The aim of this study is to determine the effectiveness of the autotransfusion caused by raising the legs at different angles. Methods: Our experimental study was conducted thru monitoring with the Task Force® monitor. Our sample consisted of healthy subjects. We monitored hemodynamic variables while the legs were positioned at 0° and later at different angles (30°, 45° and 90°). Data collection and analysis was conducted IBM SPSS Statistics 22, with the Friedman test and post hoc paired Wilcoxon signed-rank with the Bonferroni correction applied. Results: A comparison of the 30° and 90° leg raise showed a significant cardiac output increase of 0,5±0,6 l/min which is 7,56 % (Z = -2,417; p = 0,016). Statistical significance difference between the 45° and 90° leg raise could not be concluded, although the cardiac output increased by 0,4±0,6 l/min (5,97 %). We also determined that there were no statistical significances in the differences between the mean values of heart rate or stroke volume at different angles. Discussion: Increased blood volume consequently increases blood flow, blood pressure and organ blood supply. We concluded that the highest cardiac output, heart rate and stroke volume mean increase can be achieved by raising the legs by 90°, but at this moment we are only able to confirm the statistical significance of the differences in cardiac output between the 30° and 90° leg raises.
Keywords:	fainting, leg raise, hemodynamics, cardiac output, heart rate

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