master's thesis
Transfusion therapy in patients with severe haemorrhage

Martina Ilinić (2016)
Metadata
TitleTransfuzijsko liječenje bolesnika s teškim krvarenjem
AuthorMartina Ilinić
Mentor(s)Dubravka Ivić (thesis advisor)
Abstract
Ciljevi istraživanja: Utvrditi najčešće uzroke masivnog krvarenja u ispitanika liječenih u Jedinici intenzivnog liječenja (JIL), prikazati lokalnu strategiju transfuzijskog liječenja, utvrditi postupa li se u skladu s konvencionalnim ili novim smjernicama te utječe li strategija resuscitacije na ishod liječenja. Nacrt studije: Retrospektivno istraživanje. Ispitanici i metode: Ispitanici su bolesnici liječeni u JIL-u zbog hemoragijskog šoka u razdoblju od 1. 1. 2012. do 31. 12. 2015. Podatci su prikupljeni iz povijesti bolesti i bolesničkih kartona, uključujući uzroke krvarenja, volumen infuzijskih tekućina i krvi, potrebu za kirurškom hemostazom te ishod liječenja. Rezultati: U istraživanje je uključeno 52 ispitanika, s nešto većim udjelom muškaraca (59,6 %). Medijan dobi je bio 61 godinu (interkvartilnog raspona 44,75-73,25). Medijan trajanja liječenja u JIL-u bio je 3 dana (interkvartilnog raspona 2-6). U 67,3 % slučajeva uzrok krvarenju bila je trauma. Tijekom resuscitacije infundirano je ukupno 8,8 L tekućine, a udio krvnih pripravaka iznosio je 27 %. Srednji omjer plazme i eritrocita iznosio je 1:2,38 , a ukupni mortalitet 42,3 %. Kod 17 ispitanika ostvaren je omjer SSP:KE od 1:2,38 uz mortalitet od 52,94 %, dok je kod 33 ispitanika bio manji ili jednak, uz mortalitet od 39,9 %. Zaključak: Najčešći uzrok masivnom krvarenju bila je trauma. U početnoj resuscitaciji primjenjivane su kristaloidne otopine ( >2/3 infundirane tekućine). Uvođenje novih smjernica nije utjecalo na lokalnu strategiju transfuzijskog liječenja. Zbog malog broja ispitanika na temelju dobivenih rezultata nije moguće zaključiti koliko strategija resuscitacije utječe na ishod liječenja krvarećih ispitanika.
Keywordsplasma-erythrocyte ratio massive hemorrhage transfusion therapy coagulopathy
Parallel title (English)Transfusion therapy in patients with severe haemorrhage
Committee MembersSlavica Kvolik (committee chairperson)
Marina Samardžija (committee member)
Dubravka Ivić (committee member)
GranterSveučilište Josipa Jurja Strossmayera u Osijeku
Medicinski fakultet
PlaceOsijek
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Anesthesiology and Reanimatology
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeUniversity Graduate Studies
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2016-07-14
Parallel abstract (English)
Research goals: to determine most frequent causes of massive bleeding in patients treated in Intensive Care Unit (ICU), present local strategy of transfusion treatment, to determine whether the conventional or new guidelines are being followed, and whether resuscitation strategy influences treatment outcome. Study type: retrospective study Patients and methods: examinees are ICU patients treated for hemorrhagic shock in period from 1st January 2012 to 31st December 2015. Data was acquired from patient case histories and hospital records, including sources of hemorrhage, volume of intravenous fluids and blood, necessity for surgical hemostasis and treatment outcome. Results: study included 52 patients, median age 61 (44.75-73.25), with slightly larger male population (59.6 %). They were treated in ICU during 3 (2-6) days. In 67.3 % cases, bleeding was caused by trauma. During resuscitation, median of 8.8 L of fluid was infused, with blood products share being 27 %. Median ratio of Plasma (FFP): Erythrocyte (pRBC) was 1:2.38 , and total mortality rate was 42.3 %. In 17 patients FFP: pRBC ratio of 1:2.38 was achieved, with mortality rate being 52.94 %, while in 33 patients the ratio was smaller or same, with mortality rate being 39.9 %. Conclusion: Most common cause of massive hemorrhage is trauma. In initial resuscitation crystalloid solutions were administered (>2/3 of infused fluids). Implementing new guidelines did not influence local transfusion therapy strategy. Owing to small number of examinees, it is not possible to conclude how much resuscitation strategy influences treatment outcome in bleeding patients.
Parallel keywords (Croatian)omjer plazme i eritrocita masivno krvarenje transfuzijsko liječenje koagulopatija
Resource typetext
Access conditionOpen access
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:152:268283
CommitterBisera Kopf