Access restricted to higher education institution's students and staff
master's thesis
Kortikosteroidi u liječenju bolesnika sa sindromom akutnog respiracijskog distresa

Marija Ćopo (2016)
Metadata
TitleKortikosteroidi u liječenju bolesnika sa sindromom akutnog respiracijskog distresa
AuthorMarija Ćopo
Mentor(s)Vlatka Sotošek Tokmadžić (thesis advisor)
Abstract
ARDS je teško, životno ugrožavajuće stanje, u kojem upala oštećuje tkivo pluća. Terapijske opcije, koje su danas na raspolaganju, poboljšale su liječenje bolesnika s ARDS-om, ali nedovoljno dobro. Dugi niz godina traga se za farmakoterapijom koja bi isušila destruirajući edem u plućima i time omogućila bolesnicima siguran oporavak. U teoriji, kortikosteroidi značajno djeluju na upalu i smanjuju njezino progrediranje. Uspješno stišavaju upalu koja je okosnica ARDS-a djelovanjem na citokine, neutrofile i permeabilnost kapilara. Nažalost, terapija kortikosteroidima nije davala očekivane učinke te su nastavno provedene studije kako bi se shvatili učinci kortikosteroida u ARDS-u. Rezultati su uglavnom bili zbunjujući i suprotni, a najčešće se sukobljavaju kada se primjenjuju srednje doze metilprednizolona kroz duže vremenske periode (primjerice 1-2mg/kg/dnevno kroz 2 ili više tjedana). U tim je studijama metilprednizolon ocijenjen kao beznačajan po mortalitet bolesnika, jer u malim razmjerima pospješuje, odnosno pogoršava mortalitet. Davanje visokih doza (primjerice 30 mg/kg/dnevno) pokazalo se štetnim u smislu prevencije i liječenja, zbog jakog povišenja mortaliteta bolesnika. Niske doze davane u srednje dugim periodima (primjerice u prosjeku 1,14 mg/kg/dnevno kroz prosječno 7 dana) pokazale su se obećavajućim u istraživanjima bolesnika sa ARDS-om uzrokovanim aspiracijom želučanog sadržaja.
Keywordsacute respiratory distress syndrome corticosteroids treatment
Committee MembersAlan Šustić (committee chairperson)
Veljko Flego (committee member)
Alen Protić (committee member)
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za anesteziologiju, reanimatologiju i intenzivno liječenje
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Anesthesiology and Reanimatology
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2016-07-15
Parallel abstract (English)
ARDS is difficult, life-threatening condition, in which inflammation devastates lung tissue. Therapeutic options, which are now available, improve the treatment of patients with ARDS, but they are not good enough. For many years, attempts were made to achive medical treatment that will drie devasteted edema in the lungs and on that way enable patients safe recovery. In theory, KS significantly effects on inflammation and reduce its progress. KS successfully reduce inflammation, that is the backbone of ARDS, acting on cytokines, neutrophils and capillary permeability. Unfortunately, corticosteroid therapy did not give the expected effects so subsequently were performed studies to understand the effects of corticosteroids in ARDS. Results were generally confusing and contradictory, and often come into conflict when applying medium dose MP for extended periods of time (such as 1-2 mg/kg/ day for 2 weeks or more). In these studies, the MP assessed as insignificant factor for mortality of the patient because of the small proportion that enhances or worsens mortality. Aplication of high doses (for example 30 mg/kg/day) shown to be detrimental in terms of prevention and treatment, due to the strong increase of patient mortality. Low doses applied in the medium long periods (for example, an average of 1.14 mg/kg/day, for an average of 7 days) has shown promising results in studies of patients with ARDS caused by aspiration of gastric contents.
Parallel keywords (Croatian)akutni respiracijski distres sindrom kortikosteroidi liječenje
Resource typetext
Access conditionAccess restricted to higher education institution's students and staff
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:833601
CommitterBosa Licul