(diplomsko delo)
Aljaž Holc (Author), Miljenko Križmarić (Mentor), Matej Strnad (Co-mentor)

Abstract

Namen diplomskega dela je bil raziskati spremembe v sistemski in lokalni hemodinamiki človeških obtočil med manevrom oddaljenega ishemičnega prekondicioniranja. Predvsem sistoličnega in diastoličnega krvnega tlaka, minutnega iztisa srca, frekvence srca in regionalne tkivne oksigeniranosti. Izvedli smo eksperimentalno prospektivno raziskavo, izvedba pa je potekala v simulacijskem okolju. Gibanje vrednosti parametrov sistemske hemodinamike smo spremljali z monitorjem Task Force, reginalno oksigeniranost pa z napravo INVOS™ 5100c. Prvi nam ponuja kontinuirano merjenje krvnega tlaka v realnem času skupaj z merjenjem minutnega iztisa in frekvence srca s pomočjo bioimpendančne metode. Manever prekondicioniranja pa smo izvedli s pomočjo običajne manšete za oscilometrično merjenje krvnega tlaka. Ugotovili smo porast sistoličnega tlaka pri polovici in stagnacijo pri drugi polovici preiskovancev hkrati pa porast diastoličnega krvnega tlaka pri vseh preiskovancih. Frekvenca srca je porasla pri dveh preiskovancih, pri istih pa hkrati povzročila porast v minutnem iztisu srca. Pri preostalih so vrednosti stagnirale. Zabeležili smo močan padec tkivne oksigeniranosti pri vseh preiskovancih v fazi ko je manšeta napolnjena in preseganje začetnih vrednosti v fazi reoksigenacije kar poznamo kot pojav reakcijske hiperemije. Povzamemo lahko da manever oddaljenega prekondicioniranja sicer vpliva na parametre sistemske hemodinamike v pričakovani smeri vendar ne povzroča močnih nenadnih sprememb, ki bi utegnile ogrožati bolnika. Drugače je pri regionalni hemodinamiki kjer so bile spremembe precejšnje (tudi 50% razlike v rSO2). Raziskava je bila izvedena na zdravih posameznikih pri zavesti, zato ni bilo moč popolnoma izključiti psiholoških vplivov na parametre, ki so kljub konstantnem fizičnem okolju vsekakor bili prisotni.

Keywords

ishemično prekondicioniranje;hemodinamika;krvni tlak;frekvenca srca;minutni iztis;oksigeniranost;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UM FZV - Faculty of Health Sciences
Publisher: [A. Holc]
UDC: 616.1(043.2)
COBISS: 2243748 Link will open in a new window
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Other data

Secondary language: English
Secondary title: HAEMODYNAMIC CHANGES DURING ISCHEMIC PRECONDITIONING
Secondary abstract: The purpose of the study was to research changes in systemic and regional hemodynamics during the remote ischemic preconditioning. Mostly we focused on systolic and diastolic blood pressure, cardiac output, heart rate and regional tissue oxygenation. Experimental prospective research was made in the environment of simulation laboratory. The flow of systemic hemodynamic parameters was being monitored with Task Force monitor. At the mean time we monitored tissue oxygenation with INVOS™ 5100c device. The first one possesses the option of real time continuous blood pressure measurement, as well as measurement of heart rate and cardiac output through bioimpedance method. We managed to improvise the preconditioning maneuver with an ordinary cuff, normally used for non-invasive blood pressure measurement. We found out that systolic blood pressure arose by two volunteers and remained the same by the other two. Meanwhile diastolic blood pressure arose by all four volunteers. Heart rate arose by two volunteers as well, causing consequent rise of cardiac output for same two volunteers. At the same time heart rate remained the same by the other two as well as cardiac output. Regional oxygenation suffered severe decline when cuff was filled with air with noticeable rebound quickly after the cuff release. Not only did it reach the original value but it surpassed it instead. It is phenomena known as reactive hyperemia. All in all we are able to conclude that remote ischemic preconditioning maneuver has an influence on systemic hemodynamics in expected way, but it does not cause changes of an extent that could possibly endanger safety of a patient. It is a bit different by regional hemodynamics where we monitored up to 50% difference in tissue oxygenation (rSO2) during various phases of the research. Research included healthy conscious volunteers thus we could not fully eliminate psychological influence on parameters despite constant environment.
Secondary keywords: ischemic preconditioning;hemodynamics;blood pressure;heart rate;cardiac output;oxygenation;
URN: URN:SI:UM:
Type (COBISS): Bachelor thesis/paper
Thesis comment: Univ. v Mariboru, Fak. za zdravstvene vede
Pages: IV, 23 f.
ID: 9160615