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Analiza zdravljenja bolnikov s COVID-19 v Enoti za intenzivno medicino Splošne bolnišnice Novo mesto
ID Bučar, Tajda (Avtor), ID Kerec Kos, Mojca (Mentor) Več o mentorju... Povezava se odpre v novem oknu, ID Vernig, Katja (Komentor)

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Izvleček
Na Kitajskem se je decembra 2019 prvič pojavil nov sev koronavirusu, ki so ga poimenovali koronavirus 2 hudega akutnega respiratornega sindroma, bolezen, ki jo povzroča, pa COVID-19. Virus se je v relativno kratkem času razširil po vsem svetu, zaradi česar je bila razglašena pandemija. Namen magistrske naloge je bila retrospektivna analiza zdravljenja odraslih bolnikov, ki so bili med 03. 10. 2020 in 31. 03. 2021 zaradi COVID-19 hospitalizirani v Enoti za intenzivno medicino (EIM) Splošne bolnišnice Novo mesto. Podatke o zdravstvenem stanju bolnikov in poteku hospitalizacije smo pridobili iz bolnišničnega e-informacijskega sistema, temperaturnih listov in rezultatov mikrobioloških preiskav. Primerjali smo tudi količinsko izdajo zdravil iz oddelka bolnišnične lekarne v EIM, v času zdravljenja bolnikov s COVID-19 glede na primerljiva obdobja v letih 2017 – 2020. Podatke smo pridobili s pomočjo lekarniškega e-informacijskega sistema. Izmed 119 bolnikov je bilo 86 oseb (72 %) moškega spola, mediana starosti vseh bolnikov je bila 67 let. 89 % bolnikov (106/119) je imelo vsaj eno sočasno obolenje in 82 % (89/109) jih je imelo ob sprejemu v bolnišnico predpisano kronično terapijo, z mediano zdravilnih učinkovin (ZU) 4. Slabšanje respiratorne insuficience ali odpoved dihanja ob COVID pljučnici je bil vzrok za hospitalizacijo pri 88 % bolnikov (105/119). 86 % bolnikov (102/119) je med hospitalizacijo prejemalo temeljno zdravljenje s protivnetnimi in/ali protivirusnimi ZU. Monoterapijo s kortikosteroidom je imelo 70 % bolnikov (71/102), s protivirusno ZU remdesivir trije bolniki. 27,5 % bolnikov (28/102) je prejemalo kombinacijo kortikosteroida in remdesivirja. Vsi bolniki so prejemali tudi zdravljenje s kisikom in mehansko ventilacijo ter podporno terapijo (mediana ZU 12; več kot 90 % jih je prejemalo nizkomolekularne heparine, raztopine za uravnavanje ravnotežja elektrolitov ter vitamina D in C). Zdravljenje s protimikrobnimi zdravili je potrebovalo 79 % bolnikov (94/119), z mediano ZU 2. Mediana trajanja hospitalizacije vseh bolnikov je bila 11 dni. Med hospitalizacijo je umrlo 41/119 bolnikov (34,5 %), ostali so bili po izboljšanju zdravstvenega stanja premeščeni na neintenzivni oddelek bolnišnice. Umrli bolniki so bili značilno starejši (mediana 74 let), imeli so več sočasnih obolenj (51 % bolnikov je imelo 3 ali več sočasnih obolenj) in več zdravil v kronični terapiji pred sprejemom (mediana ZU 6); značilne povezave s spolom nismo dokazali. Statistično značilna povečanja izdaje zdravil iz bolnišnične lekarne v EIM smo dokazali za vitamin D in C, heparinsko skupino, glukokortikoide, peniciline z zaviralci laktamaz beta, cefalosporine 3. generacije, vankomicin, flukonazol, paracetamol idr.

Jezik:Slovenski jezik
Ključne besede:Koronavirusna bolezen 2019, koronavirus 2 hudega akutnega respiratornega sindroma, farmakoterapija, hospitalizacija
Vrsta gradiva:Magistrsko delo/naloga
Organizacija:FFA - Fakulteta za farmacijo
Leto izida:2022
PID:20.500.12556/RUL-136504 Povezava se odpre v novem oknu
Datum objave v RUL:10.05.2022
Število ogledov:460
Število prenosov:170
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Sekundarni jezik

Jezik:Angleški jezik
Naslov:Treatment analysis of COVID-19 patients in the Intensive care unit of the General hospital Novo mesto
Izvleček:
In December 2019, a new strain of coronavirus, named severe acute respiratory syndrome coronavirus 2 first appeared in China, and the disease it caused was named COVID-19. The virus spread worldwide in a relatively short time, causing a pandemic to be declared. The purpose of this master's thesis was to retrospectively analyse the treatment of adult patients who were hospitalised due to COVID-19 in the Intensive Care Unit (ICU) of Novo mesto General Hospital between 03. 10. 2020 and 31. 03. 2021. Data on the medical status of patients and the course of hospitalisation were obtained from the hospital electronic information system, medical charts, and microbiological test results. We also compared the quantitative dispensing of medications by the hospital pharmacy in the ICU during the treatment of patients with COVID-19 with comparable periods in 2017 – 2020. Data were obtained using the pharmacy electronic information system. Of the 119 patients, 86 (72%) were male, and the median age of all patients was 67 years. 89% of patients (106/119) had at least one concomitant disease and 82% (89/109) had been prescribed chronic therapy on admission to the hospital, with a median of 4 drugs. Exacerbation of respiratory insufficiency in COVID pneumonia was the cause of hospitalisation in 88% of patients (105/119). 86% of patients (102/119) received basic anti-inflammatory and/or antiviral therapy during hospitalisation. 70% of patients (71/102) were prescribed corticosteroid monotherapy, and three patients antiviral drug remdesivir. 27.5% of patients (28/102) were prescribed a combination of corticosteroids and remdesivir. All patients also received oxygen therapy and mechanical ventilation, as well as supportive therapy (median number of drugs 12; more than 90% received low molecular weight heparin, electrolyte balance solutions, and vitamins D and C). 79% of patients (94/119) required antimicrobial therapy (median number of drugs 2). The median duration of hospitalisation of all patients was 11 days. During hospitalisation, 41 out of 119 patients died (34.5%), and the rest were transferred to the non-intensive care unit of the hospital after their medical condition improved. Patients who died were generally older (median 74 years), had multiple comorbidities (51% of patients had 3 or more comorbidities), and multiple pre-admission chronic therapies (with a median of 6 drugs); we were not able to demonstrate a significant gender-related correlation. A significant increase in dispensing of drugs in EIM was demonstrated for vitamins D and C, the heparin group, glucocorticoids, penicillins with beta-lactamase inhibitors, third-generation cephalosporins, vancomycin, fluconazole, paracetamol, etc.

Ključne besede:Coronavirus disease 2019, Severe Acute Respiratory Syndrome Coronavirus 2, Pharmacotherapy, Hospitalization

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