Kvalitet života posle mehaničke ventilacije kod bolesnika lečenih od pneumonije

  • Nenad Zornić Faculty of medical sciences University of Kragujevac
  • Dragan Milovanović University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Department for Clinical Pharmacology, Kragujevac, Serbia
  • Miroslav Stojadinović University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Clinic for Nephrology and Urology, Kragujevac, Serbia
  • Dragče Radovanović University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Clinic for Surgery, Kragujevac, Serbia
  • Goran Davidović University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Clinic for Cardiology, Kragujevac, Serbia
  • Stefan Simović University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Clinic for Cardiology, Kragujevac, Serbia
  • Zoran Bukumirić University of Belgrade, Faculty of Medicine, Institute for Medical Statistics and Informatics, Belgrade, Serbia
  • Vladimir Janjić University of Kragujevac, Faculty of Medical Sciences, Department of Psychiatry, Belgrade, Serbia
  • Nebojša Marić Military Medical Academy, Department of Thoracic Surgery, Belgrade, Serbia
  • Jasna Jevdjić University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Department for Anesthesiology and Reanimation, Kragujevac, Serbia
  • Vesna Rosić University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Department for Histology, Kragujevac, Serbia
  • Jelena Nešić University of Kragujevac, Faculty of Medical Sciences, Clinical Center “Kragujevac”, Clinic for Cardiology, , Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP160905008Z
Ključne reči: disanje, mehaničko;, pneumonija;, intenzivna nega;, kvalitet života;, prognoza.

Sažetak


Uvod/Cilj. Bolesnici sa pneumonijom koji zahtevaju mehaničku ventilaciju (MV) povezani su sa nekoliko loših ishoda, kao što su produžena hospitalizacija, veća stopa smrtnosti i povećano širenje patogena otpornih na antibiotike. MV kod bolesnika sa vanbolnički stečenom pneumonijom (community-acquired pneumonia – CAP) može izazvati razvoj psihološke simptomatologije, koje su često zanemarene u jedinicama intenzivnog lečanja (JIL), i smanjenjem kvaliteta života nakon prestanka MV. Cilj studije je bio da se proceni kvalitet života kod bolesnika sa CAP koji se leče primenom MV u JIL. Metode. Istraživanje je sprovedeno u obliku studije koja je obuhvatala hospitalizovane zbog CAP. Kvalitet života definisan je kao primarni ishod, dok je primena MV pretpostavljena kao primarni prognostički faktor koji negativno utiče na ishod. Bolesnici su regrutovani iz populacije bolesnika sa CAP koje su bile hospitalizovane u JIL u Kliničkom centru Kragujevac, Srbija, od januara 2013. do januara 2014. godine. Eksperimentalna grupa sastojala se od bolesnika koji su bili na MV, a kontrolna grupa bili su bolesnici sa CAP, kiji nisu bili podvrgnuti MV. Kvalitet života procenjen je pomoću EuroQoL Group-EQ-5D indeksa. Izračunavanje ukupne vrednosti EQ-5D-5L izvršeno je korišćenjem unapred definisanog, validiranog kartografskog ključa, u skladu sa kombinacijama odgovora. Statistička analiza obav­ljena je korišćenjem χ2 testa, Studentovog t-testa, univarijantne i multivariantne logističke regresione analize. Rezultati. Bolesnici sa MV imali su lošije vrednosti EQ5D-5L u poređenju sa kontrolnom grupom za svih pet domena. Mobilnost, samozbrinjavanje i uobičajene aktivnosti bili su najlošije ocenjeni tokom čitavog perioda praćenja. Bol ili neugodnost i anksioznost ili depresija značajno su se razlikovali između studijske i kontrolne grupe u sedmom i tridesetom danu lečenja. Zaključak. Bolesnici sa MV imaju slabiji kvalitet života, naročito u tri domena. Glavni razlozi su prisustvo hroničnih komorbiditeta kod populacije koja zahteva primenu MV.

Reference

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2020/12/08
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Vol. 75 Br. 9 (2018): September Vol. 75 (No. 9)
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