1. Neurological outcome in patients after successful resuscitation in out-of-hospital settingsMartin Marinšek, Andreja Sinkovič, David Šuran, 2020, izvirni znanstveni članek Opis: Neurological outcome is an important determinant of death in admitted survivors after out-of-hospital cardiac arrest (OHCA). Studies demonstrated several significant pre-hospital predictors of ischemic brain injury (time to resuscitation, time of resuscitation, and cause of OHCA). Our aim was to evaluate the relationship between post-resuscitation clinical parameters and neurological outcome in OHCA patients, when all recommended therapeutic strategies, including hypothermia, were on board. We retrospectively included consecutive 110 patients, admitted to the medical ICU after successful resuscitation due to OHCA. Neurological outcome was defined by cerebral performance category (CPC) scale I-V. CPC categories I-II defined good neurological outcome and CPC categories III-V severe ischemic brain injury. Therapeutic measures were aimed to achieve optimal circulation and oxygenation, early percutaneous coronary interventions (PCI) in acute coronary syndromes (ACS), and therapeutic hypothermia to improve survival and neurological outcome of OHCA patients. We observed good neurological outcome in 37.2% and severe ischemic brain injury in 62.7% of patients. Severe ischemic brain injury was associated significantly with known pre-hospital data (older age, cause of OHCA, and longer resuscitations), but also with increased admission lactate, in-hospital complications (involuntary muscular contractions/seizures, heart failure, cardiogenic shock, acute kidney injury, and mortality), and inotropic and vasopressor support. Good neurological outcome was associated with early PCI, dual antiplatelet therapy, and better survival. We conclude that in OHCA patients, post-resuscitation early PCI and dual antiplatelet therapy in ACS were significantly associated with good neurological outcome, but severe ischemic brain injury was associated with several in-hospital complications and the need for vasopressor and inotropic support.
Ključne besede: out-of-hospital cardiac arrest, OHCA, ischemic brain injury, resuscitation
Objavljeno v DKUM: 30.01.2025; Ogledov: 0; Prenosov: 5
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2. The role of environmental PM2.5 in admission acute heart failure in ST-elevation myocardial infarction patients : an observational retrospective studyAndreja Sinkovič, Andrej Markota, Manja Kraševec, David Šuran, Martin Marinšek, 2021, izvirni znanstveni članek Opis: Background: Air pollution with increased concentrations of fine (< 2.5 μm) particulate matter (PM2.5) increases the risk of cardiovascular morbidity and mortality. Even short-term increase of PM2.5 may help trigger ST-elevation myocardial infarction (STEMI) and heart failure (HF) in susceptible individuals, even in areas with good air quality.
Purpose: To evaluate the role of PM2.5 levels ≥ 20 μg/m3 in admission acute HF in STEMI patients.
Materials and Methods: In 290 STEMI patients with the leading reperfusion strategy primary percutaneous coronary intervention (PPCI), we retrospectively studied independent predictors of admission acute HF and included admission demographic and clinical data as well as ambient PM2.5 levels ≥ 20 μg/m3. We defined admission acute HF in STEMI patients as classes II–IV by Killip Kimball classification.
Results: Acute admission HF was observed in 34.5% of STEMI patients. PPCI was performed in 87.1% of acute admission HF patients and in 94.7% non-HF patients (p= 0.037). Significant independent predictors of acute admission HF were prior diabetes (OR 2.440, 95% CI 1.100 to 5.400, p=0.028), admission LBBB (OR 10.190, 95% CI 1.160 to 89.360, p=0.036), prior resuscitation (OR 2.530, 95% CI 1.010 to 6.340, p=0.048), admission troponin I≥ 5μg/l (OR 3.390, 95% CI 1.740 to 6.620, p< 0.001), admission eGFR levels (0.61, 95% CI 0.52 to 0.72, p < 0.001), and levels of PM2.5 ≥ 20 μg/m3 (OR 2.140, 95% CI 1.005 to 4.560, p=0.049) one day before admission.
Conclusion: Temporary short-term increase in PM2.5 levels (≥ 20 μg/m3) one day prior to admission in an area with mainly good air quality was among significant independent predictors of acute admission HF in STEMI patients.
Ključne besede: admission acute heart failure, ST-elevation myocardial infarction, air pollution, PM2.5
Objavljeno v DKUM: 14.10.2024; Ogledov: 0; Prenosov: 3
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3. Prikaz primera hudega poteka pljučnice povzročene z virusom Varicella-Zoster, zdravljene z aciklovirjem in zunajtelesno membransko oksigenacijoLuka Varda, Metin Omerović, Barbara Kit, Franc Svenšek, Jure Fluher, Iva Cestar, Martin Marinšek, Andrej Markota, 2024, drugi znanstveni članki Ključne besede: Varicella-Zoster virus, pljučnica, zunajtelesna membranska oksigenacija, cor pulmonale, prikaz primera
Objavljeno v DKUM: 30.07.2024; Ogledov: 147; Prenosov: 47
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4. Factors of hospital mortality in men and women with ST-elevation myocardial infarction - an observational, retrospective, single centre studyMartin Marinšek, David Šuran, Andreja Sinkovič, 2023, izvirni znanstveni članek Opis: Purpose: There are well-known gender differences in mortality of patients with ST-elevation myocardial infarction (STEMI). Our purpose was to assess factors of hospital mortality separately for men and women with STEMI, which are less well known.
Patients and Methods: In 2018– 2019, 485 men and 214 women with STEMI underwent treatment with primary percutaneous coronary intervention (PCI). We retrospectively compared baseline characteristics, treatments and hospital complications between men and women, as well as between nonsurviving and surviving men and women with STEMI.
Results: Primary PCI was performed in 94% of men and 91.1% of women with STEMI, respectively. The in-hospital mortality was significantly higher in women than in men (14% vs 8%, p=0.019). Hospital mortality in both genders was associated significantly to older age, heart failure, prior resuscitation, acute kidney injury, to less likely performed and less successful primary PCI and additionally in men to hospital infection and in women to bleeding. In men and women ≥ 65 years, mortality was similar (13.3% vs 17.8%, p = 0.293).
Conclusion: Factors of hospital mortality were similar in men and women with STEMI, except bleeding was more likely observed in nonsurviving women and infection in nonsurviving men.
Ključne besede: ST-elevation myocardial infarction, female sex, male sex, sex differences, hospital mortality, 30-day survival, 6-month survival
Objavljeno v DKUM: 12.07.2024; Ogledov: 124; Prenosov: 22
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5. STEMI patients in the first and second waves of the COVID-19 pandemic in northeast Slovenia - a retrospective, single-center observational studyAndreja Sinkovič, Manja Kraševec, David Šuran, Martin Marinšek, 2022, izvirni znanstveni članek Opis: The COVID-19 pandemic has affected the outcomes of ST-elevation myocardial infarction (STEMI) patients in most countries. We aimed to retrospectively assess the admissions, treatments, complications, and mortality of STEMI patients in the northeast of Slovenia during the first (March–May 2020) and second waves (October–December 2020) of the COVID-19 pandemic and to compare them with data from 2019 (March–October). Comparing 2019 and both waves of the COVID-19 pandemic, we observed nonsignificant differences in the number of STEMI admissions, baseline characteristics, use of primary percutaneous coronary intervention (PCI) within the first 3 (40.5%* vs. 38.7% vs. 25%*, *p = 0.074) or 6 h, TIMI III flow after primary PCI, and hospital complications, as well as significant increases in hospital heart failure (23.3% vs. 42%, p = 0.015) and mitral regurgitation in the second wave (10% vs. 26.9%, p = 0.008) of the pandemic and a nonsignificant increase in hospital mortality (8.9% vs. 9.4% vs. 13.6%) during both waves of the pandemic. We conclude that, due to the increased severity of the COVID-19 pandemic in the second wave, there were longer delays to primary PCI in STEMI patients, resulting in significantly increased hospital heart failure and non-significantly increased hospital mortality.
Ključne besede: ST-elevation myocardial infarction, COVID-19, time delay, primary percutaneous coronary intervention, heart failure, mortality, pandemic
Objavljeno v DKUM: 04.07.2024; Ogledov: 134; Prenosov: 22
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7. In-hospital bleeding occurring while treating ST-segment elevation myocardial infarction during the COVID-19 pandemic: STEMI during the COVID-19 pandemicMatej Kvartuh, Domen Lah, Martin Marinšek, David Šuran, Andreja Sinkovič, 2023, izvirni znanstveni članek Ključne besede: COVID-19 pandemic, ST-elevation myocardial infarction, bleeding, mortality, hospital complications
Objavljeno v DKUM: 21.12.2023; Ogledov: 289; Prenosov: 20
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8. Vpliv iducirane hipotermije ob nenadnem zastoju srcaFilip Bračko, 2023, diplomsko delo Opis: Uvod: Inducirana oz. terapevtska hipotermija je nadzorovano znižanje telesne temperature v terapevtske namene in se priporoča kot standard pri zdravljenju pacientov v kritičnem stanju. Hipotermija izboljša preskrbo možganov z načinom zmanjšanja celičnega metabolizma in posledično zmanjšane potrebe po kisiku, kar daje pacientu boljše možnosti za pozitiven nevrološki izid zdravljenja. Namen zaključnega dela je raziskati vpliv inducirane hipotermije na nevrološki izid pri pacientih po preživelem nenadnem zastoju srca.
Metode: Z namenom izdelave zaključnega dela smo v podatkovnih bazah PubMed, Science Direct in Cochrane Library poiskali raziskave, pri čemer smo si pomagali z iskalnim nizom in zastavljenimi omejitvami. Potek iskanja raziskav smo predstavili v PRISMA diagramu. Uporabljena je bila deskriptivna metoda dela.
Rezultati: Inducirana ali terapevtska hipotermija izboljša nevrološki izid in okrevanje pacientov, ne glede na to, ali gre za bolnišnični ali izvenbolnišnični srčni zastoj. Inducirana hipotermija prav tako ni povezana s povečanjem smrtnosti in pojavom neželenih stranskih učinkov.
Razprava in zaključek: Pacienti po preživelem nenadnem zastoju srca imajo s pomočjo moderne medicinske obravnave velike možnosti preživetja in izhoda z dobrim nevrološkim izidom zdravljenja. Inducirana hipotermija predstavlja način zdravljenja, ki bi moral postati standard v obravnavi akutno bolnega pacienta po preživelem zastoju srca, saj raziskave potrjujejo njeno učinkovitost.
Ključne besede: hipotermija, srčni zastoj, zdravljenje, nevrološki izid
Objavljeno v DKUM: 13.10.2023; Ogledov: 454; Prenosov: 107
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9. Primerljivost vrednosti parametrov plinske analize arterijske krvi in plinske analize venske krvi pri kritično bolnem pacientuBožidar Bele, 2023, magistrsko delo Opis: Uvod: Plinska analiza arterijske krvi je temeljna diagnostična preiskava pri določanju pacientovega metabolnega, kardiovaskularnega in respiratornega stanja, pridobitev vzorca pa predstavlja za pacienta invaziven poseg. Novejši pristopi omogočajo določitev parametrov iz vzorca venske krvi. Namen zaključnega dela je bil ugotoviti primerljivost vrednosti parametrov pH, HCO₃, pCO₂, pO₂, Na, K in Cl med parametri arterijske in venske krvi.
Metodologija: Izveden je bil pregled literature. Uporabljena je bila deskriptivna metoda dela z analizo in kompilacijo identificiranih virov. Iskanje je potekalo v podatkovnih bazah CINAHL, PubMed, Cochrane Library, Web of Science in Wiley Online Library. Uporabljen je bil tudi iskalnik Google Scholar. Vključenim raziskavam je bila ocenjena kakovost, ugotovitve pa so bile sintetizirane.
Rezultati: Vključenih je bilo 22 raziskav. Venske vrednosti pH, HCO₃ in pCO₂ so primerljive z arterijskimi. Za te parametre se lahko uporablja venski vzorec krvi. Pri določanju Na, K in Cl je potrebna previdnost, saj parametri med seboj niso primerljivi. Odsvetuje se uporaba vzorca venske krvi za določitev vrednosti pO₂.
Razprava in zaključek: Vzorec arterijske krvi je primarna izbira za plinsko analizo krvi. Vzorec venske krvi je lahko uporabljen za parametre pH, HCO₃, in pCO₂, pri čemer je pri interpretaciji vrednosti ostalih parametrov potrebna previdnost.
Ključne besede: plinska analiza krvi, vzorec arterijske krvi, vzorec venske krvi, pacient, primerljivost parametrov
Objavljeno v DKUM: 10.08.2023; Ogledov: 726; Prenosov: 180
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