Aspirace žaludečního obsahu a respirační selhání u dětí - proteomická analýza séra a bronchiálního aspirátu

• Main Author: Hrdlička, René
• Other Authors: Kobr, Jiří
• Format: Doctoral Thesis
• Language: Czech
• Published: 2017
• Online Access: http://www.nusl.cz/ntk/nusl-450683

The aim of the study was the application of new immunoassay procedures in the respiratory failure diagnosis in children based on aspirations. Risk of aspiration, especially in children of the lowest age group, is significantly higher than in those of the other age groups. In some cases, the aspiration may be a fatal incident as sudden infant death syndrome. Currently, there is no exact diagnosis, which would allow to distinguish, when the aspiration is the cause and when it is the result of the respiratory failure. The problem remains also a diagnosis of bacterial contamination during aspiration. This prevents rational deployment of antibiotic treatment. The theoretical part deals with individual biomarkers and their potential contribution to the diagnosis of aspiration. In the current availability of multiplex analysis methodology biomarkers were selected and their dynamics in serum and tracheal aspirate in patients fulfilling the criteria have been analyzed. The biomarkers include cytokines (TNF-α, IL-6, BNP), adhesion molecules (ICAM-1, VCAM- 1, fractalkine) and signal molecules (MMP9 and TIMP1). The group included 15 patients aged under 18 years with lung failure requiring mechanical ventilation based on aspirations. The severity of the clinical condition of the patient was assessed according...