"2"^^ . "3"^^ . . "\u0160t\u011Btk\u00E1\u0159ov\u00E1, Ivana" . "chronic pain, severe spasticity, intrathecal delivery systems, complications"@en . . . "12"^^ . "Bolest" . "CZ - \u010Cesk\u00E1 republika" . "Komplikace dlouhodob\u00E9 intraspin\u00E1ln\u00ED aplikace l\u00E9k\u016F" . . "1212-0634" . "N, P(NR8232), P(NR8523), Z(MSM0021620816)" . . . "Complications of long-term intraspinal drug delivery systems"@en . "Komplikace dlouhodob\u00E9 intraspin\u00E1ln\u00ED aplikace l\u00E9k\u016F"@cs . "Chronick\u00E1 nen\u00E1dorov\u00E1 bolest a t\u011B\u017Ek\u00E1 spasticita nejsou v\u017Edy dostate\u010Dn\u011B ovlivniteln\u00E9 standardn\u00EDmi l\u00E9\u010Debn\u00FDmi postupy. Intraspin\u00E1ln\u00ED (subarachnoid\u00E1ln\u00ED) aplikace l\u00E9k\u016F s pou\u017Eit\u00EDm pln\u011B programovateln\u00FDch pumpov\u00FDch syst\u00E9m\u016F jsou l\u00E9\u010Debnou mo\u017Enost\u00ED pro vybran\u00E9 nemocn\u00E9 se silnou chronickou bolest\u00ED a s t\u011B\u017Ekou spasticitou. Tato neuromodula\u010Dn\u00ED metoda se pou\u017E\u00EDv\u00E1 od 80. let minul\u00E9ho stolet\u00ED k l\u00E9\u010Db\u011B jinak nezvl\u00E1dnuteln\u00FDch chronick\u00FDch n\u00E1dorov\u00FDch i nen\u00E1dorov\u00FDch bolestiv\u00FDch stav\u016F. K l\u00E9\u010Db\u011B spastick\u00FDch stav\u016F je subarachnoid\u00E1ln\u00ED aplikace baklofenu pumpov\u00FDmi syst\u00E9my pou\u017E\u00EDv\u00E1na od roku 1992. Hlavn\u00ED v\u00FDhodou aplikace l\u00E9k\u016F do subarachnoid\u00E1ln\u00EDho prostoru ve srovn\u00E1n\u00ED s ostatn\u00EDmi l\u00E9\u010Debn\u00FDmi p\u0159\u00EDstupy je velk\u00E9 p\u0159ibl\u00ED\u017Een\u00ED aplikace l\u00E9k\u016F k m\u00EDst\u016Fm jejich p\u016Fsoben\u00ED v m\u00ED\u0161e. Pou\u017Eit\u00ED n\u00EDzk\u00FDch d\u00E1vek l\u00E9k\u016F sni\u017Euje pravd\u011Bpodobnost v\u00FDskytu komplikac\u00ED a ne\u017E\u00E1douc\u00EDch vedlej\u0161\u00EDch \u00FA\u010Dink\u016F. P\u0159ednost\u00ED je siln\u00FD a protrahovan\u00FD analgetick\u00FD (antispastick\u00FD) \u00FA\u010Dinek p\u0159i stabiln\u00ED terapeutick\u00E9 hladin\u011B a prodlou\u017Een\u00E9m trv\u00E1n\u00ED p\u016Fsoben\u00ED. Tyto implantibiln\u00ED syst\u00E9my jsou invazivn\u00ED a finan\u010Dn\u011B n\u00E1ro\u010Dn\u00E9 a proto je spr\u00E1vn\u00E1 a bezpe\u010Dn\u00E1 funkce t\u011Bchto syst\u00E9m\u016F velmi d\u016Fle\u017Eit\u00E1. Odezva na subarachnoid\u00E1ln\u00ED aplikaci l\u00E9k\u016F se li\u0161\u00ED u jednotliv\u00FDch nemocn\u00FDch. Pou\u017Eit\u00ED striktn\u00EDch aseptick\u00FDch z\u00E1sad p\u0159i implantaci syst\u00E9mu je z\u00E1kladn\u00EDm p\u0159edpokladem k prevenci infek\u010Dn\u00EDch komplikac\u00ED. V na\u0161\u00ED pr\u00E1ci jsou pops\u00E1ny komplikace a ne\u017E\u00E1douc\u00ED vedlej\u0161\u00ED \u00FA\u010Dinky, jejich p\u0159\u00ED\u010Diny, mo\u017Enosti rozpozn\u00E1n\u00ED, manifestace projev\u016F, l\u00E9\u010Dba a mo\u017Enosti prevence jejich vzniku. Ne\u017E\u00E1douc\u00ED vedlej\u0161\u00ED \u00FA\u010Dinky a komplikace d\u011Bl\u00EDme do t\u0159\u00ED z\u00E1kladn\u00EDch skupin. Jsou to vedlej\u0161\u00ED \u00FA\u010Dinky l\u00E9k\u016F, komplikace spojen\u00E9 s implantac\u00ED syst\u00E9mu a komplikace spojen\u00E9 s \u010Dinnost\u00ED vlastn\u00EDho syst\u00E9mu. V\u011Bt\u0161ina t\u011Bchto ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F je nez\u00E1va\u017En\u00FDch, ale n\u011Bkter\u00E9 z nich mohou b\u00FDt velmi z\u00E1va\u017En\u00E9 a i smrteln\u00E9. Z\u00E1va\u017En\u00E9 komplikace se \u010Dasto mus\u00ED \u0159e\u0161it opera\u010Dn\u00EDm z\u00E1krokem nebo dokonce mus\u00ED b\u00FDt l\u00E9\u010Dba ukon\u010Dena a syst\u00E9m odstran\u011Bn. V dal\u0161\u00EDm textu jsou pops\u00E1ny na\u0161e zku\u0161enosti s pou\u017Eit\u00EDm" . "Complications of long-term intraspinal drug delivery systems"@en . . . "429437" . . . . . "1" . . . "Chronick\u00E1 nen\u00E1dorov\u00E1 bolest a t\u011B\u017Ek\u00E1 spasticita nejsou v\u017Edy dostate\u010Dn\u011B ovlivniteln\u00E9 standardn\u00EDmi l\u00E9\u010Debn\u00FDmi postupy. Intraspin\u00E1ln\u00ED (subarachnoid\u00E1ln\u00ED) aplikace l\u00E9k\u016F s pou\u017Eit\u00EDm pln\u011B programovateln\u00FDch pumpov\u00FDch syst\u00E9m\u016F jsou l\u00E9\u010Debnou mo\u017Enost\u00ED pro vybran\u00E9 nemocn\u00E9 se silnou chronickou bolest\u00ED a s t\u011B\u017Ekou spasticitou. Tato neuromodula\u010Dn\u00ED metoda se pou\u017E\u00EDv\u00E1 od 80. let minul\u00E9ho stolet\u00ED k l\u00E9\u010Db\u011B jinak nezvl\u00E1dnuteln\u00FDch chronick\u00FDch n\u00E1dorov\u00FDch i nen\u00E1dorov\u00FDch bolestiv\u00FDch stav\u016F. K l\u00E9\u010Db\u011B spastick\u00FDch stav\u016F je subarachnoid\u00E1ln\u00ED aplikace baklofenu pumpov\u00FDmi syst\u00E9my pou\u017E\u00EDv\u00E1na od roku 1992. Hlavn\u00ED v\u00FDhodou aplikace l\u00E9k\u016F do subarachnoid\u00E1ln\u00EDho prostoru ve srovn\u00E1n\u00ED s ostatn\u00EDmi l\u00E9\u010Debn\u00FDmi p\u0159\u00EDstupy je velk\u00E9 p\u0159ibl\u00ED\u017Een\u00ED aplikace l\u00E9k\u016F k m\u00EDst\u016Fm jejich p\u016Fsoben\u00ED v m\u00ED\u0161e. Pou\u017Eit\u00ED n\u00EDzk\u00FDch d\u00E1vek l\u00E9k\u016F sni\u017Euje pravd\u011Bpodobnost v\u00FDskytu komplikac\u00ED a ne\u017E\u00E1douc\u00EDch vedlej\u0161\u00EDch \u00FA\u010Dink\u016F. P\u0159ednost\u00ED je siln\u00FD a protrahovan\u00FD analgetick\u00FD (antispastick\u00FD) \u00FA\u010Dinek p\u0159i stabiln\u00ED terapeutick\u00E9 hladin\u011B a prodlou\u017Een\u00E9m trv\u00E1n\u00ED p\u016Fsoben\u00ED. Tyto implantibiln\u00ED syst\u00E9my jsou invazivn\u00ED a finan\u010Dn\u011B n\u00E1ro\u010Dn\u00E9 a proto je spr\u00E1vn\u00E1 a bezpe\u010Dn\u00E1 funkce t\u011Bchto syst\u00E9m\u016F velmi d\u016Fle\u017Eit\u00E1. Odezva na subarachnoid\u00E1ln\u00ED aplikaci l\u00E9k\u016F se li\u0161\u00ED u jednotliv\u00FDch nemocn\u00FDch. Pou\u017Eit\u00ED striktn\u00EDch aseptick\u00FDch z\u00E1sad p\u0159i implantaci syst\u00E9mu je z\u00E1kladn\u00EDm p\u0159edpokladem k prevenci infek\u010Dn\u00EDch komplikac\u00ED. V na\u0161\u00ED pr\u00E1ci jsou pops\u00E1ny komplikace a ne\u017E\u00E1douc\u00ED vedlej\u0161\u00ED \u00FA\u010Dinky, jejich p\u0159\u00ED\u010Diny, mo\u017Enosti rozpozn\u00E1n\u00ED, manifestace projev\u016F, l\u00E9\u010Dba a mo\u017Enosti prevence jejich vzniku. Ne\u017E\u00E1douc\u00ED vedlej\u0161\u00ED \u00FA\u010Dinky a komplikace d\u011Bl\u00EDme do t\u0159\u00ED z\u00E1kladn\u00EDch skupin. Jsou to vedlej\u0161\u00ED \u00FA\u010Dinky l\u00E9k\u016F, komplikace spojen\u00E9 s implantac\u00ED syst\u00E9mu a komplikace spojen\u00E9 s \u010Dinnost\u00ED vlastn\u00EDho syst\u00E9mu. V\u011Bt\u0161ina t\u011Bchto ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F je nez\u00E1va\u017En\u00FDch, ale n\u011Bkter\u00E9 z nich mohou b\u00FDt velmi z\u00E1va\u017En\u00E9 a i smrteln\u00E9. Z\u00E1va\u017En\u00E9 komplikace se \u010Dasto mus\u00ED \u0159e\u0161it opera\u010Dn\u00EDm z\u00E1krokem nebo dokonce mus\u00ED b\u00FDt l\u00E9\u010Dba ukon\u010Dena a syst\u00E9m odstran\u011Bn. V dal\u0161\u00EDm textu jsou pops\u00E1ny na\u0161e zku\u0161enosti s pou\u017Eit\u00EDm"@cs . . "Komplikace dlouhodob\u00E9 intraspin\u00E1ln\u00ED aplikace l\u00E9k\u016F"@cs . "[FD897B17A327]" . "RIV/00023884:_____/07:#0001683!RIV12-MZ0-00023884" . "Vrba, Ivan" . . . . "Chronic nonmalignant pain and severe spasticity are not always manageable with standard treatment modalities. Intraspinal (intrathecal) infusion using fully implantable pump and catheter systems is a possibility of therapy for selected patients with severe chronic pain and spasticity. Intrathecal drug delivery using fully implantable pumps and catheter systems has been used since the 1980s to treat chronic intractable pain associated with cancer or noncancar causes. Programmable systems to administer intrathecal baclofen have been used since 1992 to treat spasticity. The main advantage of intrathecal drug delivery over other treatment modalities and routes of administration is that drugs are delivered near their sites of action within the spinal cord. Administration of relatively low drug dosage reduces the likelihood of side effects and complications. Intrathecal drug delivery systems offers the advantages of potent analgesic (antispastic) response with a more stable therapeutic drug level, increased duration of action, and decreased pharmacological complications. Because implantable long-term spinal drug delivery systems for pain and spasticity are invasive and costly, durability, stability and mainly safety of the delivery (pump and catheter) systems are of significant importance. Patients respond differently to implantable drug delivery therapy. The use of meticulous aseptic techniques during the implantation procedure is essential to prevent costly and time-consuming infectious complications. Prevention, early recognition, and prompt management of adverse events will optimize patients outcomes. Adverse events are an unavoidable part of long-term intrathecal delivery drug systems. In this study, there are described adverse side effects and complications, their origins, detection, manifestation and their management-prevention in this article. There are three main categories of potential adverse events and compl"@en . "10" . . . "RIV/00023884:_____/07:#0001683" . "Komplikace dlouhodob\u00E9 intraspin\u00E1ln\u00ED aplikace l\u00E9k\u016F" . .