{"id":28293,"date":"2017-05-23T07:29:46","date_gmt":"2017-05-23T05:29:46","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=28293"},"modified":"2017-05-23T08:30:00","modified_gmt":"2017-05-23T06:30:00","slug":"rozhovor-s-mudr-seidlovou-o-porodu-zeny-v-komatu","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=28293","title":{"rendered":"Rozhovor s MUDr. Seidlovou o porodu \u017eeny v komatu"},"content":{"rendered":"

P\u0159\u00edpad t\u0159iat\u0159icetilet\u00e9 Veroniky, kter\u00e1 byla po t\u011b\u017ek\u00e9 autonehod\u011b v \u0159\u00edjnu 2015 p\u0159evezena do Fakultn\u00ed nemocnice Brno, kde byla hospitalizov\u00e1na, v k\u00f3matu zde porodila zdrav\u00e9ho chlapce a posl\u00e9ze se z\u00a0k\u00f3matu probrala, vyvolal velkou odezvu.<\/strong><\/p>\n

Informovala o n\u011bm v\u0161echna hlavn\u00ed zpravodajsk\u00e1 m\u00e9dia, mnoho lid\u00ed dojal, odborn\u00edky vyprovokoval k\u00a0nov\u00fdm ot\u00e1zk\u00e1m.<\/p>\n

V\u00a0n\u00e1sleduj\u00edc\u00edm rozhovoru se dozv\u00edte, jak na tento p\u0159\u00edpad s v\u00edce ne\u017e ro\u010dn\u00edm odstupem vzpom\u00edn\u00e1 MUDr. Dagmar Seidlov\u00e1, Ph.D., prim\u00e1\u0159ka II. Anesteziologicko-resuscita\u010dn\u00edho odd\u011blen\u00ed, kde pacientka le\u017eela t\u0159i m\u011bs\u00edce.<\/p>\n

V\u00a0jak\u00e9m stavu jste pacientku p\u0159ijali na Va\u0161e odd\u011blen\u00ed? <\/em><\/strong><\/p>\n

Pacientka byla na II. ARO p\u0159elo\u017eena v\u00a0hlubok\u00e9m k\u00f3matu \u2013 vegetativn\u00edm stavu ozna\u010dovan\u00e9m jako tzv. coma vigile, kdy nereagovala na zevn\u00ed podn\u011bty. D\u00fdchala spont\u00e1nn\u011b, nebyla schopna \u017ev\u00fdkat ani polykat \u2013 potravu p\u0159ij\u00edmala pomoc\u00ed sondy. V\u00a0t\u00e9 dob\u011b byla ve 24. t\u00fddnu t\u011bhotenstv\u00ed.<\/p>\n

P\u0159es jak\u00e1 odd\u011blen\u00ed pro\u0161la? <\/em><\/strong><\/p>\n

Po dopravn\u00ed nehod\u011b byla zdravotnickou z\u00e1chrannou slu\u017ebou p\u0159ivezena na Odd\u011blen\u00ed urgentn\u00edho p\u0159\u00edjmu, kde byla vy\u0161et\u0159ena, zaji\u0161t\u011bna a o\u0161et\u0159ena. Bylo zji\u0161t\u011bno z\u00e1va\u017en\u00e9 poran\u011bn\u00ed mozku a kr\u010dn\u00ed p\u00e1te\u0159e s\u00a0po\u0161kozen\u00edm m\u00edchy. Komplexn\u00ed resuscita\u010dn\u00ed p\u00e9\u010de j\u00ed byla poskytov\u00e1na na Klinice anesteziologie, resuscitace a intenzivn\u00ed medic\u00edny FN Brno. Po m\u011bs\u00edci, tj. ve 24. t\u00fddnu t\u011bhotenstv\u00ed, co\u017e je pova\u017eov\u00e1no za dobu, kdy d\u00edt\u011b m\u016f\u017ee p\u0159e\u017e\u00edt, byla p\u0159elo\u017eena k\u00a0n\u00e1m na II. ARO na Obiln\u00ed trh. Sou\u010d\u00e1st\u00ed tohoto pracovi\u0161t\u011b je Perinatologick\u00e9 centrum v\u011bnuj\u00edc\u00ed se p\u00e9\u010di o extr\u00e9mn\u011b nedono\u0161en\u00e9 novorozence.<\/p>\n

Jak\u00e1 byla progn\u00f3za? <\/em><\/strong><\/p>\n

Progn\u00f3za byla velmi nep\u0159\u00edzniv\u00e1, jestli\u017ee se pacient po m\u011bs\u00edci v k\u00f3matu neza\u010dne prob\u00edrat, ale hlavn\u011b nejev\u00ed v\u016fbec \u017e\u00e1dn\u00e9 zn\u00e1mky zlep\u0161ov\u00e1n\u00ed neurologick\u00e9ho n\u00e1lezu, v\u011bt\u0161inou se u\u017e z\u00a0k\u00f3matu neprobere.<\/p>\n

V\u00edme ale, \u017ee Veronika se navzdory nep\u0159\u00edzniv\u00e9 progn\u00f3ze prob\u00edrat za\u010dala, kdy a jak k\u00a0tomu do\u0161lo? <\/em><\/strong><\/p>\n

Bylo to ke konci t\u011bhotenstv\u00ed, v lednu 2016, kdy\u017e byla 14 dn\u00ed p\u0159ed porodem. V\u00a0t\u00e9 dob\u011b za\u010dala Veronika reagovat.<\/p>\n

Pro\u010d bylo t\u011bhotenstv\u00ed ukon\u010deno d\u0159\u00edve?<\/em><\/strong><\/p>\n

L\u00e9ka\u0159i udr\u017eovali t\u011bhotenstv\u00ed od 20. do 35. t\u00fddne. Stav pacientky se ve 34. t\u00fddnu postupn\u011b zhor\u0161oval a bylo vid\u011bt, \u017ee t\u011bhotenstv\u00ed je z\u00e1t\u011b\u017e\u00ed, kterou u\u017e d\u00e1l nen\u00ed schopna zvl\u00e1dat. Celou dobu jsme zva\u017eovali risk a benefit jak pro d\u00edt\u011b, tak pro matku a v\u00a0okam\u017eiku, kdy p\u0159ev\u00e1\u017eil risk matky nad benefitem d\u00edt\u011bte, a p\u0159edpokl\u00e1dali jsme, \u017ee podle ultrazvuku tak\u0159ka dvoukilov\u00e9 d\u00edt\u011b bude \u017eivotaschopn\u00e9, jsme t\u011bhotenstv\u00ed ukon\u010dili.<\/p>\n

Jak\u00fd byl zdravotn\u00ed stav d\u00edt\u011bte?<\/em><\/strong><\/p>\n

Chlape\u010dek se narodil zdrav\u00fd s\u00a0porodn\u00ed hmotnost\u00ed 1970 g. M\u011bl je\u0161t\u011b nezral\u00e9 pl\u00edce, musel b\u00fdt kr\u00e1tkodob\u011b na um\u011bl\u00e9 ventilaci. Po m\u011bs\u00edci si jej p\u0159evzala do dom\u00e1c\u00ed p\u00e9\u010de rodina bratra pacientky. Nyn\u00ed je to zcela norm\u00e1ln\u011b se vyv\u00edjej\u00edc\u00ed ro\u010dn\u00ed d\u00edt\u011b.<\/p>\n

Kr\u00e1tce po porodu se za\u010dal zdravotn\u00ed stav pacientky zlep\u0161ovat, jak si to vysv\u011btlujete? <\/em><\/strong><\/p>\n

Ano. \u00a0V pr\u016fb\u011bhu m\u011bs\u00edce po porodu, kdy je\u0161t\u011b z\u016fstala na na\u0161em odd\u011blen\u00ed, ud\u011blala Veronika v\u00fdrazn\u00fd pokrok. Na tento fakt existuj\u00ed dva r\u016fzn\u00e9 pohledy. Jeden, \u017ee t\u011bhotenstv\u00ed ji tak vy\u010derp\u00e1valo, \u017ee se nemohla zlep\u0161ovat, a druh\u00fd m\u016f\u017ee b\u00fdt \u00fapln\u011b opa\u010dn\u00fd \u2013 tedy t\u00edm, \u017ee Veronika byla s\u00a0d\u00edt\u011btem po porodu d\u00e1le v\u00a0kontaktu, se za\u010dala zlep\u0161ovat. Svou roli sehr\u00e1ly jist\u011b ob\u011b okolnosti.<\/p>\n

Tak\u017ee postupn\u011b u\u017e byla schopna reagovat na podn\u011bty? <\/em><\/strong><\/p>\n

Ano. Byla schopn\u00e1 fixovat pohled, objevila se mimika v\u00a0obli\u010deji, stiskla ruku, opakovala gesta. Neurologick\u00fd n\u00e1lez se postupn\u011b upravoval, i kdy\u017e ona sama si to samoz\u0159ejm\u011b nepamatuje. Veronika si za\u010d\u00edn\u00e1 v\u0161e uv\u011bdomovat a\u017e od \u010dervna 2016.<\/p>\n

Na l\u00e9ka\u0159sk\u00e9 p\u00e9\u010di se muselo bezesporu pod\u00edlet velk\u00e9 mno\u017estv\u00ed odborn\u00edk\u016f, jak prob\u00edhala spolupr\u00e1ce? <\/em><\/strong><\/p>\n

Hlavn\u00ed oblast p\u00e9\u010de byla sice v\u00a0r\u00e1mci intenzivn\u00ed medic\u00edny, ale cht\u011bla bych podotknout, \u017ee o t\u00e9to pacientce nem\u016f\u017eeme v\u00a0\u017e\u00e1dn\u00e9m p\u0159\u00edpad\u011b mluvit jenom jako o na\u0161\u00ed pacientce, tedy o pacientce na\u0161eho odd\u011blen\u00ed, proto\u017ee na jej\u00ed z\u00e1chran\u011b se pod\u00edlela cel\u00e1 \u0159ada odborn\u00edk\u016f r\u016fzn\u00fdch odd\u011blen\u00ed (pracovn\u00edci zdravotnick\u00e9 z\u00e1chrann\u00e9 slu\u017eby, urgentn\u00edho p\u0159\u00edjmu, KARIM, pediat\u0159i, neonatologov\u00e9, porodn\u00edci, neurochirurgov\u00e9, neurologov\u00e9, traumatologov\u00e9, endokrinologov\u00e9 a dal\u0161\u00ed) a jen d\u00edky jejich souh\u0159e se nakonec poda\u0159ilo zdravotn\u00ed stav pacientky optimalizovat. Ale ani tady to neskon\u010dilo, proto\u017ee Veronika byla n\u00e1sledn\u011b p\u0159evezena do \u00dast\u0159edn\u00ed vojensk\u00e9 nemocnice v\u00a0Praze, kde pokra\u010dovala v\u00a0rehabilitaci a pozd\u011bji tak\u00e9 do l\u00e1zn\u00ed. Jej\u00ed p\u0159\u00edpad byl o dokonal\u00e9m nav\u00e1z\u00e1n\u00ed zdravotnick\u00e9 p\u00e9\u010de. A nelze pominout pr\u00e1ci soci\u00e1ln\u00edho odd\u011blen\u00ed, kter\u00e9 se zapojilo do cel\u00e9ho syst\u00e9mu a pomohlo rodin\u011b s\u00a0nelehk\u00fdmi probl\u00e9my soci\u00e1ln\u00edmi a pr\u00e1vn\u00edmi.<\/p>\n

Mohla m\u00edt pozitivn\u00ed vliv na zlep\u0161en\u00ed jej\u00edho zdravotn\u00edho stavu tak\u00e9 metoda baz\u00e1ln\u00ed stimulace? <\/em><\/strong><\/p>\n

Ur\u010dit\u011b. Metoda baz\u00e1ln\u00ed stimulace je vyu\u017e\u00edv\u00e1na u pacient\u016f s\u00a0t\u011b\u017ek\u00fdm posti\u017een\u00edm mozkov\u00fdch funkc\u00ed a vede ke stimulaci mozku zprost\u0159edkov\u00e1n\u00edm vjem\u016f z t\u011bla. Poda\u0159ilo se n\u00e1m do o\u0161et\u0159ovatelsk\u00e9 p\u00e9\u010de a baz\u00e1ln\u00ed stimulace zapojit Veroni\u010dinu maminku, kter\u00e1 s n\u00ed byla ka\u017ed\u00fd den v\u00a0bezprost\u0159edn\u00edm kontaktu n\u011bkolik hodin, a jist\u011b i vyv\u00edjej\u00edc\u00ed se a posl\u00e9ze narozen\u00e9 d\u00edt\u011b bylo pro Veroniku d\u016fle\u017eit\u00fdm podn\u011btem. Souhra medic\u00ednsk\u00e9 p\u00e9\u010de a v\u0161ech t\u011bchto faktor\u016f vedla k\u00a0tomu, \u017ee se pacientka za\u010dala prob\u00edrat.<\/p>\n

Jak je na tom Veronika dnes? <\/em><\/strong><\/p>\n

Dnes Veronika \u017eije v\u00a0bezbari\u00e9rov\u00e9m prost\u0159ed\u00ed dom\u00e1cnosti sv\u00fdch rodi\u010d\u016f. Vy\u017eaduje pomoc v\u00a0z\u00e1kladn\u00edch z\u00e1le\u017eitostech, pohybuje se s dopomoc\u00ed na voz\u00edku. Co je z\u00e1sadn\u00ed \u2013 nem\u00e1 poru\u0161en\u00fd intelekt, komunikuje i telefonicky, tr\u00e9nuje \u0159e\u010d za pomoci logopeda, ale i kdy\u017e denn\u011b n\u011bkolik hodin rehabilituje, p\u0159etrv\u00e1vaj\u00ed n\u00e1sledky poran\u011bn\u00ed m\u00edchy. \u00a0Se sv\u00fdm synem je ve st\u00e1l\u00e9m kontaktu, mazl\u00ed a hraje si s\u00a0n\u00edm, a jak sama \u0159\u00edk\u00e1, d\u011blaj\u00ed pokroky spolu.<\/p>\n

Tento p\u0159\u00edpad je bezesporu velkou raritou, v\u00edme, \u017ee obdobn\u00e9 p\u0159\u00edpady, kdy pacientka v\u00a0k\u00f3matu porod\u00ed a n\u00e1sledn\u011b se z\u00a0k\u00f3matu probere, se vyskytuj\u00ed jen v \u0159\u00e1du jednotek na cel\u00e9m sv\u011bt\u011b\u2026\u00a0 <\/em><\/strong><\/p>\n

Nesporn\u011b jde o v\u00fdjime\u010dn\u00fd p\u0159\u00edpad, proto\u017ee v\u011bt\u0161ina t\u011bchto pacient\u016f se neprobere, nebo dojde nap\u0159. k\u00a0\u00famrt\u00ed plodu. Vn\u00edm\u00e1m to jako medic\u00ednsk\u00fd \u00fasp\u011bch cel\u00e9 nemocnice, na n\u011bm\u017e m\u00e1 velk\u00fd pod\u00edl o\u0161et\u0159ovatelsk\u00e1 pr\u00e1ce sester.<\/p>\n","protected":false},"excerpt":{"rendered":"

P\u0159\u00edpad t\u0159iat\u0159icetilet\u00e9 Veroniky, kter\u00e1 byla po t\u011b\u017ek\u00e9 autonehod\u011b v \u0159\u00edjnu 2015 p\u0159evezena do Fakultn\u00ed nemocnice Brno, kde byla hospitalizov\u00e1na, v k\u00f3matu zde porodila zdrav\u00e9ho chlapce […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":24479,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-28293","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28293","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28293"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28293\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/24479"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28293"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28293"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28293"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}