MEDIX, God. 14 Br. 79  •  Pregledni članak  •  Neurologija HR ENG

Telemedicina u trijaži bolesnika s moždanim udaromTelemedicine in triage of stroke patients

Tomislav Breitenfeld

Primjena trombolitičke terapije danas je jedina efikasna metoda liječenja akutnog ishemijskog moždanog udara, no na žalost dostupna je tek malom broju bolesnika, jer mnogi žive predaleko od centara osposobljenih za njenu primjenu. U tom kontekstu telemedicina se javlja kao rješenje kojim bi se mogla proširiti primjena trombolize u smislu povezivanja regionalnih bolnica sa specijalistima u nekom od cerebrovaskularnih centara i time omogućiti daljinsku ekspertizu putem modela telestroke. Trenutno je model telestroke razvijen i rutinski se koristi u SAD-u u sklopu programa REACH (Remote Evaluation of Acute IsCHemic Stroke) i telemedicinskog sustava STRokE DOC, u Francuskoj u sklopu studije TRUST-tPA (Therapeutic Trial Evaluating Efficacy of Telemedicine (TELESTROKE) of Patients With Acute Stroke), dok je najveći projekt organiziran u Njemačkoj – TEMPiS (The Telemedic Pilot Project of an Integrative Stroke Care in Eastern Bavaria). Ordiniranje trombolitičke terapije kod akutnog ishemijskog moždanog udara uz telemedicinsku konzultaciju u dosadašnjim pokusima i projektima pokazalo se izvedivo, uspješno i sigurno.

Ključne riječi:
moždani udar; telemedicina; trombolitička terapija

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 14 Br. 79
narudžba izdanja

Systemic thrombolysis is the most effective acute stroke therapy. Unfortunately, only a small number of stroke patients receive thrombolytic therapy and benefit from the expertise and experience of the stroke teams, usually because there are no stroke units close to their homes. In areas where local stroke specialists are not available, telemedicine can provide an effective solution as it enables an emergency department physician in a regional hospital to establish contact with a specialist in a stroke treatment center and thus receive remote expertise via telestroke model. Currently, the telestroke model is routinely used in the USA through REACH (Remote Evaluation of Acute IsCHemic Stroke) service and STRokE DOC project and in Europe through TRUST-tPA (Therapeutic Trial Evaluating Efficacy of Telemedicine [TELESTROKE] of Patients With Acute Stroke) trial in France and TEMPiS (The Telemedic Pilot Project of an Integrative Stroke Care in Eastern Bavaria) project in Bavaria, Germany. Telemedicine may help extend the use of thrombolytic therapy to a greater number of stroke patients. Administration of thrombolytic therapy using telemedicine consultation in the ongoing trials and projects has been feasible and safe.

Key words:
stroke; telemedicine; thrombolytic therapy