{"id":1677,"date":"2021-12-06T09:39:00","date_gmt":"2021-12-06T08:39:00","guid":{"rendered":"http:\/\/nudch.eu\/vsetko-co-je-dolezite-vediet-o-pims"},"modified":"2022-11-25T14:04:59","modified_gmt":"2022-11-25T13:04:59","slug":"vsetko-co-je-dolezite-vediet-o-pims","status":"publish","type":"post","link":"https:\/\/nudch.eu\/en\/vsetko-co-je-dolezite-vediet-o-pims","title":{"rendered":"V\u0161etko, \u010do  je d\u00f4le\u017eit\u00e9 vedie\u0165 o PIMS"},"content":{"rendered":"<p><strong><u>V\u00a0Bratislave 17. decembra 2021 <\/u><\/strong><strong>\u00a0&#8211; V\u00a0N\u00e1rodnom \u00fastave detsk\u00fdch chor\u00f4b lek\u00e1ri sleduj\u00fa zv\u00fd\u0161en\u00fd po\u010det pacientov s\u00a0pediatrick\u00fdm z\u00e1palov\u00fdm multisyst\u00e9mov\u00fdm syndr\u00f3mom (PIMS). Po\u010das celej prvej a\u00a0druhej vlny pand\u00e9mie ochorenia COVID-19 bolo v\u00a0N\u00daDCH hospitalizovan\u00fdch celkovo 14 tak\u00fdchto det\u00ed, od polovice okt\u00f3bra 2021 sa u\u017e lek\u00e1ri starali o\u00a0\u010fal\u0161\u00edch 8 det\u00ed s\u00a0v\u00fdrazn\u00fdm n\u00e1rastom v\u00fdskytu za posledn\u00e9 dva t\u00fd\u017edne.<\/strong> <strong>Na naj\u010dastej\u0161ie ot\u00e1zky rodi\u010dov odpoved\u00e1 doc. MUDr. Tom\u00e1\u0161 Dallos, PhD., detsk\u00fd reumatol\u00f3g Detskej kliniky (DK) LF UK a\u00a0N\u00daDCH. <\/strong><\/p>\n<p><strong>Ak sa u\u00a0die\u0165a\u0165a potvrd\u00ed ochorenie PIMS, je potrebn\u00e9 die\u0165a hospitalizova\u0165? <\/strong><\/p>\n<p><em>,,PIMS-TS\/MIS-C je potenci\u00e1lne ve\u013emi z\u00e1va\u017en\u00e9 ochorenie, preto s\u00fa spravidla v\u0161etci pacienti hospitalizovan\u00ed. V\u00a0N\u00daDCH s\u00fa v\u0161etci ak\u00fatni pacienti o\u0161etrovan\u00ed ev. prij\u00edman\u00ed na \u010fal\u0161ie oddelenia cez Oddelenie urgentn\u00e9ho pr\u00edjmu (OUP). A\u00a0n\u00e1sledne pod\u013ea z\u00e1va\u017enosti aktu\u00e1lneho klinick\u00e9ho stavu, ev. e\u0161te pretrv\u00e1vaj\u00facej pozitivity SARS-CoV2 PCR testu, sa tieto deti prij\u00edmaj\u00fa na oddelenia Detskej kliniky LF UK a\u00a0N\u00daDCH resp. na pracovisko R2 ur\u010den\u00e9 pre pozit\u00edvnych pacientov a\u00a0v\u00a0najz\u00e1va\u017enej\u0161\u00edch stavoch na Detsk\u00fa kliniku anest\u00e9ziol\u00f3gie a\u00a0intenz\u00edvnej medic\u00edny (DKAIM) N\u00daDCH. Tieto oddelenia preberaj\u00fa aj pacientov z\u00a0in\u00fdch pediatrick\u00fdch pracov\u00edsk z\u00a0okolia Bratislavy. Ke\u010f\u017ee klinick\u00fd stav die\u0165a\u0165a s\u00a0PIMS-TS\/MIS-C sa m\u00f4\u017ee r\u00fdchlo meni\u0165, v\u0161etky zainteresovan\u00e9 pracovisk\u00e1 \u00fazko spolupracuj\u00fa, aby bola pre die\u0165a v\u017edy zabezpe\u010den\u00e1 optim\u00e1lna starostlivos\u0165. Na starostlivosti o\u00a0tieto deti sa okrem pediatrov a\u00a0lek\u00e1rov intenz\u00edvnej medic\u00edny podie\u013eaj\u00fa aj neurol\u00f3govia, chirurgovia, r\u00e1diol\u00f3govia aj na\u0161e laborat\u00f3ri\u00e1. Z\u00e1va\u017enos\u0165 priebehu PIMS-TS\/MIS-C je u\u00a0konkr\u00e9tneho die\u0165a\u0165a nepredv\u00eddate\u013en\u00e1 a\u00a0klinick\u00fd stav sa m\u00f4\u017ee n\u00e1hle zhor\u0161i\u0165. Preto ka\u017ed\u00e9 die\u0165a, u\u00a0ktor\u00e9ho vznikne podozrenie na PIMS-TS\/MIS-C, by malo by\u0165 hospitalizovan\u00e9 na oddelen\u00ed, z\u00a0ktor\u00e9ho je mo\u017en\u00fd bezodkladn\u00fd preklad na pracovisko intenz\u00edvnej medic\u00edny. <\/em><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Ak\u00fa s\u00fa pr\u00edznaky PIMS? <\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>,,<em>Vzh\u013eadom na \u0161irok\u00e9 spektrum pr\u00edznakov, ktor\u00e9 sa pri PIMS-TS\/MIS-C m\u00f4\u017eu vyskytn\u00fa\u0165 v\u00a0r\u00f4znom porad\u00ed a\u00a0intenzite, je rozpoznanie ochorenia vo v\u010dasnom \u0161t\u00e1diu ve\u013emi problematick\u00e9. V\u00a0pr\u00edpade, \u017ee sa u\u00a0die\u0165a\u0165a klinick\u00fd stav zhor\u0161uje alebo typicky vyv\u00edja, m\u00f4\u017ee by\u0165 potrebn\u00e9 Urgentn\u00fd pr\u00edjem nav\u0161t\u00edvi\u0165 aj opakovane v\u00a0priebehu nieko\u013ek\u00fdch dn\u00ed. V\u0161etky deti s\u00a0PIMS-TS\/MIS-C maj\u00fa vysok\u00e9 hor\u00fa\u010dky, ktor\u00e9 pretrv\u00e1vaj\u00fa nieko\u013eko dn\u00ed. Postihnutie gastrointestin\u00e1lneho traktu je jedn\u00fdm z\u00a0dominantn\u00fdch pr\u00edznakov &#8211; u\u00a0det\u00ed s\u00fa ve\u013emi \u010dast\u00e9 v\u00fdrazn\u00e9 bolesti brucha, ktor\u00e9 m\u00f4\u017eu imitova\u0165 n\u00e1hlu bru\u0161n\u00fa pr\u00edhodu, pr\u00edpadne aj vracanie a\u00a0hna\u010dky. Postupne sa objav\u00ed za\u010dervenanie o\u010d\u00ed, ktor\u00e9 sa podob\u00e1 na z\u00e1pal spojiviek a ko\u017en\u00e1 vyr\u00e1\u017eka, ktor\u00e1 m\u00e1 ve\u013emi r\u00f4znorod\u00fd vzh\u013ead. Pri kombin\u00e1cii t\u00fdchto pr\u00edznakov je ur\u010dite potrebn\u00e9 vyh\u013eada\u0165 lek\u00e1ra. Av\u0161ak ka\u017ed\u00fd pr\u00edznak osamote by ur\u010dite nemal vzbudzova\u0165 automaticky obavy z\u00a0PIMS-TS, ke\u010f\u017ee je pravdepodobnej\u0161ie, \u017ee je prejavom in\u00e9ho, be\u017enej\u0161ieho ochorenia. Niektor\u00e9 deti maj\u00fa aj bolesti hlavy alebo poci\u0165uj\u00fa v\u00fdrazn\u00fa slabos\u0165, m\u00f4\u017eu ma\u0165 pr\u00edznaky ako pri z\u00e1pale mozgov\u00fdch bl\u00e1n &#8211; bolesti hlavy, vracanie, setloplachos\u0165. \u00a0Ak vznikne na z\u00e1klade kombin\u00e1cie uveden\u00fdch pr\u00edznakov podozrenie na PIMS-TS\/MIS-C, \u00a0treba \u00eds\u0165 s\u00a0die\u0165a\u0165om na pohotovos\u0165, kde sa daj\u00fa hne\u010f urobi\u0165 potrebn\u00e9 vy\u0161etrenia. U\u00a0det\u00ed sa zdravotn\u00fd stav \u00a0zhor\u0161uje postupne. Pozorn\u00fd rodi\u010d si v\u0161imne, \u017ee die\u0165a nie je v\u00a0poriadku a\u00a0resp. celkovo sa m\u00e1 hor\u0161ie ako pri be\u017enom ochoren\u00ed. Vzh\u013eadom na to je \u00a0m\u00e1lo pravdepodobn\u00e9, \u017ee by sa die\u0165a e\u0161te doma dostalo do tak z\u00e1va\u017en\u00e9ho stavu, aby muselo by\u0165 transportovan\u00e9 sanitkou. T\u00fa treba vola\u0165 vtedy, ak die\u0165a u\u017e str\u00e1ca vedomie, je zm\u00e4ten\u00e9 alebo v\u00fdrazne du\u0161n\u00e9 (r\u00fdchlo a\u00a0s\u0165a\u017eene d\u00fdcha), alebo je zjavn\u00e1 porucha prekrvenia a\u00a0okysli\u010denia, ktor\u00e1 sa prejav\u00ed\u00a0 studen\u00fdmi rukami, modr\u00fdmi perami.<\/em><\/p>\n<p><em>\u00a0<\/em><\/p>\n<p><strong>Po akom \u010dase od prekonania ochorenia sa prejav\u00ed PIMS? <\/strong><\/p>\n<p><em>PIMS-TS\/MIS-C sa u\u00a0det\u00ed doposia\u013e hospitalizovan\u00fdch v\u00a0N\u00daDCH naj\u010dastej\u0161ie prejavil po 5-6 t\u00fd\u017ed\u0148och (22-60 dn\u00ed) od potvrden\u00e9ho COVID- 19. Deti prich\u00e1dzali do N\u00daDCH na 4.-5. de\u0148 hor\u00fa\u010dok (1-14 dn\u00ed), v\u00e4\u010d\u0161inou s\u00a0gastrointistin\u00e1lnymi a\u00a0ko\u017en\u00fdmi pr\u00edznakmi, niektor\u00e9 u\u017e aj so za\u010d\u00ednaj\u00facimi z\u00e1va\u017en\u00fdmi pr\u00edznakmi \u2013 najm\u00e4 v\u00fdrazn\u00fdm poklesom krvn\u00e9ho tlaku.<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Ako dlho zvy\u010dajne trv\u00e1\u00a0lie\u010dba pacientov s PIMS?<\/strong><\/p>\n<p><em>Je pozoruhodn\u00e9, \u017ee aj napriek \u0165a\u017ek\u00e9mu priebehu u\u00a0niektor\u00fdch det\u00ed, je \u00faprava klinick\u00e9ho stavu pri\u00a0PIMS-TS\/MIS-C pomerne r\u00fdchla a\u00a0kompletn\u00e1. V\u00e4\u010d\u0161ina det\u00ed bola hospitalizovan\u00e1 okolo 8 dn\u00ed, dlh\u0161ie to bolo u\u00a0det\u00ed so z\u00e1va\u017enej\u0161\u00edm priebehom, ktor\u00e9 vy\u017eadovali aj starostlivos\u0165 na DKAIM (celkovo do 20 dn\u00ed).<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><strong>S\u00fa viac ohrozen\u00e9 polymorb\u00eddne deti a ak\u00fa \u0161ancu maj\u00fa pacienti s PIMS na vylie\u010denie? <\/strong><\/p>\n<p><em>\u017diadne z\u00a0det\u00ed s\u00a0PIMS-TS\/MIS-C hospitalizovan\u00fdch v\u00a0N\u00daDCH nebolo predt\u00fdm chor\u00e9, \u010di polymorb\u00eddne, spravidla i\u0161lo o\u00a0dovtedy \u00faplne zdrav\u00e9 deti. \u00damrtia pri PIMS-TS\/MIS-C boli op\u00edsan\u00e9 v\u00a0literat\u00fare u\u00a01% postihnut\u00fdch det\u00ed a\u00a0nedaj\u00fa sa vyl\u00fa\u010di\u0165 ani pri adekv\u00e1tnej starostlivosti. V\u00a0na\u0161ich podmienkach sme \u00famrtie na PIMS-TS\/MIS-C zatia\u013e nezaznamenali. \u00a0<strong>Z\u00e1verom je potrebn\u00e9 kon\u0161tatova\u0165, \u017ee na z\u00e1klade dostupn\u00fdch \u00fadajov sa zd\u00e1, \u017ee o\u010dkovanie proti COVID19 deti chr\u00e1ni aj pred v\u00fdvojom PIMS-TS, ke\u010f\u017ee v\u00a0literat\u00fare boli op\u00edsan\u00e9 len 2 deti, u\u00a0ktor\u00fdch sa PIMS-TS\/MIS-C vyvinul aj napriek tomu, \u017ee boli o\u010dkovan\u00e9.<\/strong><\/em><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>V\u00a0Bratislave 17. decembra 2021 \u00a0&#8211; V\u00a0N\u00e1rodnom \u00fastave detsk\u00fdch chor\u00f4b lek\u00e1ri sleduj\u00fa zv\u00fd\u0161en\u00fd po\u010det pacientov s\u00a0pediatrick\u00fdm z\u00e1palov\u00fdm multisyst\u00e9mov\u00fdm syndr\u00f3mom (PIMS). Po\u010das celej prvej a\u00a0druhej vlny pand\u00e9mie ochorenia COVID-19 bolo v\u00a0N\u00daDCH hospitalizovan\u00fdch celkovo 14 tak\u00fdchto det\u00ed, od polovice okt\u00f3bra 2021 sa u\u017e lek\u00e1ri starali o\u00a0\u010fal\u0161\u00edch 8 det\u00ed s\u00a0v\u00fdrazn\u00fdm n\u00e1rastom v\u00fdskytu za posledn\u00e9 dva t\u00fd\u017edne. Na naj\u010dastej\u0161ie ot\u00e1zky [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[78],"tags":[75],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.14 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>V\u0161etko, \u010do je d\u00f4le\u017eit\u00e9 vedie\u0165 o PIMS | National Institute of Children\u2019s Diseases<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/nudch.eu\/en\/vsetko-co-je-dolezite-vediet-o-pims\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"V\u0161etko, \u010do je d\u00f4le\u017eit\u00e9 vedie\u0165 o PIMS | National Institute of Children\u2019s Diseases\" \/>\n<meta property=\"og:description\" content=\"V\u00a0Bratislave 17. decembra 2021 \u00a0&#8211; V\u00a0N\u00e1rodnom \u00fastave detsk\u00fdch chor\u00f4b lek\u00e1ri sleduj\u00fa zv\u00fd\u0161en\u00fd po\u010det pacientov s\u00a0pediatrick\u00fdm z\u00e1palov\u00fdm multisyst\u00e9mov\u00fdm syndr\u00f3mom (PIMS). 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Po\u010das celej prvej a\u00a0druhej vlny pand\u00e9mie ochorenia COVID-19 bolo v\u00a0N\u00daDCH hospitalizovan\u00fdch celkovo 14 tak\u00fdchto det\u00ed, od polovice okt\u00f3bra 2021 sa u\u017e lek\u00e1ri starali o\u00a0\u010fal\u0161\u00edch 8 det\u00ed s\u00a0v\u00fdrazn\u00fdm n\u00e1rastom v\u00fdskytu za posledn\u00e9 dva t\u00fd\u017edne. 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