TENSION PNEUMOTHORAX AFTER TRACHEAL LACERATION DUE TO INTUBATION

Laceracija dušnika je rijetka, ali ozbiljna komplikacija koja se može javiti nakon endotrahealne intubacije. Pojavljuje se s incidencijom od 0,01 do 0,37 % ovisno o izvoru (1-4). Prikazujemo slučaj 61-godišnjeg bolesnika koji je primljen u jedinicu intenzivnog liječenja kirurških bolesnika u Kliniku za anesteziologiju, reanimatologiju i intenzivno liječenje Kliničkog bolničkog centra Zagreb nakon operacije karcinoma završnog dijela debelog crijeva. Bolesnik se pola sata nakon dolaska naglo klinički pogoršava uz sinus tahikardiju, hipotenziju, hipoksiju te abdominalnu distenziju. Ultrazvukom prsnog koša dokaže se tenzijski pneumotoraks koji se inicijalno zbrinjava perkutanom dekompresijskom iglom. Na rendgenogramu prsnog koša pokaže se pneumotoraks obostrano. Kompjuteriziranom tomografi jom prsnog koša se dodatno pokaže pneumomedijastinum i suspektna laceracija dušnika koja se na bronhoskopiji vidi kao blagi eritem sluznice. Pacijent je u jedinici intenzivnog liječenja proveo 4 dana, uz primjenu antibiotika širokog spektra i cijelo vrijeme boravka bio stabilan.Tracheal laceration is a rare but serious complication that can occur after endotracheal intubation. The incidence of tracheal laceration ranges from 0.01% to 0.37%. We present a case of a 61-year-old patient admitted to the Intensive Care Unit (ICU) of the Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb University Hospital Centre, after colon cancer surgery. The patient showed acute clinical aggravation, presented by sinus tachycardia, hypotension, hypoxia and abdominal distension half an hour upon arrival. Chest ultrasound showed tension pneumothorax initially treated by percutaneous decompression with a needle. Chest x-ray revealed two-sided pneumothorax. Computerized tomography of the thorax demonstrated pneumomediastinum and suspected laceration of the trachea that appeared on bronchoscopy as mild erythema of the mucous membrane. The patient was in the ICU for four days, where he was administered broad spectrum antibiotics and was stable throughout his stay

Reproducibility of Internal and External Training Load During Recreational Small-Sided Football Games

This is an Accepted Manuscript of an article published by Taylor & Francis in Research Quarterly for Exercise and Sport on 05.02.2020, available at: https://doi.org/10.1080/02701367.2019.1697794.Purpose: The aim of this study was to evaluate the reproducibility of internal and external load parameters during recreational small-sided football games. Methods: Ten healthy untrained young adult males (age: 20.2 ± 1.9 yr, body mass: 69.2 ± 6.3 kg, height: 175.4 ± 5.9 cm, body fat: 19.7 ± 5.2%) performed two 2 × 20-min sessions of four versus four plus goalkeeper small-sided games (SSG) 1 week apart on a standard, outdoor, 40 × 20-m artificial grass pitch. Twelve external (total distance, peak speed, player load, work rate and distance covered at 0–2, 2–5, 5–7, 7–9, 9–13, 13–16, 16–20 and >20 km/h) and seven internal load parameters (heart rate and time spent in different heart rate zones [Results: No statistical differences (p> .05) between sessions were found in any measures. Minimal test-retest variability was noted for mean and peak heart rate (HRpeak) relative to HRpeak with CV values of 3.4% and 2.6%, respectively. Acceptable variability (CVmean), HRpeak, distance covered at 5–7, 13–16 and >20 km/h, and percentage of time above 95%HRpeak were the most reliable variables (ICC = 0.74–0.79), followed by total distance covered, peak speed, and percentage of time at 80–90% HRpeak (ICC = 0.39–0.67). The lowest reliability was observed for distance covered in the moderate speed zones 7–9 km/h (ICC = 0.12) and 9–13 km/h (ICC = −0.09), and percentage of time at 70–80% HRpeak (ICC = −0.01). Conclusions: Small-sided games can be used when planning training-induced exercise responses in relation to total distance covered, peak speed, and mean heart rate. This evidence further supports the use of SSG when organizing recreational football training, in young adult males, with the purpose of improving health profile due to the high reproducibility of HRmean and total distance covered

Decision day – A retrospective analysis of COVID-19 patients treated with high PEEP non-invasive ventilation

Background and objectives. This retrospective analysis investigates the effect of high levels of Positive End-Expiratory Pressure (PEEP) during Non-Invasive Ventilation (NIV) in patients with COVID 19 Acute Respiratory Distress Syndrome (ARDS). Materials and methods. In the University Hospital Center Zagreb from October 2021 to February 2022, the study analyzed data from 97 patients who received NIV for acute respiratory support during ICU stay. The effect of NIV on survival, the length of stay in the ICU as well as the duration of the support itself was investigated. Results. Results show that despite low mortality in patients with NIV support, mortality is quite high in patients who required intubation. There is also a divergence of the respiratory support level parameter after the 3rd day on NIV, which suggests that moment as pivotal for assessing the continuation of NIV support. Conclusions. The results show that high level PEEP is a viable option for starting respiratory support in ARDS, but also the importance of timely assessment to optimize patient outcomes

Ceftazidime/ Avibactam for Treatment of Intrahospital Ventilator-Associated Pneumonia in COVID-19 Patients

U razdoblju pandemije koronavirusne bolesti 2019. (COVID-19) mnogi bolesnici kojima je bila potrebna invazivna mehanička ventilacija, primljeni su u jedinice intenzivnog liječenja (JIL) zbog teškog respiratornog zatajenja povezanog s bolešću COVID-19. Prijam u JIL i invazivna mehanička ventilacija neovisni su rizici za pneumoniju povezanu s ventilatorom (engl. ventilator associated pneumonia; VAP), kod koje je zabilježena visoka stopa smrtnosti i dulji boravak u JIL-u te je produljeno bolničko liječenje. Ako govorimo o uzročnicima VAP-a, Pseudomonas aeruginosa bio je jedan od glavnih gram-negativnih nefermentirajućih uzročnika ove patologije, zajedno s Burkholderia cepacia i Stenotrophomonas maltophilia u manjoj mjeri. Protiv gram-negativnih mikroorganizama otpornih na karbapeneme, ceftazidim/avibaktam (CZA) jedan je od najčešće korištenih antimikrobnih lijekova. Cilj ovog preglednog članka bio je opisati korištenje CZA u liječenju bolesnika s infekcijom COVID-19 koji su razvili VAP uzrokovan P. aeruginosa, B. cepacia i S. maltophilia, usporediti to s podatcima objavljenim u literaturi te skrenuti pozornost na kontinuiranu primjenu lijeka kao drugačijeg modaliteta u odnosu na standardni način primjene u bolusu. Unatoč visokoj smrtnosti kritično oboljelih bolesnika s COVID-om, CZA predstavlja valjanu opciju liječenja VAP-a uzrokovanog nefermentirajućim gram-negativnim mikroorganizmima.In the period of the coronavirus diseFase 2019 (COVID-19) pandemic, many patients requiring invasive mechanical ventilation were admitted to the intensive care unit (ICU) due to severe respiratory failure associated with COVID-19 infection. In fact, ICU admission and invasive ventilation increased the risk of ventilator-associated pneumonia (VAP), which is associated with a high mortality rate and longer ICU and hospital stays. Pseudomonas aeruginosa was the first causative agent of this pathology (VAP), but rare non-fermenting Gram-negative microorganisms such as Burkholderia cepacea and Stenotrophomonas maltophilia have also emerged as potential etiological agents. One of the most frequently used antibiotics against carbapenem- resistant Gram-negative microorganisms is ceftazidime/avibactam (CZA). The aim of this review article was to describe the use of CZA in a series of cases of patients with COVID-19 infection who developed difficult-to-treat VAP due to P. aeruginosa, B. cepacea and S. maltophilia and to compare it with data published in the literature, as well as to draw attention to the continuous administration of the drug as a different modality compared to the standard method of bolus administration. Despite the high mortality of critically ill patients with COVID-19, CZA, especially in combination therapy, could represent a valid treatment option for VAP caused by non-fermenting Gram-negative microorganisms

Acinetobacter Baumannii Pneumonia Associated with Mechanical Ventilation in COVID-19 Pandemic

Infekcije uzrokovane bakterijom Acinetobacter baumannii predstavljaju veliki javnozdravstveni problem. Acinetobacter baumannii kontaminira bolničko okruženje, kožu i sluznice pacijenata te se prenosi rukama osoblja uzrokujući oportunističke infekcije kao što su upale pluća povezane s mehaničkom ventilacijom, bakterijemije, infekcije rana te urinarne infekcije. Ventilatorom uzrokovana upala pluća druga je po učestalosti nozokomijalna infekcija u jedinicama intenzivnog liječenja. Vodeći čimbenik rizika za razvoj ventilatorom uzrokovane upale pluća jest invazivna mehanička ventilacija. U pacijenata s bolešću COVID-19, liječenje u jedinicama intenzivnog liječenja često je zahtijevalo intubaciju i uporabu mehaničke ventilacije izlažući ih riziku od razvoja ventilatorom uzrokovane upale pluća. S obzirom na brojna preklapanja u kliničkoj slici COVID upale pluća i upale pluća povezane s ventilatorom, teško je sa sigurnošću odrediti njezinu prevalenciju. Oštećenja pluća uzrokovana bolešću COVID-19, imunosupresivna terapija, često profilaktičko korištenje antibiotika i organizacijske teškoće – prenapučenost u jedinicama intenzivnog liječenja, manjak osoblja, potreba za zaštitom osoblja od virusa SARS-CoV-2 (engl. Severe acute respiratory syndrome coronavirus 2) infekcije i dr., pridonijeli su povećanoj pojavnosti ventilatorom izazvane upale pluća uzrokovane Acinetobacter baumannii u pacijenata oboljelih od COVID-a. Brojni mehanizmi otpornosti na antibiotike, uz posljedično sve veću prevalenciju višestruko otpornih sojeva Acinetobacter baumannii predstavljaju izazov u liječenju. U osjetljivih sojeva, monoterapija karbapenemima dovodi do pozitivnog ishoda. Liječenje karbapenem-otpornih Acinetobacter baumannii sojeva u kompliciranim infekcijama provodi se uglavnom kolistinom. Kolistin se može primjenjivati intravenski i inhalacijski te ga se preporučuje koristiti u kombinaciji s drugim djelotvornim antibioticima.Infections caused by Acinetobacter baumannii are a major public health issue. Acinetobacter baumannii contaminates the hospital environment, skin, and mucous membranes of patients and is transmitted by the hands of staff, causing opportunistic infections such as pneumonia associated with mechanical ventilation, bacteremia, wound infections, and urinary tract infections. Ventilator-associated pneumonia is the second most common nosocomial infection in the intensive care units. The leading risk factor for the development of ventilator-associated pneumonia is invasive mechanical ventilation. In the patients with COVID-19 disease, the treatment in intensive care units often required intubation and the use of mechanical ventilation, exposing them to the risk of developing ventilator-associated pneumonia. Given the numerous overlaps in the clinical picture of COVID-19 pneumonia and ventilator-associated pneumonia, it is difficult to determine its prevalence with certainty. Lung damage caused by COVID-19, immunosuppressive therapy, frequent prophylactic use of antibiotics, and organizational difficulties (overcrowding in intensive care units, staff shortages, the need to protect staff from severe acute respiratory syndrome coronavirus 2 infection, etc.) have contributed to the increased incidence of ventilator-associated pneumonia in COVID-19 patients. Numerous mechanisms of antibiotic resistance and the increasing prevalence of multidrug-resistant strains such as carbapenem-resistant Acinetobacter baumannii present a challenge in treatment. In susceptible strains, monotherapy with carbapenems leads to a positive outcome. The treatment of carbapenem-resistant Acinetobacter baumannii strains in complicated infections is carried out mainly with colistin. Colistin can be administered intravenously or by inhalation, and it’s use in combination with other effective antibiotics is recommended

Spontana heterotopična, ektopična cervikalna i ektopična tubarna trudnoća - uvijek prisutna dijagnostička poteškoća: prikaz triju slučajeva

The incidence of heterotopic/ectopic pregnancy in recent times has increased partly due to the increase in assisted reproductive technologies, whereas such medical cases and cervical pregnancy in particular are extremely rare with spontaneous conception. We report on three patients referred to our department in one week: one patient each with spontaneous heterotopic pregnancy, cervical pregnancy and tubal pregnancy. All of them had conceived spontaneously and were properly diagnosed and treated, however, additional care is needed in diagnosing and managing the potentially fatal consequences of ectopic pregnancy if not recognized early and managed properly, despite its low incidence.Incidencija heterotopičnih/ektopičnih trudnoća se u posljednje vrijeme povećava između ostalog i zbog sve veće upotrebe metoda pomognute oplodnje, ali ovi slučajevi, a naročito cervikalna trudnoća, iznimno su rijetki u spontanim zanošenjima. Prikazujemo tri bolesnice koje su se javile u našu Kliniku u tjedan dana: bolesnica sa spontanom heterotopičnom trudnoćom, druga s cervikalnom i treća s tubarnom trudnoćom. Sve su spontano zanijele, pravodobno dijagnosticirane i izliječene, ali naglašavamo da je osobita pozornost potrebna u dijagnozi i liječenju potencijalno fatalnih posljedica izvanmaterničnih trudnoća ako nisu prepoznate i liječene dovoljno rano, unatoč tako iznimno rijetkoj pojavnosti

Pulmonary Function in Persons Who are Professionally Exposed to Formaldehyde Fumes

The present study examines long-term effects of occupational exposure to formaldehyde fumes on lung function. Forced spirometry and diffusing lung capacity were measured in 16 health-service professionals (8 medical doctors and 8 laboratory technicians) working at the pathoanatomic laboratory for at least 4 years with daily exposure 8+1 hours. Control group employed 16 males, which were matched by age and stature to members of the exposed group. Only non-smokers were included in the study. Spirometric parameters in study participants exposed to formaldehyde fumes compared to control group were not significantly different indicating absence of restrictive and/or obstructive deterioration of lung function in exposed group. The only parameter differing in two groups was blood volume of pulmonary capillaries (Vc’) which was significantly larger in a group exposed to formaldehyde fumes. The possibility that the hyperemic lung reaction is the consequence of the exposure to formaldehyde fumes should be further explored

ASSOCIATION OF GENETIC MUTATIONS WITH PREGNANCY COMPLICATIONS IN WOMEN TREATED WITH LOW MOLECULAR WEIGHT HEPARIN IN KBC SPLIT (2010-2012) : CROSS-SECTIONAL STUDY

Cilj ovog istraživanja bio je utvrditi prisutnost i učestalost mutacija u genima za Faktor V, Faktor II, MTHFR, PAI-1 i ACE koje su važne u patologiji koagulacije krvi te izmjeriti uspješnost liječenja niskomolekularnim heparinom. Analizirano je ukupno 86 uzoraka krvi pacijentica s navedenim dijagnozama. Od cjelokupnog broja, analizirano je 85 uzoraka za Faktor V, 83 za Faktor II, 83 uzoraka za MTHFR, 84 uzorka za PAI-1 i 82 uzoraka za ACE. Utvrđeno je kako je heterozigotni genotip za Faktor V imalo 11,6% (10/85) ispitanica. Heterozigotni genotip za Faktor II imalo je 9% (10,4%) ispitanica, dok je mutirani, homozigotni genotip imalo njih 1,2% (1/85). Heterozigotni genotip za MTHFR utvrđen je u 53,9% (45/85) ispitanica, dok je mutirani, homozigotni genotip utvrđen u njih 15,3% (13/85). Delecijski, homozigotni polimorfizam (DD) za PAI-1 utvrđen je u 35,7% (30/84), insercijsko-delecijski (ID) u 57,1% (48/84), a insercijski polimorfizam (II) u 7,1% (6/84) ispitanica. Delecijski, homozigotni polimorfizam (DD) za ACE prisutan je u 32,4% (24/82) ispitanica, insercijsko-delecijski polimorfizam (II) u 47,3% (35/82), a insercijski polimorfizam (II) u 20,2% (15/82) ispitanica. Pokušali smo i dokazati povezanost između određenih genotipova i ishoda liječenja LMWH-om, no međutim nismo došli do statistički značajnih rezultata, najvjerojatnije, zbog malog uzorka. Usprkos relativno malom uzorku, znakovit je poprilično dobar rezultat liječenja LMWH-om (78 porođaja i samo 8 pobačaja) u uzorku žena sa habitualnim i sporadičnim pobačajima te ostalim komplikacijama u prijašnjim trudnoćama.OBJECTIVES: The aim of this study was to determine the presence and prevalence of mutations in Factor V, Factor II, MTHFR, PAI-1 and ACE genes, as well as the linkage between the mutations of these genes with pregnancy outcomes in pregnant women treated with low molecular weight heparin (LWMH). PATIENTS AND METHODS: All the analyses were performed in the Laboratory for Molecular Genetics in KBC Split, during the period between 2010-2012. A total of 86 blood samples of pregnant women (age 18-45) who were treated with LWMH, due to previous pregnancy complications, were analysed for Factor V, Factor II, MTHFR, PAI-1 and ACE genetic status. RESULTS: The prevalence of heterozygous mutations for Factor and Factor II V were 11,6% and 9%, while the prevalence of homozygous mutations in Factor II was observed in 1,2% of subjects. The prevalence of heterozygous status for MTHFR was 53,9% and homozygous mutations were observed in 15,3% of women. The deletion polymorphism (4G/4G) for PAI-1 was determined in 35,7% of subjects, an insertion-deletion polymorphism in 57,1% , while an insertion polymorphism was observed in 7,1% of subjects. The deletion polymorphism for ACE was determined in 32,4% patients, an insertiondeletion polymorphism in 47,3% patients, while an insertion polymorphism was shown in 20,2% of subjects. Outcomes of the treatment in KBC Split were not significantly different in comprasion with other studies, niether there were no association between outcomes and specific genotypes, probably due to small sample size. Despite to the relatively small sample size, the results of the treatment with LWMH and pregnancy outcomes in KBC Split were satisfactory (78 births and 8 abortions)

ASSOCIATION OF GENETIC MUTATIONS WITH PREGNANCY COMPLICATIONS IN WOMEN TREATED WITH LOW MOLECULAR WEIGHT HEPARIN IN KBC SPLIT (2010-2012) : CROSS-SECTIONAL STUDY

Cilj ovog istraživanja bio je utvrditi prisutnost i učestalost mutacija u genima za Faktor V, Faktor II, MTHFR, PAI-1 i ACE koje su važne u patologiji koagulacije krvi te izmjeriti uspješnost liječenja niskomolekularnim heparinom. Analizirano je ukupno 86 uzoraka krvi pacijentica s navedenim dijagnozama. Od cjelokupnog broja, analizirano je 85 uzoraka za Faktor V, 83 za Faktor II, 83 uzoraka za MTHFR, 84 uzorka za PAI-1 i 82 uzoraka za ACE. Utvrđeno je kako je heterozigotni genotip za Faktor V imalo 11,6% (10/85) ispitanica. Heterozigotni genotip za Faktor II imalo je 9% (10,4%) ispitanica, dok je mutirani, homozigotni genotip imalo njih 1,2% (1/85). Heterozigotni genotip za MTHFR utvrđen je u 53,9% (45/85) ispitanica, dok je mutirani, homozigotni genotip utvrđen u njih 15,3% (13/85). Delecijski, homozigotni polimorfizam (DD) za PAI-1 utvrđen je u 35,7% (30/84), insercijsko-delecijski (ID) u 57,1% (48/84), a insercijski polimorfizam (II) u 7,1% (6/84) ispitanica. Delecijski, homozigotni polimorfizam (DD) za ACE prisutan je u 32,4% (24/82) ispitanica, insercijsko-delecijski polimorfizam (II) u 47,3% (35/82), a insercijski polimorfizam (II) u 20,2% (15/82) ispitanica. Pokušali smo i dokazati povezanost između određenih genotipova i ishoda liječenja LMWH-om, no međutim nismo došli do statistički značajnih rezultata, najvjerojatnije, zbog malog uzorka. Usprkos relativno malom uzorku, znakovit je poprilično dobar rezultat liječenja LMWH-om (78 porođaja i samo 8 pobačaja) u uzorku žena sa habitualnim i sporadičnim pobačajima te ostalim komplikacijama u prijašnjim trudnoćama.OBJECTIVES: The aim of this study was to determine the presence and prevalence of mutations in Factor V, Factor II, MTHFR, PAI-1 and ACE genes, as well as the linkage between the mutations of these genes with pregnancy outcomes in pregnant women treated with low molecular weight heparin (LWMH). PATIENTS AND METHODS: All the analyses were performed in the Laboratory for Molecular Genetics in KBC Split, during the period between 2010-2012. A total of 86 blood samples of pregnant women (age 18-45) who were treated with LWMH, due to previous pregnancy complications, were analysed for Factor V, Factor II, MTHFR, PAI-1 and ACE genetic status. RESULTS: The prevalence of heterozygous mutations for Factor and Factor II V were 11,6% and 9%, while the prevalence of homozygous mutations in Factor II was observed in 1,2% of subjects. The prevalence of heterozygous status for MTHFR was 53,9% and homozygous mutations were observed in 15,3% of women. The deletion polymorphism (4G/4G) for PAI-1 was determined in 35,7% of subjects, an insertion-deletion polymorphism in 57,1% , while an insertion polymorphism was observed in 7,1% of subjects. The deletion polymorphism for ACE was determined in 32,4% patients, an insertiondeletion polymorphism in 47,3% patients, while an insertion polymorphism was shown in 20,2% of subjects. Outcomes of the treatment in KBC Split were not significantly different in comprasion with other studies, niether there were no association between outcomes and specific genotypes, probably due to small sample size. Despite to the relatively small sample size, the results of the treatment with LWMH and pregnancy outcomes in KBC Split were satisfactory (78 births and 8 abortions)

ASSOCIATION OF GENETIC MUTATIONS WITH PREGNANCY COMPLICATIONS IN WOMEN TREATED WITH LOW MOLECULAR WEIGHT HEPARIN IN KBC SPLIT (2010-2012) : CROSS-SECTIONAL STUDY

Cilj ovog istraživanja bio je utvrditi prisutnost i učestalost mutacija u genima za Faktor V, Faktor II, MTHFR, PAI-1 i ACE koje su važne u patologiji koagulacije krvi te izmjeriti uspješnost liječenja niskomolekularnim heparinom. Analizirano je ukupno 86 uzoraka krvi pacijentica s navedenim dijagnozama. Od cjelokupnog broja, analizirano je 85 uzoraka za Faktor V, 83 za Faktor II, 83 uzoraka za MTHFR, 84 uzorka za PAI-1 i 82 uzoraka za ACE. Utvrđeno je kako je heterozigotni genotip za Faktor V imalo 11,6% (10/85) ispitanica. Heterozigotni genotip za Faktor II imalo je 9% (10,4%) ispitanica, dok je mutirani, homozigotni genotip imalo njih 1,2% (1/85). Heterozigotni genotip za MTHFR utvrđen je u 53,9% (45/85) ispitanica, dok je mutirani, homozigotni genotip utvrđen u njih 15,3% (13/85). Delecijski, homozigotni polimorfizam (DD) za PAI-1 utvrđen je u 35,7% (30/84), insercijsko-delecijski (ID) u 57,1% (48/84), a insercijski polimorfizam (II) u 7,1% (6/84) ispitanica. Delecijski, homozigotni polimorfizam (DD) za ACE prisutan je u 32,4% (24/82) ispitanica, insercijsko-delecijski polimorfizam (II) u 47,3% (35/82), a insercijski polimorfizam (II) u 20,2% (15/82) ispitanica. Pokušali smo i dokazati povezanost između određenih genotipova i ishoda liječenja LMWH-om, no međutim nismo došli do statistički značajnih rezultata, najvjerojatnije, zbog malog uzorka. Usprkos relativno malom uzorku, znakovit je poprilično dobar rezultat liječenja LMWH-om (78 porođaja i samo 8 pobačaja) u uzorku žena sa habitualnim i sporadičnim pobačajima te ostalim komplikacijama u prijašnjim trudnoćama.OBJECTIVES: The aim of this study was to determine the presence and prevalence of mutations in Factor V, Factor II, MTHFR, PAI-1 and ACE genes, as well as the linkage between the mutations of these genes with pregnancy outcomes in pregnant women treated with low molecular weight heparin (LWMH). PATIENTS AND METHODS: All the analyses were performed in the Laboratory for Molecular Genetics in KBC Split, during the period between 2010-2012. A total of 86 blood samples of pregnant women (age 18-45) who were treated with LWMH, due to previous pregnancy complications, were analysed for Factor V, Factor II, MTHFR, PAI-1 and ACE genetic status. RESULTS: The prevalence of heterozygous mutations for Factor and Factor II V were 11,6% and 9%, while the prevalence of homozygous mutations in Factor II was observed in 1,2% of subjects. The prevalence of heterozygous status for MTHFR was 53,9% and homozygous mutations were observed in 15,3% of women. The deletion polymorphism (4G/4G) for PAI-1 was determined in 35,7% of subjects, an insertion-deletion polymorphism in 57,1% , while an insertion polymorphism was observed in 7,1% of subjects. The deletion polymorphism for ACE was determined in 32,4% patients, an insertiondeletion polymorphism in 47,3% patients, while an insertion polymorphism was shown in 20,2% of subjects. Outcomes of the treatment in KBC Split were not significantly different in comprasion with other studies, niether there were no association between outcomes and specific genotypes, probably due to small sample size. Despite to the relatively small sample size, the results of the treatment with LWMH and pregnancy outcomes in KBC Split were satisfactory (78 births and 8 abortions)