{"id":11385762,"date":"2021-04-09T00:00:00","date_gmt":"2021-04-08T22:00:00","guid":{"rendered":"https:\/\/alertdiver.eu\/uncategorized-cs_cz\/terenni-zkusenosti-lekaru-dan-europe-ohledne-potapeni-po-covidu-19\/"},"modified":"2021-04-09T00:00:00","modified_gmt":"2021-04-08T22:00:00","slug":"terenni-zkusenosti-lekaru-dan-europe-ohledne-potapeni-po-covidu-19","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/terenni-zkusenosti-lekaru-dan-europe-ohledne-potapeni-po-covidu-19\/","title":{"rendered":"Ter\u00e9nn\u00ed zku\u0161enosti l\u00e9ka\u0159\u016f DAN Europe ohledn\u011b pot\u00e1p\u011bn\u00ed po covidu-19"},"content":{"rendered":"<p style=\"text-align: justify;\">O covidu-19 toho st&aacute;le je&scaron;t\u011b mnoho nev&iacute;me a informace o tomto viru a jeho dopadu na pot&aacute;p\u011b\u010de se st&aacute;le vyv&iacute;jej&iacute;. Proto jsme krom\u011b op\u011btovn&eacute;ho zve\u0159ejn\u011bn&iacute; konsensu&aacute;ln&iacute;ch l&eacute;ka\u0159sk&yacute;ch doporu\u010den&iacute; sestaven&yacute;ch r\u016fzn&yacute;mi pot&aacute;p\u011b\u010dsk&yacute;mi a hyperbarick&yacute;mi l&eacute;ka\u0159sk&yacute;mi spole\u010dnostmi (viz hypertextov&yacute; odkaz: &bdquo;<a href=\"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/co-byste-meli-vedet-o-potapeni-po-covidu-19\/\" target=\"_blank\" rel=\"noopener\"><strong>Co byste m\u011bli v\u011bd\u011bt o pot&aacute;p\u011bn&iacute; po covidu-19<\/strong><\/a>&ldquo;) oslovili \u0159adu l&eacute;ka\u0159\u016f DAN Europe a zeptali se jich na jejich zku&scaron;enosti se zach&aacute;zen&iacute;m s pot&aacute;p\u011b\u010di, kte\u0159&iacute; se cht\u011bli vr&aacute;tit k pot&aacute;p\u011bn&iacute; pot&eacute;, co prod\u011blali onemocn\u011bn&iacute; covid-19.<\/p>\n<p style=\"text-align: justify;\">Konkr&eacute;tn\u011b jsme oslovili n&aacute;sleduj&iacute;c&iacute; l&eacute;ka\u0159e: Oscara Camacho (z Portugalska), Petera Germonpr&eacute; (z Belgie), Ole Hyldegaarda (z D&aacute;nska), Jacka Kota (z Polska), Anne R&auml;is&auml;nen-Sokolowski (z Finska), Adela Tahera (z Egypta), Ulicha van Laak (z N\u011bmecka) a J&uuml;rga Wendlinga (ze &Scaron;v&yacute;carska). Ka\u017ed&yacute; z t\u011bchto l&eacute;ka\u0159\u016f o&scaron;et\u0159il dva a\u017e dvacet pot&aacute;p\u011b\u010d\u016f, kte\u0159&iacute; byli zasa\u017eeni covidem-19. Dr. Germonpr&eacute; l&eacute;\u010dil pouze vojensk&eacute; pot&aacute;p\u011b\u010de, zat&iacute;mco Dr. Camacho o&scaron;et\u0159oval komer\u010dn&iacute; i rekrea\u010dn&iacute; pot&aacute;p\u011b\u010de. Zde jsou jejich odpov\u011bdi.<\/p>\n<p style=\"text-align: justify;\"><img decoding=\"async\" class=\"fr-dib fr-draggable\" src=\"\/wp-content\/uploads\/imgimport\/1044\/diver2-1500.jpg\" style=\"width: auto;\"><\/p>\n<h4>DAN Europe: Jak&eacute; jsou obecn\u011b va&scaron;e zku&scaron;enosti s pot&aacute;p\u011b\u010di, kte\u0159&iacute; se cht\u011bj&iacute; vr&aacute;tit k pot&aacute;p\u011bn&iacute; po onemocn\u011bn&iacute; covidem-19?<\/h4>\n<p style=\"text-align: justify;\"><strong>Oscar Camacho (OC):<span>&nbsp;<\/span><\/strong>V&scaron;ichni komer\u010dn&iacute; pot&aacute;p\u011b\u010di byli b\u011bhem akutn&iacute;ho onemocn\u011bn&iacute; bez p\u0159&iacute;znak\u016f nebo s prakticky ne&scaron;kodn&yacute;mi p\u0159&iacute;znaky jako anosmie (\u010dichotupost \u010di ztr&aacute;ta \u010dichu) \/ dysgeuzie (porucha chuti). Pokud jde o rekrea\u010dn&iacute; pot&aacute;p\u011b\u010de, dva jedinci byli v&aacute;\u017en\u011b nemocn&iacute;. Oba byli hospitalizov&aacute;ni. Jeden byl p\u0159ijat na norm&aacute;ln&iacute; odd\u011blen&iacute; s neinvazivn&iacute; ventilac&iacute;. Ten druh&yacute; byl &scaron;est t&yacute;dn\u016f na jednotce intenzivn&iacute; p&eacute;\u010de. V&scaron;ichni pot&aacute;p\u011b\u010di (komer\u010dn&iacute; i rekrea\u010dn&iacute;) byli velmi znepokojeni mo\u017en&yacute;m n&aacute;sledn&yacute;m stavem sv&yacute;ch plic a mo\u017enost&iacute;\/nemo\u017enost&iacute; vr&aacute;tit se k pot&aacute;p\u011bn&iacute;. U zm&iacute;n\u011bn&yacute;ch dvou rekrea\u010dn&iacute;ch pot&aacute;p\u011b\u010d\u016f, kte\u0159&iacute; byli hospitalizov&aacute;ni, prok&aacute;zal sken plic oboustrannou fibr&oacute;zu a opakovan\u011b se velmi rychle unavili, proto jsem jim n&aacute;vrat k pot&aacute;p\u011bn&iacute; d\u016frazn\u011b nedoporu\u010dil s t&iacute;m, \u017ee jejich zdravotn&iacute; stav znovu vyhodnot&iacute;m po &scaron;esti m\u011bs&iacute;c&iacute;ch.<\/p>\n<p style=\"text-align: justify;\"><strong>Peter Germonpr&eacute; (PG):<\/strong><span>&nbsp;<\/span>V&scaron;ichni byli podrobeni l&eacute;ka\u0159sk&yacute;m prohl&iacute;dk&aacute;m podle vojensk&yacute;ch l&eacute;ka\u0159sk&yacute;ch po\u017eadavk\u016f (tj. z&aacute;t\u011b\u017eov&yacute; test s SpO2, test plicn&iacute;ch funkc&iacute;, kardiologick&eacute; vy&scaron;et\u0159en&iacute; a plicn&iacute; CT). N\u011bkte\u0159&iacute; byli &bdquo;uzemn\u011bni&ldquo; po dal&scaron;&iacute; t\u0159i m\u011bs&iacute;ce, ne\u017e jim bylo umo\u017en\u011bno pokra\u010dovat v pot&aacute;p\u011bn&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>Ole Hyldegaard (OH):<\/strong><span>&nbsp;<\/span>Nebyly zji&scaron;t\u011bny \u017e&aacute;dn&eacute; probl&eacute;my ani z&aacute;va\u017en&eacute; d&yacute;chac&iacute; pot&iacute;\u017ee.<\/p>\n<p style=\"text-align: justify;\"><strong>Jacek Kot (JK):<\/strong><span>&nbsp;<\/span>P\u016fsobil jsem jako l&eacute;ka\u0159sk&yacute; konzultant pro jedin&eacute;ho pot&aacute;p\u011b\u010de, kter&yacute; se cht\u011bl vr&aacute;tit k pot&aacute;p\u011bn&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>Anne R&auml;is&auml;nen-Sokolowski (ARS):<\/strong><span>&nbsp;<\/span>(ARS): V&scaron;ichni m\u011bli velmi m&iacute;rn&yacute; pr\u016fb\u011bh onemocn\u011bn&iacute;. Jeden byl pouze Ab pozitivn&iacute; a nev\u011bd\u011bl, kdy ten virus ve skute\u010dnosti m\u011bl.<\/p>\n<p style=\"text-align: justify;\"><strong>Adel Taher (AT):<\/strong><span>&nbsp;<\/span>V\u011bt&scaron;ina pot&aacute;p\u011b\u010d\u016f se zd&aacute;la b&yacute;t klinicky bezprobl&eacute;mov&aacute; s dobr&yacute;m vstupem vzduchu na obou stran&aacute;ch. &nbsp;Vy&scaron;et\u0159en&iacute; by odhalilo, zda prod\u011blali covid-19, nebo by to v\u011bd\u011bli a ozn&aacute;mili by to p\u0159edem. V p\u0159&iacute;pad\u011b pochybnost&iacute; bych po\u017e&aacute;dal o CT plic. V n\u011bkolika p\u0159&iacute;padech, kdy k infekci do&scaron;lo p\u0159ed m&eacute;n\u011b ne\u017e dv\u011bma m\u011bs&iacute;ci, by se objevily p\u0159&iacute;znaky tzv. opacifikace brou&scaron;en&eacute;ho skla<strong>&nbsp;<span>&nbsp;<\/span><\/strong>(Ground Glass Opacifications = GGO, co\u017e je term&iacute;n ozna\u010duj&iacute;c&iacute; oblast zv&yacute;&scaron;en&eacute;ho &uacute;tlumu v <a href=\"https:\/\/radiopaedia.org\/articles\/lung?lang=us\" rel=\"nofollow\">plic&iacute;ch<\/a> prok&aacute;zan&yacute; po\u010d&iacute;ta\u010dovou tomografi&iacute;), v\u011bt&scaron;inou baz&aacute;ln&iacute;. Vy&scaron;et\u0159en&iacute; po \u010dty\u0159ech a\u017e &scaron;esti m\u011bs&iacute;c&iacute;ch po po\u010d&aacute;te\u010dn&iacute; infekci uk&aacute;zalo &uacute;stup GGO.<\/p>\n<p style=\"text-align: justify;\"><strong>Ulich van Laak (UvL):<\/strong><span>&nbsp;<\/span>Posti\u017een&iacute; jedinci se ve v&scaron;ech t\u0159ech p\u0159&iacute;padech zdr&aacute;hali dodr\u017eovat konsensu&aacute;ln&iacute; doporu\u010den&iacute;, nav&iacute;c se dom&aacute;hali rychl&eacute;ho a neodpov\u011bdn&eacute;ho povolen&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>J&uuml;rg Wendling (JW):<\/strong><span>&nbsp;<\/span>V\u011bt&scaron;ina rekrea\u010dn&iacute;ch pot&aacute;p\u011b\u010d\u016f a n\u011bkte\u0159&iacute; profesion&aacute;ln&iacute; pot&aacute;p\u011b\u010di se \u0159&iacute;dili na&scaron;imi doporu\u010den&iacute;mi. \u017d&aacute;dn&yacute; z na&scaron;ich pacient\u016f s m&iacute;rn&yacute;mi a\u017e z&aacute;va\u017en&yacute;mi p\u0159&iacute;znaky b\u011bhem akutn&iacute;ho onemocn\u011bn&iacute; covidem-19 neprojevoval p\u0159i vy&scaron;et\u0159ov&aacute;n&iacute; podle &scaron;v&yacute;carsk&eacute;ho postupov&eacute;ho diagramu n\u011bjak&eacute; n&aacute;sledky (provedli jsme z&aacute;t\u011b\u017eov&yacute; test s pulsoxymetri&iacute; \/ pletysmografi&iacute; t\u011bla a DLCO). Cht\u011bl bych dodat, \u017ee moje koment&aacute;\u0159e jsou vlastn\u011b souhrnem zku&scaron;enost&iacute; nejaktivn\u011bj&scaron;&iacute;ch l&eacute;ka\u0159\u016f pot&aacute;p\u011b\u010dsk&eacute; medic&iacute;ny ze &Scaron;v&yacute;carsk&eacute; podvodn&iacute; a hyperbarick&eacute; l&eacute;ka\u0159sk&eacute; spole\u010dnosti (SUHMS), kte\u0159&iacute; ka\u017ed&yacute; m\u011bs&iacute;c pod&aacute;vaj&iacute; zpr&aacute;vy o sv&yacute;ch zku&scaron;enostech.<\/p>\n<h4>Existuj&iacute; n\u011bjak&eacute; potenci&aacute;ln&iacute; probl&eacute;my, kter&yacute;ch by si pot&aacute;p\u011b\u010di m\u011bli b&yacute;t v\u011bdomi?<\/h4>\n<p style=\"text-align: justify;\"><strong>PG:<\/strong><span>&nbsp;<\/span>Nezaznamenali jsme \u017e&aacute;dn&eacute; &bdquo;podivn&eacute;&ldquo; p\u0159&iacute;pady DCS (po &bdquo;norm&aacute;ln&iacute;ch&ldquo; ponorech), co\u017e mohlo b&yacute;t tak&eacute; d\u016fsledkem omezen&iacute;, kter&aacute; jsme zavedli pom\u011brn\u011b z&aacute;hy (podle pokyn\u016f Holandsk&eacute; spole\u010dnosti pro pot&aacute;p\u011bn&iacute; a hyperbarickou medic&iacute;nu = DSDHM). Tato omezen&iacute; byla zve\u0159ejn\u011bna a doporu\u010dena ji\u017e v dubnu 2020.<\/p>\n<p style=\"text-align: justify;\"><strong>OH:<\/strong><span>&nbsp;<\/span>P\u0159ed pokra\u010dov&aacute;n&iacute;m v pot&aacute;p\u011bn&iacute; se doporu\u010duje (alespo\u0148) otestov&aacute;n&iacute; plicn&iacute;ch funkc&iacute;, pokud infekce covidem-19 vyvolala n\u011bjak&eacute; p\u0159&iacute;znaky plicn&iacute;ho charakteru.<\/p>\n<p style=\"text-align: justify;\"><strong>JK:<\/strong><span>&nbsp;<\/span>Trval&eacute; zm\u011bny plicn&iacute; tk&aacute;n\u011b (ni\u017e&scaron;&iacute; poddajnost) a ni\u017e&scaron;&iacute; z&aacute;t\u011b\u017eov&aacute; kapacita.<\/p>\n<p style=\"text-align: justify;\"><strong>ARS:<\/strong><span>&nbsp;<\/span>Pl&iacute;ce mohou \u010dinit probl&eacute;my.<\/p>\n<p style=\"text-align: justify;\"><strong>AT:<\/strong><span>&nbsp;<\/span>Nasycen&iacute; kysl&iacute;kem p\u0159i n&aacute;maze! Patrn&eacute; zm\u011bny ve v&yacute;sledc&iacute;ch spirometrie. Doporu\u010duje se vy\u017e&aacute;dat si je&scaron;t\u011b druh&yacute; n&aacute;zor od pulmonologa.<strong>UvL:<\/strong><span>&nbsp;<\/span>Obavy zve\u0159ejn\u011bn&eacute; Belgickou spole\u010dnost&iacute; pro pot&aacute;p\u011bn&iacute; a hyperbarickou medic&iacute;nu (BSDHM) a\/nebo dal&scaron;&iacute;mi institucemi komunita sportovn&iacute;ch pot&aacute;p\u011b\u010d\u016f moc nep\u0159ij&iacute;m&aacute; a nech&aacute;pe, na rozd&iacute;l od pot&aacute;p\u011b\u010d\u016f z oblasti v\u011bdeck&eacute;ho a vojensk&eacute;ho pot&aacute;p\u011bn&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>JW:<\/strong><span>&nbsp;<\/span>Z&iacute;skan&eacute; poznatky nebyly \u017e&aacute;dn&yacute;m p\u0159ekvapen&iacute;m. Pot&aacute;p\u011b\u010di jsou dob\u0159e informov&aacute;ni o potenci&aacute;ln&iacute;ch rizic&iacute;ch, kter&aacute; se v\u011bt&scaron;inou projevuj&iacute; sn&iacute;\u017eenou fyzickou v&yacute;konnost&iacute;. Souhlas&iacute;me s upozorn\u011bn&iacute;mi a v&yacute;strahami vydan&yacute;mi spole\u010dnost&iacute; BSDHM.<\/p>\n<h4>Na co by si m\u011bli pot&aacute;p\u011b\u010di d&aacute;vat pozor a \u010d&iacute;m by se m\u011bli zab&yacute;vat p\u0159ed n&aacute;vratem k pot&aacute;p\u011bn&iacute;?<\/h4>\n<p style=\"text-align: justify;\"><strong>OC:<\/strong><span>&nbsp;<\/span>Je t\u0159eba zjistit funkci plic!<\/p>\n<p style=\"text-align: justify;\"><strong>PG:<\/strong><span>&nbsp;<\/span>Mysl&iacute;m, \u017ee lze s jistotou \u0159&iacute;ci, \u017ee sou\u010dasn&eacute; pokyny jsou dosta\u010duj&iacute;c&iacute; na to, aby dok&aacute;zaly zabr&aacute;nit pot&aacute;p\u011b\u010d\u016fm v n&aacute;vratu k pot&aacute;p\u011bn&iacute; se zna\u010dn&yacute;m po&scaron;kozen&iacute;m plic\/srdce. T\u011b\u017eko \u0159&iacute;ci, zda jsou pokyny p\u0159&iacute;li&scaron; p\u0159&iacute;sn&eacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>OH:<\/strong><span>&nbsp;<\/span>Z&aacute;vis&iacute; to na z&aacute;va\u017enosti posti\u017een&iacute; infekc&iacute; covidem-19.<\/p>\n<p style=\"text-align: justify;\"><strong>JK:<\/strong><span>&nbsp;<\/span>Je nutno zjistit svou fyzickou zp\u016fsobilost (s&iacute;lu), mo\u017enou sn&iacute;\u017eenou spirometrii a zm\u011bny zji&scaron;t\u011bn&eacute; pomoc&iacute; po\u010d&iacute;ta\u010dov&eacute; tomografie s vysok&yacute;m prostorov&yacute;m rozli&scaron;en&iacute;m (HRCT).<\/p>\n<p style=\"text-align: justify;\"><strong>ARS:<\/strong><span>&nbsp;<\/span>Fyzick&yacute; stav pot&aacute;p\u011b\u010de se mus&iacute; vr&aacute;tit na &uacute;rove\u0148 p\u0159ed infekc&iacute; covidem-19.<\/p>\n<p style=\"text-align: justify;\"><strong>AT:<\/strong><span>&nbsp;<\/span>Postupn&yacute; n&aacute;vrat k &bdquo;norm&aacute;ln&iacute;&ldquo; &uacute;rovni fyzick&eacute; zdatnosti, kter&yacute; m\u016f\u017ee \u010dasto trvat d&eacute;le, ne\u017e se o\u010dek&aacute;valo.<\/p>\n<p style=\"text-align: justify;\"><strong>UvL:<\/strong><span>&nbsp;<\/span>Fyzick&aacute; a psychick&aacute; zdatnost jako p\u0159ed covidem-19 potvrzen&aacute; l&eacute;ka\u0159sk&yacute;m vy&scaron;et\u0159en&iacute;m (sportovn&iacute;m l&eacute;ka\u0159em, kardiologem a plicn&iacute;mi specialisty).<\/p>\n<p style=\"text-align: justify;\"><strong>JW:<\/strong><span>&nbsp;<\/span>Nahl&eacute;dn\u011bte na n&aacute;&scaron; aktualizovan&yacute; postupov&yacute; diagram vyhotoven&yacute; &Scaron;v&yacute;carskou podvodn&iacute; a hyperbarickou l&eacute;ka\u0159skou spole\u010dnost&iacute; (SUHMS).<\/p>\n<p style=\"text-align: justify;\"><img decoding=\"async\" class=\"fr-dib fr-draggable\" src=\"\/wp-content\/uploads\/imgimport\/1044\/divers3-1500.jpg\" style=\"width: auto;\"><\/p>\n<h4>Existuje n\u011bjak&aacute; konkr&eacute;tn&iacute; rada pro pot&aacute;p\u011b\u010de, kte\u0159&iacute; se vypo\u0159&aacute;d&aacute;vaj&iacute; s &bdquo;dlouh&yacute;m covidem&ldquo; a jeho r\u016fzn&yacute;mi projevy?<\/h4>\n<p style=\"text-align: justify;\"><strong>OC:<\/strong><span>&nbsp;<\/span>Pot&aacute;p\u011b\u010di by se m\u011bli nechat vy&scaron;et\u0159it na funkci plic i srdce, zejm&eacute;na pokud maj&iacute; probl&eacute;my se srdcem nebo m\u011bli n\u011bjak&eacute; p\u0159edchoz&iacute; srde\u010dn&iacute; onemocn\u011bn&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>PG:<\/strong><span>&nbsp;<\/span>Jeliko\u017e neexistuje \u017e&aacute;dn&aacute; specifick&aacute; l&eacute;\u010dba (s v&yacute;jimkou n\u011bkter&yacute;ch rehabilita\u010dn&iacute;ch program\u016f a p\u016fsoben&iacute; \u010dasov&eacute;ho odstupu), je d\u016fle\u017eit&eacute;, aby pot&aacute;p\u011b\u010di byli trp\u011bliv&iacute; a upustili od pot&aacute;p\u011bn&iacute;, dokud jim to nepovol&iacute; l&eacute;ka\u0159 specialista na pot&aacute;p\u011b\u010dskou medic&iacute;nu. Lze prov&aacute;d\u011bt v&yacute;cvik v baz&eacute;nu, ale p\u0159ed jak&yacute;mkoli tr&eacute;ninkem se stla\u010den&yacute;m plynem, a to i ve velmi mal&yacute;ch hloubk&aacute;ch, se mus&iacute; p\u0159i vy&scaron;et\u0159en&iacute; plicn&iacute;ch funkc&iacute; prok&aacute;zat norm&aacute;ln&iacute; v&yacute;sledky, jinak by mohlo hrozit abnorm&aacute;ln&iacute; zadr\u017eov&aacute;n&iacute; vzduchu v plic&iacute;ch.<\/p>\n<p style=\"text-align: justify;\"><strong>OH:<\/strong><span>&nbsp;<\/span>V pot&aacute;p\u011bn&iacute; lze pokra\u010dovat v p\u0159&iacute;pad\u011b norm&aacute;ln&iacute;ch v&yacute;sledk\u016f p\u0159i vy&scaron;et\u0159en&iacute; plic a po &uacute;sp\u011b&scaron;n&eacute;m z&aacute;t\u011b\u017eov&eacute;m testu ECC, to v&scaron;e v kombinaci s radami od l&eacute;ka\u0159sk&eacute;ho specialisty na pot&aacute;p\u011bn&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>JK:<\/strong><span>&nbsp;<\/span>Vzhledem k nezn&aacute;m&yacute;m dlouh&yacute;m d\u016fsledk\u016fm onemocn\u011bn&iacute; covidem -19 by pot&aacute;p\u011b\u010di m\u011bli prov&aacute;d\u011bt pouze konzervativn\u011bj&scaron;&iacute; pot&aacute;p\u011bn&iacute; s leh\u010d&iacute; fyzickou n&aacute;mahou pod vodou.<\/p>\n<p style=\"text-align: justify;\"><strong>ARS:<\/strong><span>&nbsp;<\/span>Fyzick&yacute; stav pot&aacute;p\u011b\u010de se mus&iacute; vr&aacute;tit na &uacute;rove\u0148 jako p\u0159ed covidem-19, naprosto nutn&eacute; je d\u016fkladn&eacute; vy&scaron;et\u0159en&iacute; kardio-respira\u010dn&iacute; soustavy.<\/p>\n<p style=\"text-align: justify;\"><strong>AT:<\/strong><span>&nbsp;<\/span>Tady v Sharmu jsem nezaznamenal \u017e&aacute;dn&eacute; p\u0159&iacute;pady &bdquo;dlouh&eacute;ho covidu&ldquo;.<\/p>\n<p style=\"text-align: justify;\"><strong>UvL:<\/strong><span>&nbsp;<\/span>Na&scaron;e doporu\u010den&iacute; pro zm&iacute;n\u011bn&eacute; dva p\u0159&iacute;pady z&aacute;va\u017en&eacute;ho onemocn\u011bn&iacute; a &bdquo;dlouh&eacute;ho covidu&ldquo; bylo nepot&aacute;p\u011bt se po dobu &scaron;esti m\u011bs&iacute;c\u016f a p\u0159ed n&aacute;vratem k pot&aacute;p\u011bn&iacute; absolvovat d\u016fkladn&eacute; l&eacute;ka\u0159sk&eacute; vy&scaron;et\u0159en&iacute; kardiovaskul&aacute;rn&iacute; soustavy a funkce plic.<\/p>\n<p style=\"text-align: justify;\"><strong>JW:<\/strong><span>&nbsp;<\/span>Pokud je v tuto chv&iacute;li zn&aacute;mo, syndrom dlouh&eacute;ho covidu je tzv. dekondice, co\u017e znamen&aacute;, \u017ee nast&aacute;v&aacute; jak&yacute;si somatoformn&iacute; v&yacute;voj s ur\u010dit&yacute;mi nep\u0159&iacute;li&scaron; patrn&yacute;mi p\u0159&iacute;znaky. Proto je d\u016fle\u017eit&eacute; v\u010dasn&eacute; zapojen&iacute; psychoterapie formou multimod&aacute;ln&iacute;ho p\u0159&iacute;stupu k rehabilitaci! N\u011bkte\u0159&iacute; pacienti s dlouh&yacute;m covidem maj&iacute; somatick&eacute; n&aacute;sledky (pl&iacute;ce a srdce) a neprojdou zkou&scaron;kou zp\u016fsobilosti k pot&aacute;p\u011bn&iacute; podle &scaron;v&yacute;carsk&eacute;ho postupov&eacute;ho diagramu.<\/p>\n<h4>Za jak&yacute;ch okolnost&iacute; byste doporu\u010dili pot&aacute;p\u011b\u010di, kter&yacute; m\u011bl covid-19, aby krom\u011b sv&eacute;ho l&eacute;ka\u0159e vyhledal dal&scaron;&iacute; konzultaci s l&eacute;ka\u0159sk&yacute;m odborn&iacute;kem na pot&aacute;p\u011bn&iacute; u<span>&nbsp;<\/span>DAN<span>&nbsp;<\/span>(co\u017e je mo\u017en&eacute; d&iacute;ky \u010dlenstv&iacute; v DAN)?<\/h4>\n<p style=\"text-align: justify;\"><strong>OC:<\/strong><span>&nbsp;<\/span>Pokud byl hospitalizov&aacute;n bez ohledu na z&aacute;va\u017enost onemocn\u011bn&iacute;. A tak&eacute; jestli\u017ee m\u011bl n\u011bjak&eacute; p\u0159edchoz&iacute; chronick&eacute; respira\u010dn&iacute; onemocn\u011bn&iacute; bez ohledu na jeho z&aacute;va\u017enost, i kdy\u017e nebyl hospitalizov&aacute;n. Rovn\u011b\u017e v p\u0159&iacute;pad\u011b, kdy u n\u011bj po covidu-19 p\u0159etrv&aacute;vaj&iacute; n\u011bjak&eacute; p\u0159&iacute;znaky.<\/p>\n<p style=\"text-align: justify;\"><strong>PG:<\/strong><span>&nbsp;<\/span>Nev\u011b\u0159&iacute;m, \u017ee p\u0159&iacute;m&aacute; (osobn&iacute;) l&eacute;ka\u0159sk&aacute; konzultace je sou\u010d&aacute;st&iacute; v&yacute;hod \u010dlenstv&iacute; v DAN. V p\u0159&iacute;pad\u011b pochybnost&iacute; v&scaron;ak lze z&iacute;skat radu na d&aacute;lku ohledn\u011b v&yacute;sledk\u016f l&eacute;ka\u0159sk&yacute;ch prohl&iacute;dek proveden&yacute;ch nebo p\u0159edepsan&yacute;ch vlastn&iacute;m l&eacute;ka\u0159em.<\/p>\n<p style=\"text-align: justify;\"><strong>OH:<\/strong><span>&nbsp;<\/span>Pacienti s plicn&iacute;mi p\u0159&iacute;znaky nebo p\u0159&iacute;znaky p\u0159esahuj&iacute;c&iacute;mi b\u011b\u017en&eacute; p\u0159&iacute;znaky podobn&eacute; ch\u0159ipce by m\u011bli absolvovat spirometrii a p\u0159&iacute;padn\u011b HRCT 12 t&yacute;dn\u016f po infekci.<\/p>\n<p style=\"text-align: justify;\"><strong>JK:<\/strong><span>&nbsp;<\/span>V ka\u017ed&eacute;m p\u0159&iacute;pad\u011b hospitalizace kv\u016fli covidu-19 s p\u0159&iacute;znaky plicn&iacute;mi, srde\u010dn&iacute;mi nebo neurologick&yacute;mi.<\/p>\n<p style=\"text-align: justify;\"><strong>ARS:<\/strong><span>&nbsp;<\/span>V\u017edy.<\/p>\n<p style=\"text-align: justify;\"><strong>AT:<\/strong><span>&nbsp;<\/span>V ka\u017ed&eacute;m p\u0159&iacute;pad\u011b, pokud jeho l&eacute;ka\u0159 p\u0159edt&iacute;m nevy&scaron;et\u0159oval p\u0159&iacute;pady covidu-19 nebo nem&aacute; dostate\u010dn&eacute; znalosti ohledn\u011b mo\u017en&yacute;ch &uacute;\u010dink\u016f, kter&eacute; m\u016f\u017ee m&iacute;t covid-19 na pot&aacute;p\u011bn&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>UvL:<\/strong><span>&nbsp;<\/span>Ka\u017ed&yacute; \u010dlen DAN, kter&yacute; m\u011bl covid-19 s p\u0159&iacute;znaky, by m\u011bl, pokud je to mo\u017en&eacute;, projednat sv\u016fj p\u0159&iacute;pad s l&eacute;ka\u0159sk&yacute;m odborn&iacute;kem na pot&aacute;p\u011bn&iacute; u DAN.<\/p>\n<p style=\"text-align: justify;\"><strong>JW:<\/strong><span>&nbsp;<\/span>Lid&eacute;, kte\u0159&iacute; prod\u011blali infekci covid-19 a cht\u011bj&iacute; pokra\u010dovat v pot&aacute;p\u011bn&iacute;, by m\u011bli kontaktovat l&eacute;ka\u0159e a vyhledat l&eacute;ka\u0159e odborn&iacute;ka na pot&aacute;p\u011b\u010dskou medic&iacute;nu. Ve &Scaron;v&yacute;carsku m&aacute;me s&iacute;\u0165 kompetentn&iacute;ch l&eacute;ka\u0159\u016f zab&yacute;vaj&iacute;c&iacute;ch se pot&aacute;p\u011bn&iacute;m, tak\u017ee dodate\u010dn&aacute; konzultace s odborn&iacute;kem na pot&aacute;p\u011bn&iacute; u DAN by p\u0159ich&aacute;zela v &uacute;vahu pouze v p\u0159&iacute;pad\u011b, \u017ee se po\u017eaduje druh&yacute; n&aacute;zor.<\/p>\n<h4>Na co by si m\u011bli pot&aacute;p\u011b\u010di d&aacute;vat pozor a \u010d&iacute;m by se m\u011bli zab&yacute;vat po n&aacute;vratu k pot&aacute;p\u011bn&iacute;?<\/h4>\n<p style=\"text-align: justify;\"><strong>OC:<\/strong><span>&nbsp;<\/span>M\u011bli by si v&scaron;&iacute;mat, zdali se snadno unav&iacute; nebo jestli u nich p\u0159etrv&aacute;vaj&iacute; respira\u010dn&iacute; p\u0159&iacute;znaky, nap\u0159. du&scaron;nost.<\/p>\n<p style=\"text-align: justify;\"><strong>PG:<\/strong><span>&nbsp;<\/span>N&aacute;ro\u010dnost ponor\u016f by se m\u011bla zvy&scaron;ovat velmi opatrn\u011b a postupn\u011b, proto\u017ee ur\u010dit\u011b chyb\u011bl dostate\u010dn&yacute; tr&eacute;nink, oslabily se pot\u0159ebn&eacute; n&aacute;vyky a zhor&scaron;ila se fyzick&aacute; kondice.<\/p>\n<p style=\"text-align: justify;\"><strong>OH:<\/strong><span>&nbsp;<\/span>Dostavuje-li se p\u0159i zv&yacute;&scaron;en&eacute; fyzick&eacute; n&aacute;maze du&scaron;nost, je nutn&eacute; neodkladn&eacute; dal&scaron;&iacute; vy&scaron;et\u0159en&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>JK:<\/strong><span>&nbsp;<\/span>Pot&aacute;p\u011b\u010di si mus&iacute; b&yacute;t v\u011bdomi zv&yacute;&scaron;en&eacute;ho rizika plicn&iacute;ho barotraumatu, p\u0159i pobytu pod vodou se mus&iacute; omezovat n&aacute;roky na fyzickou n&aacute;ro\u010dnost.<\/p>\n<p style=\"text-align: justify;\"><strong>ARS:<\/strong><span>&nbsp;<\/span>I po m&iacute;rn\u011bj&scaron;&iacute;ch infekc&iacute;ch si mus&iacute; b&yacute;t ka\u017ed&yacute; v\u011bdom nebezpe\u010d&iacute; mo\u017en&eacute;ho poran\u011bn&iacute; plic.<\/p>\n<p style=\"text-align: justify;\"><strong>AT:<\/strong><span>&nbsp;<\/span>Je t\u0159eba sledovat mo\u017enou d&yacute;chavi\u010dnost, zvl&aacute;&scaron;t\u011b p\u0159i nadm\u011brn&eacute;m zat&iacute;\u017een&iacute; pod vodou, a je&scaron;t\u011b v&iacute;ce, pokud se d&yacute;chavi\u010dnost dostavuje i p\u0159i v\u011bt&scaron;&iacute;m fyzick&eacute;m zat&iacute;\u017een&iacute; mimo vodu! Pot&aacute;p\u011b\u010di by m\u011bli tak&eacute; v\u011bnovat pozornost sv&eacute; dechov&eacute; frekvenci a spot\u0159eb\u011b d&yacute;chac&iacute;ho plynu. Rovn\u011b\u017e by se m\u011bl porovn&aacute;vat stupe\u0148 &uacute;navy po ponoru po zotaven&iacute; se z covidu-19 se stavem p\u0159ed infekc&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>UvL:<\/strong><span>&nbsp;<\/span>M\u011bli by podstoupit &bdquo;velkou&ldquo; pot&aacute;p\u011b\u010dskou l&eacute;ka\u0159skou prohl&iacute;dku. Tak&eacute; se doporu\u010duje celot\u011blov&aacute; pletysmografie (m\u011b\u0159en&iacute; nep\u0159&iacute;mo m\u011b\u0159iteln&yacute;ch plicn&iacute;ch objem\u016f) a podle v&yacute;sledk\u016f\/p\u0159&iacute;padn&yacute;ch plicn&iacute;ch p\u0159&iacute;znak\u016f i vy&scaron;et\u0159en&iacute; pomoc&iacute; HRCT (po\u010d&iacute;ta\u010dov&eacute; tomografie &nbsp;s vysok&yacute;m prostorov&yacute;m rozli&scaron;en&iacute;m).<\/p>\n<p style=\"text-align: justify;\"><strong>JW:<\/strong><span>&nbsp;<\/span>Pot&aacute;p\u011b\u010di si mus&iacute; b&yacute;t v\u011bdomi potenci&aacute;ln&iacute;ch rizik, zejm&eacute;na pokud jde o barotrauma, toxicitu kysl&iacute;ku a nebezpe\u010d&iacute; DCI, kde skute\u010dn&eacute; riziko zat&iacute;m nezn&aacute;me. V sou\u010dasnosti dni neexistuje \u017e&aacute;dn&aacute; publikace, kter&aacute; by prokazovala zv&yacute;&scaron;en&eacute; riziko DCI.<strong>&nbsp;<\/strong><\/p>\n<p style=\"text-align: justify;\"><strong><img decoding=\"async\" class=\"fr-dib fr-draggable\" src=\"\/wp-content\/uploads\/imgimport\/1044\/divers-1500.jpg\" style=\"width: auto;\"><\/strong><\/p>\n<h4>Je n\u011bco, co by m\u011bli pot&aacute;p\u011b\u010di, kte\u0159&iacute; prod\u011blali covid, v\u011bd\u011bt o o\u010dkov&aacute;n&iacute;?<\/h4>\n<p style=\"text-align: justify;\"><strong>OC:<span>&nbsp;<\/span><\/strong>O\u010dkov&aacute;n&iacute; nezm\u011bn&iacute; ani nel&eacute;\u010d&iacute; \u017e&aacute;dn&eacute; n&aacute;sledky, kter&eacute; mohou nastat.<\/p>\n<p style=\"text-align: justify;\"><strong>PG:<\/strong><span>&nbsp;<\/span>O\u010dkov&aacute;n&iacute; se doporu\u010duje i t\u011bm, kte\u0159&iacute; ji\u017e prod\u011blali covid-19.<\/p>\n<p style=\"text-align: justify;\"><strong>OH:<\/strong><span>&nbsp;<\/span>Nen&iacute; nad \u010d&iacute;m p\u0159em&yacute;&scaron;let. Nechte se o\u010dkovat, jakmile to jen bude mo\u017en&eacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>JK:<\/strong><span>&nbsp;<\/span>P\u0159i \u010dek&aacute;n&iacute; na o\u010dkov&aacute;n&iacute; proti covidu-19 se maj&iacute; dodr\u017eovat standardn&iacute; doporu\u010den&iacute;. Je t\u0159eba si uv\u011bdomit, \u017ee o\u010dkov&aacute;n&iacute; nemus&iacute; nemoci zabr&aacute;nit. Naprosto nutn&eacute; je dodr\u017eovat stanoven&aacute; opat\u0159en&iacute; (odstup, dezinfekce, rou&scaron;ka nebo respir&aacute;tor).<\/p>\n<p style=\"text-align: justify;\"><strong>ARS:<\/strong><span>&nbsp;<\/span>Postupujte podle pokyn\u016f org&aacute;n\u016f zdravotn&iacute; p&eacute;\u010de ve va&scaron;&iacute; zemi ohledn\u011b o\u010dkov&aacute;n&iacute; po covidu-19.<\/p>\n<p style=\"text-align: justify;\"><strong>AT:<\/strong><span>&nbsp;<\/span>Osobn\u011b bych doporu\u010dil pot&aacute;p\u011b\u010d\u016fm, kte\u0159&iacute; dostali prvn&iacute; d&aacute;vku vakc&iacute;ny, aby se b\u011bhem obdob&iacute;, dokud nedostanou druhou d&aacute;vku, nepot&aacute;p\u011bli, a po druh&eacute; d&aacute;vce, aby se nechali otestovat na protil&aacute;tky. Pro n\u011b i pro ostatn&iacute; bude bezpe\u010dn\u011bj&scaron;&iacute;, kdy\u017e budou minimalizovat mo\u017enost st&aacute;t se &bdquo;nevinn&yacute;m&ldquo; p\u0159en&aacute;&scaron;e\u010dem n&aacute;kazy.<\/p>\n<p style=\"text-align: justify;\"><strong>UvL:<\/strong><span>&nbsp;<\/span>V sou\u010dasn&eacute;m stavu nem&aacute;m co poradit.<\/p>\n<p style=\"text-align: justify;\"><strong>JW:<\/strong><span>&nbsp;<\/span>O\u010dkov&aacute;n&iacute; se velmi doporu\u010duje, proto\u017ee pot&aacute;p\u011bn&iacute; je spole\u010denskou aktivitou, kde nelze v\u017edy striktn\u011b dodr\u017eovat nezbytn&aacute; opat\u0159en&iacute; proti p\u0159enosu viru.<strong>&nbsp;<\/strong><\/p>\n<h4>Je podle va&scaron;ich zku&scaron;enost&iacute; pot\u0159eba n\u011bjak&eacute; aktualizace doporu\u010den&iacute; vydan&yacute;ch Belgickou spole\u010dnost&iacute; pro pot&aacute;p\u011bn&iacute; a hyperbarickou medic&iacute;nu<span>&nbsp;<\/span>(SBMHS-BVOOG)?<\/h4>\n<p style=\"text-align: justify;\"><strong>OC:<\/strong><span>&nbsp;<\/span>Nem&aacute;m \u017e&aacute;dn&yacute; n&aacute;vrh.<\/p>\n<p style=\"text-align: justify;\"><strong>PG:<\/strong><span>&nbsp;<\/span>Ne, tato doporu\u010den&iacute; sed mohou zd&aacute;t b&yacute;t pon\u011bkud p\u0159&iacute;sn&aacute;, ale jin&aacute; (nap\u0159. pokyny University of California v San Diegu (UCSD)) jsou je&scaron;t\u011b p\u0159&iacute;sn\u011bj&scaron;&iacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>JK:<\/strong><span>&nbsp;<\/span>V tuto chv&iacute;li ne, ale pot\u0159ebujeme v&iacute;ce informac&iacute;\/dat.<\/p>\n<p style=\"text-align: justify;\"><strong>ARS:<\/strong><span>&nbsp;<\/span>Mysl&iacute;m si, \u017ee ta doporu\u010den&iacute; jsou st&aacute;le platn&aacute;.<\/p>\n<p style=\"text-align: justify;\"><strong>AT:<span>&nbsp;<\/span><\/strong>Vid&iacute;me, \u017ee p\u0159&iacute;sun nov&yacute;ch informac&iacute; je docela p\u016fsobiv&yacute;, ale mno\u017estv&iacute; fale&scaron;n&yacute;ch zpr&aacute;v je doslova ohromuj&iacute;c&iacute;. Navrhuji tedy, aby SBMHS-BVOOG nebo DAN vyd&aacute;valy ka\u017ed&eacute; t\u0159i m\u011bs&iacute;ce prohl&aacute;&scaron;en&iacute; v tom smyslu, zdali je t\u0159eba vz&iacute;t v &uacute;vahu n\u011bjak&eacute; zm\u011bny, \u010di nikoli. Velkou pozornost mus&iacute;me v\u011bnovat mutuj&iacute;c&iacute;m form&aacute;m corony.<\/p>\n<p style=\"text-align: justify;\"><strong>UvL:<\/strong><span>&nbsp;<\/span>Neexistuj&iacute; \u017e&aacute;dn&aacute; ov\u011b\u0159en&aacute; data, kter&aacute; by nazna\u010dovala pot\u0159ebu aktualizace.<\/p>\n<p style=\"text-align: justify;\"><strong>JW:<\/strong><span>&nbsp;<\/span>Ano, d\u016fkazy ze &scaron;v&yacute;carsk&yacute;ch klinik a od l&eacute;ka\u0159sk&yacute;ch specialist\u016f ukazuj&iacute;, \u017ee pacienti hospitalizovan&iacute; s kysl&iacute;kovou terapi&iacute; pot\u0159ebuj&iacute; k &uacute;pln&eacute;mu uzdraven&iacute; v&iacute;ce ne\u017e t\u0159i m\u011bs&iacute;ce, a proto by se m\u011blo doporu\u010dit po\u010dkat &scaron;est m\u011bs&iacute;c\u016f s n&aacute;vratem k pot&aacute;p\u011bn&iacute;, samoz\u0159ejm\u011b i tehdy &nbsp;a\u017e po d\u016fkladn&eacute;m vy&scaron;et\u0159en&iacute;. Je t\u0159eba jasn\u011b uv&eacute;st, \u017ee pokud jde o riziko syndromu plicn&iacute;ho p\u0159etlaku, toxicitu kysl&iacute;ku a dekompresn&iacute; nemoc, doporu\u010duj&iacute; se preventivn&iacute; opat\u0159en&iacute; zalo\u017een&aacute; na teoretick&eacute;m nebezpe\u010d&iacute;, v sou\u010dasn&eacute; dob\u011b v&scaron;ak neexistuj&iacute; \u017e&aacute;dn&eacute; dolo\u017een&eacute; d\u016fkazy. Riziko (ur\u010den&eacute; pravd\u011bpodobnost&iacute; a z&aacute;va\u017enost&iacute; komplikac&iacute;) zat&iacute;m nelze ur\u010dit.Pokud jde o hodnocen&iacute; pot&aacute;p\u011b\u010d\u016f s plicn&iacute;m posti\u017een&iacute;m n&aacute;sledkem onemocn\u011bn&iacute; covid-19: Pracovn&iacute; skupina SUHMS prohla&scaron;uje, \u017ee skeny CT nejsou p\u0159i hodnocen&iacute; mo\u017enosti pokra\u010dovat v pot&aacute;p\u011bn&iacute; dostate\u010dn&eacute;. &nbsp;Pacienti s plicn&iacute;m posti\u017een&iacute;m absolvuj&iacute; b\u011bhem l&eacute;\u010dby ur\u010dit\u011b v&iacute;ce ne\u017e jen sken CT. Pro posouzen&iacute; v&yacute;sledku vy&scaron;et\u0159en&iacute; s ohledem na mo\u017enost n&aacute;vratu k pot&aacute;p\u011bn&iacute; je d\u016fle\u017eit&aacute; funk\u010dn&iacute; kapacita. Proto doporu\u010dujeme roz&scaron;&iacute;\u0159it testov&aacute;n&iacute; funkce plic p\u0159id&aacute;n&iacute;m test\u016f na difuzn&iacute; kapacitu a prov&eacute;st ergometrii na maxim&aacute;ln&iacute; kapacitu s monitorov&aacute;n&iacute;m saturace kysl&iacute;kem, co\u017e m\u016f\u017ee b&yacute;t doprov&aacute;zeno spirometri&iacute; p\u0159ed a po testech.Posouzen&iacute; srde\u010dn&iacute;ch p\u0159&iacute;hod: Podporujeme doporu\u010den&eacute; postupy. Je v&scaron;ak t\u0159eba zm&iacute;nit, \u017ee b\u011bhem op\u011btovn&eacute;ho vy&scaron;et\u0159en&iacute; l&eacute;ka\u0159sk&yacute;m odborn&iacute;kem na pot&aacute;p\u011bn&iacute; by m\u011bla b&yacute;t k dispozici &uacute;pln&aacute; dokumentace klinick&yacute;ch &uacute;daj\u016f z obdob&iacute; hospitalizace, zejm&eacute;na hodnot a v&yacute;voje hodnot troponinu a Pro-BNP.<\/p>\n<h4>D\u011bkuji v&aacute;m v&scaron;em za pomoc!<\/h4>\n<p><\/p>\n<hr>\n<p><\/p>\n<p style=\"text-align: justify;\">Dovolujeme si upozornit, \u017ee krom\u011b zve\u0159ejn\u011bn&iacute; konsensu&aacute;ln&iacute;ch l&eacute;ka\u0159sk&yacute;ch doporu\u010den&iacute; pro n&aacute;vrat k pot&aacute;p\u011bn&iacute; po onemocn\u011bn&iacute; covidem-19 (&bdquo;<a href=\"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/co-byste-meli-vedet-o-potapeni-po-covidu-19\/\" target=\"_blank\" rel=\"noopener\"><strong>Co byste m\u011bli v\u011bd\u011bt o pot&aacute;p\u011bn&iacute; po covidu-19<\/strong><\/a><strong>&ldquo;<\/strong>)<strong><span>&nbsp;<\/span><\/strong>jsme zve\u0159ejnili p\u0159ehledn&yacute; postupov&yacute;<span>&nbsp;<\/span><a href=\"https:\/\/www.daneurope.org\/documents\/20126\/313383\/flowchart-covid-and-diving.pdf\/421830f4-4fce-d1db-f1d7-7e563cd59829?t=1622033012611\" target=\"_blank\" rel=\"noopener\"><strong>diagram t\u011bchto doporu\u010den&iacute;<\/strong><\/a><span>&nbsp;<\/span>vyvinut&yacute; &Scaron;v&yacute;carskou podvodn&iacute; a hyperbarickou l&eacute;ka\u0159skou spole\u010dnost&iacute; (SUHMS), kter&aacute;\u017eto doporu\u010den&iacute; byla revidov&aacute;na dne 29.01.2021. Upozor\u0148ujeme, \u017ee doporu\u010den&iacute; uveden&aacute; ve zm&iacute;n\u011bn&eacute;m postupov&eacute;m diagramu jsou o n\u011bco konzervativn\u011bj&scaron;&iacute; ne\u017e doporu\u010den&iacute; obecn&aacute;.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>O covidu-19 toho st&aacute;le je&scaron;t\u011b mnoho nev&iacute;me a informace o tomto viru a jeho dopadu na pot&aacute;p\u011b\u010de se st&aacute;le vyv&iacute;jej&iacute;. Proto jsme krom\u011b op\u011btovn&eacute;ho zve\u0159ejn\u011bn&iacute;&#8230;<\/p>\n","protected":false},"author":1,"featured_media":11376506,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[384],"tags":[1881],"authors":[1488],"class_list":["post-11385762","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clanky","tag-zdravotni-cast","authors-michael-menduno-cs_cz"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ter\u00e9nn\u00ed zku\u0161enosti l\u00e9ka\u0159\u016f DAN Europe ohledn\u011b pot\u00e1p\u011bn\u00ed po covidu-19 - Alert Diver<\/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:\/\/alertdiver.eu\/cs_CZ\/clanky\/terenni-zkusenosti-lekaru-dan-europe-ohledne-potapeni-po-covidu-19\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ter\u00e9nn\u00ed zku\u0161enosti l\u00e9ka\u0159\u016f DAN Europe ohledn\u011b pot\u00e1p\u011bn\u00ed po covidu-19 - Alert Diver\" \/>\n<meta property=\"og:description\" content=\"O covidu-19 toho st&aacute;le je&scaron;t\u011b mnoho nev&iacute;me a informace o tomto viru a jeho dopadu na pot&aacute;p\u011b\u010de se st&aacute;le vyv&iacute;jej&iacute;. 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