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Pathophysiologie des Schocks

  • Andreas RiethEmail author
Chapter
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Zusammenfassung

Der Schock ist definiert als Zustand des akuten Kreislaufversagens mit Organdysfunktion, welche eine entscheidende Rolle für den Verlauf spielt. Grundlegende Mechanismen sind Hypovolämie, kardiale Dysfunktion, Obstruktion und Maldistribution. Das Auftreten gemischter Pathophysiologien erschwert die Differenzialdiagnostik und die Therapie: So kann der septische Schock zu einer begleitenden Kardiomyopathie führen, und im Verlauf des kardiogenen Schocks kommt es häufig zu einer systemischen inflammatorischen Reaktion ähnlich wie bei der Sepsis. Während die kausale Therapie häufiger Schockformen wie die des septischen oder des kardiogenen Schocks bei akutem Myokardinfarkt weitgehend standardisiert ist, stellen seltenere Formen wie das Vasoplegie-Syndrom oder das Rechtsherzversagen mit Schock komplexe klinische Situationen dar. Das invasive hämodynamische Monitoring wird routinemäßig nicht mehr empfohlen, ist aber bei unklarer Konstellation und instabilem Patienten weiterhin sinnvoll.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2020

Authors and Affiliations

  1. 1.Kerckhoff-Klinik/KardiologieCampus der Justus-Liebig-Universität GießenBad NauheimDeutschland

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