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Aspekte zur praktischen Anwendung von Hypothermie in der Herzchirurgie

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Empfehlungen zum Einsatz und zur Verwendung der Herz-Lungen-Maschine

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8.8 Zusammenfassung

Die Erkenntnis, dass Hypothermie die Stoffwechselrate reduziert und die Ischämietoleranz von Organismen verlängert, hat entscheidenden Einfluss auf die Entwicklung der Herzchirurgie in den letzten 60 Jahren genommen. Seit der Entwicklung des kardiopulmonalen Bypasses ist der therapeutische Einsatz von Hypothermie eng mit der Herzchirurgie verbunden. Man unterscheidet zwischen milder (32–35°C), moderater (26–31°C), tiefer (20–25°C) und profounder (<20°C) Hypothermie. Während in den Anfängen der Herzchirurgie verschiedene Grade der Hypothermie bei praktisch allen operativen Eingriffen mit der Herz-Lungen-Maschine verwendet wurden, ist die active Kühlung heute meist nur noch Eingriffen vorbehalten, bei denen ein Herz-Kreislauf-Stillstand in Frage kommt oder bei komplexeren Operationen im Kindesalter. Trotz der enormen Erfahrung, die Herzchirurgen mit der Verwendung von Hypothermie erworben haben, gibt es keine einheitlichen Empfehlungen, die nach Evidence-based-Medicine-Kriterien den Einsatz von Hypothermie bei herzchirurgischen Eingriffen beschreiben. Mit diesem Kapitel warden wir versuchen, Empfehlungen zu entwerfen, um eine einheitlichere Verwendung von Hypothermie in der deutschen Herzchirurgie zu ermöglichen. Dies sollte die Auswertbarkeit der Qualitätskontrolle und damit möglicherweise die Patientenversorgung verbessern.

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Authors and Affiliations

  1. Abteilung für Herz- und Gefäßchirurgie, Chirurgische Universitätsklinik Freiburg, Hugstetter Str. 55, 79106, Freiburg

    Dipl.-Ing. C. Benk (Leitender Kardiotechniker)

  2. Abteilung für Herz- und Gefäßchirurgie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg

    PD Dr. med. C. Schlensak & PD Dr. med. T. Doenst

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  1. Dipl.-Ing. C. Benk
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  2. PD Dr. med. C. Schlensak
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  3. PD Dr. med. T. Doenst
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Editors and Affiliations

  1. Klinik für Thorax- und Kardiovaskuläre Chirurgie, Universitäts-Klinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstrasse 5, 40225, Düsseldorf

    Peter Feindt

  2. Zentrum für Herzchirurgie Erlangen-Nürnberg, Universitätsklinikum Erlangen, Krankenhausstr. 12, 91054, Erlangen

    Frank Harig  & Michael Weyand  & 

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Benk, C., Schlensak, C., Doenst, T. (2006). Aspekte zur praktischen Anwendung von Hypothermie in der Herzchirurgie. In: Feindt, P., Harig, F., Weyand, M. (eds) Empfehlungen zum Einsatz und zur Verwendung der Herz-Lungen-Maschine. Steinkopff. https://doi.org/10.1007/3-7985-1646-4_9

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  • DOI: https://doi.org/10.1007/3-7985-1646-4_9

  • Publisher Name: Steinkopff

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