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Aktueller Stand der Behandlung des schweren ARDS einschließlich der Verwendung des extrakorporalen Gasaustausches

  • Chapter
Book cover Besondere Aspekte der extrakorporalen Zirkulation

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Zusammenfassung

Ashbaugh et al. (3) beschrieben 1967 ein Syndrom - bestehend aus Atemnot, Tachypnoe, Zyanose und bilateralen Infiltrationen auf der Röntgenaufnahme des Thorax -, das sie in Anlehnung an das Atemnotsyndrom des Neugeborenen als Adult Respiratory Distress Syndrome (ARDS) bezeichneten. Die Diagnose des ARDS basiert auf klinischen, radiologischen und pathophysiologischen Veränderungen: Klinische Zeichen des akuten Atemversagens, schwerste Hypoxämie, erhöhter pulmonaler Rechts-Links-Shunt, gesteigerte Totraumventilation, verringerte pulmonale Compliance sowie radiologisch sichtbare, diffuse bilaterale Lungeninfiltrationen. Ein Linksherzversagen muß ausgeschlossen sein. Oft handelt es sich bei den Erkrankten um vorher gesunde junge Menschen, bei denen das akute Lungenversagen als Folge einer Reihe von Krankheitsbildern auftritt, welche vom „Beinahe-Ertrinken” (28) über die Aspiration von saurem Mageninhalt (33), Trauma, Infektion, bis zum Endotoxin- und hämorrhagischen Schock (7) reicht. Eine eindeutige ursächliche Beziehung dieser Krankheitsbilder zum ARDS kann jedoch in vielen Fällen nicht hergestellt werden.

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  1. Klinik für Anästhesiologie und operative Intensivmedizin Klinikum Rudolf Virchow, Freie Universität Berlin, Berlin, Deutschland

    Dr. K. Lewandowski & Leiter: Prof. Dr. K. J. Falke (Leiter)

  2. Klinik für Anästhesiologie und operative Intensivmedizin, FU Berlin, UKRV, Augustenburger Platz 1, W-1000, Berlin 65, Deutschland

    Dr. K. Lewandowski

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  1. Abt. Herz- und Gefäßchirurgie, Klinikum der Albert-Ludwigs-Universität, Hugstetterstraße 55, 7800, Freiburg, Deutschland

    G. Fraedrich

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© 1992 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG Darmstadt

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Lewandowski, K., Falke, K.J. (1992). Aktueller Stand der Behandlung des schweren ARDS einschließlich der Verwendung des extrakorporalen Gasaustausches. In: Fraedrich, G., von Segesser, L., Hasse, J., Schlosser, V. (eds) Besondere Aspekte der extrakorporalen Zirkulation. Steinkopff. https://doi.org/10.1007/978-3-642-72489-3_3

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  • DOI: https://doi.org/10.1007/978-3-642-72489-3_3

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-72490-9

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