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

  • K. Lewandowski
  • K. J. Falke

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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Copyright information

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

Authors and Affiliations

  • K. Lewandowski
    • 1
    • 2
  • K. J. Falke
    • 1
  1. 1.Klinik für Anästhesiologie und operative Intensivmedizin Klinikum Rudolf VirchowFreie Universität BerlinBerlinDeutschland
  2. 2.Klinik für Anästhesiologie und operative IntensivmedizinFU Berlin, UKRVBerlin 65Deutschland

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