Advertisement

Prophylaxe und Therapie der akuten respiratorischen Insuffizienz im Rahmen des multiplen Organdysfunktionssyndroms

  • H. Burchardi
  • M. Sydow

Zusammenfassung

Vor über mehr als 25 Jahren wurde erstmalig auf eine akute respiratorische Insuffizienz aufmerksam gemacht [3, 96], die seitdem unter verschiedenen Bezeichnungen [„Schocklunge“, „adult respiratory distress syndrome“ (ARDS) und neuerdings „acute lung injury“ (ALI) [9] bzw. im deutschen Schrifttum „Akutes Lungenversagen“ (ALV) in der Intensivmedizin eine erhebliche Bedeutung spielt. Diese akute respiratorische Insuffizienz beruht auf einer schweren diffusen Schädigung des Lungenparenchyms. Sie ist funktionell gekennzeichnet durch: 1. arterielle Hypoxämie unterschiedlichen Schweregrades, 2. diffuse röntgenologische Infiltration, 3. verminderte Dehnbarkeit (Compliance) der Lunge und 4. eine erniedrigte funktionelle Residuallkapazität (FRC).

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Alverdy JC, Aoys E, Moss GS (1988) Total parenteral nutrition promotes bacterial translocation from the gut. Surgery 104: 185–90PubMedGoogle Scholar
  2. 2.
    Artigas A (1988) Adult respiratory distress syndrome: Changing concepts of clinical evaluation and recovery. In: Vincent JL (ed) Update in intensive care and emergency medicine. Update 1988. Springer, Berlin Heidelberg New York Tokyo, pp 97–114Google Scholar
  3. 3.
    Asbaugh DG, Bigelow DB, Petty TL, Levine BE (1967) Acute respiratory distress in adults. Lancet 2: 319–323CrossRefGoogle Scholar
  4. 4.
    Baker SP, O’Neill B (1976) The injury severity score: An update. J Trauma 16: 882–885PubMedCrossRefGoogle Scholar
  5. 5.
    Baum M, Benzer H, Mutz N, Pauser G, Toncar L (1980) Inversed Ratio Ventilation (IRV). Die Rolle des Atemzeitverhältnisses in der Beatmung beim ARDS. Anaesthesist 29: 592–596PubMedGoogle Scholar
  6. 6.
    Baum M, Benzer H, Putensen C, Koller W, Putz G (1989) Biphasic positive airway pressure (BIPAP) — eine neue Form der augmentierenden Beatmung. Anaesthesist 38: 452–458PubMedGoogle Scholar
  7. 7.
    Benzer H, Koller W (1987) Die Strategie der Beatmung. Intensivmedizin 24: 214–219Google Scholar
  8. 8.
    Benzer H (1991) Therapie der respiratorischen Insuffizienz. In: Kilian J, Benzer H, Ahnefeld FW (eds) Grundzüge der Beatmung; Klinische Anästhesiologie und Intensivtherapie, Bd 39. Springer, Berlin Heidelberg New York Tokyo, pp 215–278CrossRefGoogle Scholar
  9. 9.
    Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, LeGall JR, Morris A, Spragg R, the consensus committee (1994) Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. Intensive Care Med 20: 225–232PubMedCrossRefGoogle Scholar
  10. 10.
    Bolton C, Gilbert JJ, Hahn AF, Sibbald WJ (1984) Polyneuropathy in critically ill patients. J Neurol Neurosurg Psycol 47: 1223–1231CrossRefGoogle Scholar
  11. 11.
    Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA, Balk RA and the Methylprednisolone Severe Sepsis Study Group (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317: 653–658PubMedCrossRefGoogle Scholar
  12. 12.
    Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101: 1644–1655PubMedCrossRefGoogle Scholar
  13. 13.
    Border JR, Hassett J, LaDuca J, Seibel R, Steinberg S, Mills B, Losi P, Border D (1987) The gut origin septic states in blunt multiple trauma (ISS=40) in the ICU. Ann Surg 206: 427–448PubMedCrossRefGoogle Scholar
  14. 14.
    Braschi A, Iotti G (1989) Partial ventilatory support in 1989. Intensive Care Med 15: 488–490PubMedCrossRefGoogle Scholar
  15. 15.
    Brochard L, Pluskwa F, Lemaire F (1987) Improved efficacy of spontaneous breathing with inspiratory pressure support. Am Rev Respir Dis 136: 411–415PubMedCrossRefGoogle Scholar
  16. 16.
    Bryan CL, Jenkinson SG (1988) Oxygen toxicity. Clin Chest Med 9: 141–152PubMedGoogle Scholar
  17. 17.
    Burchardi H, Rathgeber J, Sydow M (1995) The concept of analgosedation depends on the concept of mechanical ventilation. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, Berlin Heidelberg New York TokyoGoogle Scholar
  18. 18.
    Burchardi H, Sydow M, Crozier TA, Burgdorff J (1990) Organversagen bei Polytrau-mapatienten — Einfluß einer frühen Osteosynthese von Frakturen auf Komplikationen. Anästh Intensivther Notfallmed 25: 64–71PubMedCrossRefGoogle Scholar
  19. 19.
    Burke DJ, Alverdy JC, Aoys E, Moss GS (1989) Glutamine supplemented total parenteral nutrition improves gut immune function. Arch Surg 124: 1396–9PubMedCrossRefGoogle Scholar
  20. 20.
    Cameron JS (1990) Acute renal failure in the ICU: The nephcologisf’s view. In Bihari D, Neild G (eds) Acute renal failure in the intensive therapy unit. Springer, Berlin Heidelberg New York Tokyo, pp 3–11CrossRefGoogle Scholar
  21. 21.
    Carrico CJ, Meakins JL, Marshall JC, Fry D, Maier RV (1986) Multiple-organ-failure syndrome. Arch Surg 121: 196–208PubMedCrossRefGoogle Scholar
  22. 22.
    Cerra FB (1989) Is there a role for nutritional support in gastrointestinal surgery? In: Najarian JS (ed) Progress in gastrointestinal surgery. Year Book Medical Publishers, Chicago, p 388–394Google Scholar
  23. 23.
    Coalson JJ, King RJ, Winter VT, Prihoda TJ, Anzueto AR, Peters JI, Johanson WG jr (1989) O2- and pneumonia-induced lung injury. I. Pathological and morphometric studies. J Appl Physiol 67: 346–356PubMedGoogle Scholar
  24. 23a.
    Dantzker DR, Brook CJ, Dehart P, Lynch JP, Weg JG (1979) Ventilation-perfusion distributions in the adult respiratory distress syndrome. Am Rev Respir Dis 120: 1039–1052PubMedGoogle Scholar
  25. 24.
    DeCamp MM, Demling RH (1988) Posttraumatic multisystem organ failure. JAMA 260: 530–534PubMedCrossRefGoogle Scholar
  26. 25.
    Decramer M, Lacquet LM, Fagard R, Rogiers P (1994) Corticosteroids contribute to muscle weakness in chronic airflow obstruction. Am J Respir Crit Care Med 150: 11–6PubMedCrossRefGoogle Scholar
  27. 26.
    Douglas WW, Rehder K, Beynen FM, Sessler AD, Marsh HM (1977) Improved oxygenation in patients with acute respiratory failure: the prone position. Am Rev Respir Dis 115: 559–566PubMedGoogle Scholar
  28. 27.
    Dreyfuss D, Saumon G (1992) Barotrauma is volutruma, but which volume is the one responsible? Intensive Care Med 18: 39–41CrossRefGoogle Scholar
  29. 28.
    Duke GJ, Bersten AD (1992) Dopamine and renal salvage in the critically ill patients. Anaesth Intensive Care 20: 277–302PubMedGoogle Scholar
  30. 29.
    Dyck P (1989) Hypoxic neuropathy: Does hypoxia play a role in diabetic neuropathy? The 1988 Wartenberg lecture. Neurology 39: 111–118PubMedCrossRefGoogle Scholar
  31. 30.
    Epstein M (1993) Calcium antagonists and the kidney: Future therapeutic perspectives. Am J Kidney Dis 21 [Suppl 3]: 16–25PubMedGoogle Scholar
  32. 31.
    Faist E, Baue AE, Dittmer H, Heberer G (1983) Multiple organ failure in polytrauma patients. J Trauma 23: 775–787PubMedCrossRefGoogle Scholar
  33. 32.
    Falke JK (1988) Intermittent mandatory ventilation: revisited. In: Vincent JL (ed) Update in intensive care and emergency medicine. Update 5. Springer, Berlin Heidelberg New York Tokyo, pp 759–766Google Scholar
  34. 33.
    Feihl F, Perret C (1994) Permissive hypercapnia. How permissive should we be? Am J Respir Crit Care Med 150: 1722–1737PubMedCrossRefGoogle Scholar
  35. 34.
    Flancbaum L, Choban PS, Dasta JF (1994) Quantitative effects of low-dose dopamine on urine output in oliguric surgical intensive care unit patients. Crit Care Med 22: 61–68PubMedGoogle Scholar
  36. 35.
    Fong Y, Marano MA, Barber A, He W, Moldawer LL, Bushman ED, Coyle SM, Shires GT, Lowry SF (1989) Total parenteral nutrition and bowel rest modify the metabolic response to endotoxin in humans. Ann Surg 210: 449–547PubMedCrossRefGoogle Scholar
  37. 36.
    Froese AB. Bryan AC (1974) Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology 41: 242–255PubMedCrossRefGoogle Scholar
  38. 37.
    Frostell C, Fratacci MD, Wain JC, Jones R, Zapol WM (1991) Inhaled nitric oxide. A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction. Circulation 83: 2038–2047PubMedCrossRefGoogle Scholar
  39. 38.
    Fu Z, Costello ML, Tsukimoto K, Prediletto R, Elliott AR, Mathieu-Costello O, West JB (1992) High lung volume increases stress failure in pulmonary capillaries. J Appl Physiol 73: 123–133PubMedGoogle Scholar
  40. 39.
    Garbe G, Sydow M (1990) Selektive Dekontamination des Tractus Digestivus — Eine neuartige Infektionstherapie. Krankenhauspharmazie 11: 233–238Google Scholar
  41. 40.
    Gattinoni L, Pesenti A, Mascheroni D, Marcolin R, Fumagalli R, Rossi F, Iapichino G, Romagnoli G, Uziel L, Agostoni A et al. (1986) Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. JAMA 256: 881–886PubMedCrossRefGoogle Scholar
  42. 41.
    Gattinoni L, Pesenti A, Avalli L, Rossi F, Bombino M (1987) Pressure-volume curve of total respiratory system in acute respiratory failure. Am Rev Respir Dis 136: 730–736PubMedCrossRefGoogle Scholar
  43. 42.
    Gattinoni L, Pesenti A, Bombino M, Baglioni S, Rivolta M, Rossi F, Rossi G, Fumagalli R, Marcolin R, Mascheroni D, Torresin A (1988) Relationships between lung computed tomography density, gas exchange, and PEEP in acute respiratory failure. Anesthesiology 69: 824–832PubMedCrossRefGoogle Scholar
  44. 43.
    Gattinoni L, Pelosi P, Vitale G, Pesenti A, D’Andrea L, Mascheroni D (1991) Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure. Anesthesiology 74: 15–23PubMedCrossRefGoogle Scholar
  45. 44.
    Gerlach H, Pappert D, Lewandowski K, Rossaint R, Falke KJ (1993) Long term inhalation with evaluated low doses of nitric oxide for selective improvement of oxygenation in patients with adult respiratory distress syndrome. Intensive Care Med 19: 443–449PubMedCrossRefGoogle Scholar
  46. 45.
    Gerlach H, Rossaint R, Pappert D, Falke KJ (1993) Time course and dose-response of nitric oxide inhalation for systemic oxygenation and pulmonary hypertension in patients with adult respiratory distress syndrome. Eur J Clin Invest 23: 499–502PubMedCrossRefGoogle Scholar
  47. 46.
    Gerstner G, Grunberger W (1980) Dopamine treatment for prevention of renal failure in patients with severe eclampsia. Clin Exp Obstet Gynecol 7: 219–222PubMedGoogle Scholar
  48. 47.
    Gooch JL, Suchyta MR, Balbierz JM, Petajan JH, Clemmer TP (1991) Prolonged paralysis after treatment with neuromuscular junction blocking agents. Crit Care Med 19: 1125–1131PubMedCrossRefGoogle Scholar
  49. 48.
    Goris RJA, Gimbrere JSF, Niekerk JLM, Schoots FJ, Booy HD (1982) Early ostheosynthesis and prophylactic mechanical ventilation in the multitrauma patient. J Trauma 22: 895–903PubMedCrossRefGoogle Scholar
  50. 49.
    Graziani G, Cantaluppi A, Casati S, Citterio A, Scalamogna A, Aroldi A, Silenzio R, Branceccio D, Ponticelli C (1984) Dopamine and frusemide in oliguric acute renal failure. Nephron 37: 39–42PubMedCrossRefGoogle Scholar
  51. 50.
    Griffin D, Fairman N, Coursin DB, Rawthorne L, Grossman JE (1992) Acute myopathy during the treatment of status asthmaticus with corticosteriods and steroidal muscle relaxants. Chest 102: 510–514PubMedCrossRefGoogle Scholar
  52. 51.
    Gurevitch MJ, Van Dyke J, Young ES, Jackson K (1986) Improved oxygenation and lower peak airway pressure in severe adult respiratory distress syndrome. Treatment with inverse ratio ventilation. Chest 89: 211–213PubMedCrossRefGoogle Scholar
  53. 52.
    Hickling KG, Henderson SJ, Jackson R (1990) Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 16: 372–377PubMedCrossRefGoogle Scholar
  54. 53.
    Hillman K (1990) Prevention of posttraumatic complications. In: Vincent JL (ed) Update of intensive care and emergency medicine, Vol 10. Springer, Berlin Heidelberg New York Tokyo pp 514–519Google Scholar
  55. 54.
    Hörmann C, Baum M, Putensen C, Mutz NJ, Benzer H (1994) Biphasic positive airway pressure (BIPAP)- a new model of ventilatory support. Eur J Anaesth 11: 37–42Google Scholar
  56. 55.
    Holcroft JW, Vassar MJ, Turner JE, Deriet RW, Kramer GC (1987) 3% NaCl and 7, 5% NaCl/Dextran 70 in the resuscitation of severely injured patients. Ann Surg 206: 279–288PubMedCrossRefGoogle Scholar
  57. 56.
    Hwang TL, O’Dwyer ST, Smith RJ, Wilmore DW (1986) Preservation of small bowel mucosa using glutamine-enriched parenteral nutrition. Surg Forum 37: 56–58Google Scholar
  58. 57.
    Inque S, Epstein MD, Alexander JW, Trocki O, Jacobs P, Gura P (1989) Prevention of yeast translocation across the gut yeast translocation across the gut by a single enteral feeding after burn injury. J Parenter Enteral Nutr 13: 565–571CrossRefGoogle Scholar
  59. 58.
    Johnson KD, Cadambi A, Seibert GB (1985) Incidence of adult respiratory distress syndrome in patients with multiple muscoloskeletal injuries: Effect of early operative stabilisation of fractures. J Trauma 25: 375–384PubMedCrossRefGoogle Scholar
  60. 59.
    Kerver AJH, Rommes JH, Mevissen-Verhage EAE, Hulstaert PF, Vos A, Verhoef J, Wittebol P (1988) Prevention of colonization and infection in critically ill patients: a prospective randomized study. Crit Care Med 16: 1087–1093PubMedCrossRefGoogle Scholar
  61. 60.
    Kien ND, Kramer GC, White DA (1991) Acute hypotension caused by rapid hypertonic saline infusion in anesthetized dogs. Anesth Analg 73: 597–602PubMedGoogle Scholar
  62. 61.
    Klein S (1990) Glutamine: An essential nonessential aminoacid for the gut. Gastroenterology 99: 297–281Google Scholar
  63. 62.
    Knaus WA, Draper EA, Wagner DP, Zimmermann JE (1985) Prognosis in acute organ-system failure. Ann Surg 202: 6085–693CrossRefGoogle Scholar
  64. 63.
    Koller W, Benzer H, Duma S, Mutz N, Pauser G (1983) Ein Modell zur einheitlichen Behandlung und Therapieauswertung beim schweren ARDS. Anaesthesist 32: 576–581PubMedGoogle Scholar
  65. 64.
    Kottier BM, Decker KD, Deutsch H, Fretschner R (1992) Lähmungen durch Kohlenhydrate — Die Rolle der Hypernatriämie. Anaesthesist 41: 302–303Google Scholar
  66. 65.
    Lachmann B, Jonson B, Linroth M, Robertson B (1982) Modes of artificial ventilation in severe respiratory distress syndrome. Lung function and morphology in rabbits after wash-out of alveolar surfactant. Crit Care Med 10: 724–732PubMedCrossRefGoogle Scholar
  67. 66.
    Lachmann B (1987) The role of pulmonary surfactant in the pathogenesis and therapy of ARDS. In: Vincent JL (ed) Update in intensive care and emergency medicine. Springer, Berlin Heidelberg New York Tokyo, pp 123–134Google Scholar
  68. 67.
    Langer M, Mascheroni D, Marcolin R, Gattinoni L (1988) The prone position in ARDS patients. A clinical study. Chest 94: 103–107PubMedCrossRefGoogle Scholar
  69. 68.
    Lazarus JM (1990) Prophylaxis of acute renal failure in the intensive care unit. In: Bihari D, Neild G (eds) Acute renal failure in the intensive therapy unit. Springer, Berlin Heidelberg New York Tokyo, pp 279–308CrossRefGoogle Scholar
  70. 69.
    Ledingham McAI, Alcock SR, Eastaway AT, McDonald JC, McKay IC, Ramsay G (1988) Triple regimen of selective decontamination of the digestive tract, systemic cefotaxime and microbiological surveillance for prevention of acquired infection in intensive care. Lancet I: 785–790CrossRefGoogle Scholar
  71. 70.
    Lewandowski K, Slama K, Falke JK (1992) Approaches to improve survival in severe ARDS. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine 1992. Springer, Berlin Heidelberg New York Tokyo, pp 372–383CrossRefGoogle Scholar
  72. 71.
    Lewis JF, Jobe AH (1993) Surfactant and the adult respiratory distress syndrome. Am Rev Respir Dis 147: 218–233PubMedCrossRefGoogle Scholar
  73. 72.
    Lindner A (1983) Synergism of dopamine and frusemide in diuretic-resistant, oliguric acute renal failure. Nephron 33: 121–126PubMedCrossRefGoogle Scholar
  74. 73.
    Liu SF, Crawley DE, Barnes PJ, Evans TW (1991) Endothelium-derived relaxing factor inhibits hypoxic pulmonary vasoconstriction in rats. Am Rev Respir Dis 143: 32–37PubMedCrossRefGoogle Scholar
  75. 74.
    Liu SF, Crawley DE, Evans TW, Barnes PJ (1991) Endogenous nitric oxide modulates adrenergic neural vasoconstriction in guinea-pig pulmonary artery. Br J Pharmacol 104: 565–569PubMedCrossRefGoogle Scholar
  76. 75.
    Lo CW, Walker WA (1989) Changes in the gastrointestinal tract during enteral or parenteral feeding. Nutr Rev 47: 193–198PubMedCrossRefGoogle Scholar
  77. 76.
    Mang H, Rügheimer E, Frostell CG (1992) Gefahren und Möglichkeiten der Therapie mit inhaliertem Stickstoffmonoxid. Intensivmedizin 29: 107–113Google Scholar
  78. 77.
    Marshall JC, Sweeney D (1990) Microbial infection and the septic response in critical surgical illness. Sepsis, not infection, determines outcome. Arch Surg 125: 17–25PubMedCrossRefGoogle Scholar
  79. 78.
    Marshall JC (1992) Multiple organ failure and infection: cause, consequence, or coincidence. In: Vincent JL (ed) Yearbook of Intensive Care and Emergency Medicine 1992. Springer, Berlin Heidelberg New York Tokyo, pp 3–13CrossRefGoogle Scholar
  80. 79.
    Martinez-Pellus AE, Merino P, Bru M, Conejero R, Seller G, Munoz C, Fuentes T, Gonzalez G, Alvarez B (1993) Can selective digestive decontamination avoid the endotoxemia and cytokine activation promoted by cardiopulmonary bypass? Crit Care Med 21: 1684–91PubMedCrossRefGoogle Scholar
  81. 80.
    Maunder RJ, Shuman WP, McHugh JW, Marglin SI, Butler J (1986) Preservations of normal lung regions in the adult respiratory distress syndrome. Analysis by computed tomography. JAMA 255: 2463–2465PubMedCrossRefGoogle Scholar
  82. 81.
    McClelland P, Murray AE, Williams PS, Saene HKF van, Gilbertson AA, Mostafa SM, Bone JM (1990) Reducing sepsis in severe combined acute renal and respiratory failure by selective decontamination of the digestive tract. Crit Care Med 18: 935–939PubMedCrossRefGoogle Scholar
  83. 82.
    Mead J, Takishima T, Leith D (1970) Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol 28: 596–608PubMedGoogle Scholar
  84. 83.
    Merritt TA, Hallman M, Spragg R, Heldt GP, Gilliard N (1989) Exogenous surfactant treatments for neonatal respiratory distress syndrome and their potential role in the adult respiratory distress syndrome. Drugs 38: 591–611PubMedCrossRefGoogle Scholar
  85. 84.
    Messmer K, Kreimeier U (1989) Microcirculatory therapy in shock. Resuscitation 18[Suppl]: S51-S61CrossRefGoogle Scholar
  86. 85.
    Mochizuki H, Trocki O, Dominioni L, Brackett KA, Joffe SN, Alexander JW (1984) Mechanisms of prevention of postburn hypermetabolism and catabolism by early enteral feeding. Ann Surg 200: 297–310PubMedCrossRefGoogle Scholar
  87. 86.
    Moncada S, Radomski MW, Palmer RM (1988) Endothelium-derived relaxing factor. Identification as nitric oxide and role in the control of vascular tone and platelet function. Biochem Pharmacol 37: 2495–501PubMedCrossRefGoogle Scholar
  88. 87.
    Moncada S, Palmer RM, Higgs EA (1991) Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol Rev 43: 109–42PubMedGoogle Scholar
  89. 88.
    Montgomery AB, Stager MA, Carrico CJ, Hudson LD (1985) Causes of mortality in patients with adult respiratory distress syndrome. Am Rev Respir Dis 132: 485–489PubMedGoogle Scholar
  90. 89.
    Moore FA, Moore EE, Jones TN, McCroskey BL, Peterson VM (1989) TEN versus TPN following major abdominal trauma-Reduced septic morbidity. J Trauma 29: 916–923PubMedCrossRefGoogle Scholar
  91. 90.
    Moore FA, Feliciano DV, Andrassy RJ, McArdle AH, Booth FV, Morgenstein-Wagner TB, Kellum JM jr, Welling RE, Moore EE (1992) Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta analysis. Ann Surg 216: 172–83PubMedCrossRefGoogle Scholar
  92. 91.
    Murray JF, Matthay MA, Luce JM, Flick MR (1988) An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 138: 720–723PubMedCrossRefGoogle Scholar
  93. 92.
    Nast-Kolb D, Kessler S, Duswald KH, Betz A, Schweiberer L (1986) Extremitätenverletzungen polytraumatisierter Patienten: stufengerechte Behandlung. Unfallchirurgie 89: 149–154Google Scholar
  94. 93.
    Nosaka S, Sakai T, Yonekura M, Yoshikawa K (1990) Surfactant for adults with respiratory failure. Lancet 336: 947–948PubMedCrossRefGoogle Scholar
  95. 94.
    Pappert D, Roissant R, Slama K, Griming T, Falke KJ (1994) Positioning in severe ARDS influences ventilation/perfusion relationships of the lung. Chest 106: 1511–1516PubMedCrossRefGoogle Scholar
  96. 95.
    Pesenti A (1990) Target blood gases during ARDS ventilatory management. Intensive Care Med 16: 349–351PubMedCrossRefGoogle Scholar
  97. 96.
    Petty TL, Asbaugh DG (1971) The adult respiratory distress syndrome: Clinical features, factors influencing prognosis and principles of management. Chest 60: 233–239PubMedCrossRefGoogle Scholar
  98. 97.
    Piehl MA, Brown RS (1976) Use of extreme position changes in acute respiratory failure. Crit Care Med 4: 13–4PubMedCrossRefGoogle Scholar
  99. 98.
    Pingleton SK (1988) Complications of acute respiratory failure. Am Rev Respir Dis 137: 1463–1493PubMedCrossRefGoogle Scholar
  100. 99.
    Radermacher P, Santak B, Wust HJ, Tarnow J, Falke KJ (1990) Prostacyclin for the treatment of pulmonary hypertension in the adult respiratory distress syndrome: effects on pulmonary capillary pressure and ventilation perfusion distributions. Anesthesiology 72: 238–244PubMedCrossRefGoogle Scholar
  101. 100.
    Räsänen J, Cane RD, Downs JB, Hurst JM, Jousela IT, Kirby RR, Rogove HJ, Stock MC (1991) Airway pressure release ventilation during acute lung injury: A prospective multicenter trial. Crit Care Med 19: 1234–1241PubMedCrossRefGoogle Scholar
  102. 101.
    Richman PS, Spragg RG, Robertson B, Merritt TA, Curstedt T (1989) The adult respiratory distress syndrome: first trials with surfactant replacement. Eur Respir J 3 [Suppl]: S109-S111Google Scholar
  103. 102.
    Rossaint R, Slama K, Falke KJ (1991) Therapie des akuten Lungenversagens. Dtsch Med Wochenschr 116: 1635–1639PubMedCrossRefGoogle Scholar
  104. 103.
    Rossaint R, Falke KJ, Lopez F, Slama K, Pison U, Zapol WM (1993) Inhaled nitric oxide for the adult respiratory distress syndrome. N Engl J Med 328: 399–405PubMedCrossRefGoogle Scholar
  105. 103a.
    Roissant R, Pappert D, Gerlach H, Falke K (1994) Die Therapie des ARDS. Teil 2: Neue Behandlungsmethoden — erste klinische Erfahrungen. Anaestheist 43: 364–375CrossRefGoogle Scholar
  106. 104.
    Selective digestive decontamination in intensive care unit patients (1992) Report of the 1st European Consensus Conference in Intensive Care and Emergency Medicine. Intensive Care Med 18: 182–8CrossRefGoogle Scholar
  107. 105.
    Shapiro BA, Cane RD, Harrison RA (1984) Positive end-expiratory pressure therapy in adults with special reference to acute lung injury: A review of the literature and suggested clinical correlations. Crit Care Med 12: 127–141PubMedCrossRefGoogle Scholar
  108. 106.
    Shoemaker WC, Bland RD, Appel PL (1985) Therapy of critically ill postoperative patients based on outcome prediction and prospective clinical trials. Surg Clin N Am 65: 811–833PubMedGoogle Scholar
  109. 107.
    Smith RJ (1990) Glutamine metabolism and its physiologic importance. J Parenter Enteral Nutr 14 [Suppl]: S40-S43CrossRefGoogle Scholar
  110. 108.
    Sori AJ, Rush BF jr, Lysz TW, Smith SM, Machiedo GW (1986) The gut as a source of sepsis after hemorrhagic shock. Am J Surg 155: 187–192CrossRefGoogle Scholar
  111. 109.
    Spragg RG, Gilliard N, Richman PM, Smith RM, Hite D, Pappert D, Robertson B, Curstedt T, Strayer DS (1994) Acute effects of a single dose of procine surfactant on patients with adult respiratory distress syndrome. Chest 105: 195–202PubMedCrossRefGoogle Scholar
  112. 110.
    Stock MC, Downs JB, Frohlicher DA (1987) Airway pressure release ventilation. Crit Care Med 15: 462–466PubMedCrossRefGoogle Scholar
  113. 111.
    Stoutenbeek CP, Saene HKF van, Miranda DR, Zandstra DF (1984) The effect of selective decontamination of the digestive tract on colonisation and infection rate in multiple trauma patients. Intensive Care Med 10: 185–192PubMedCrossRefGoogle Scholar
  114. 112.
    Stoutenbeek CP, Saene HKF van, Miranda DR, Zandstra DF, Binendijk B (1984) The prevention of superinfection in multiple trauma patients. J Antimicrob Chemother 14 [Suppl B]: 203–211PubMedCrossRefGoogle Scholar
  115. 113.
    Sydow M, Burchardi H, Crozier TA, Rüchel R, Busse C, Seyde W (1990) Einfluß der selektiven Dekontamination auf nosokomiale Infektionen, Erregerspektrum und Antibiotikaresistenz bei langzeitbeatmeten Intensivpatienten. Anästh Intensivther Notfallmed 25: 416–423PubMedCrossRefGoogle Scholar
  116. 114.
    Sydow M, Denecke T, Zinserling J, Zielmann S, Crozier TA, Burchardi H (1994) Messung des intrinsischen PEEP unter Beatmung — Validierung einer neuen optionalen Meßmethode des Beatmungsgerätes EVITA. Anästhesist 43: 115–120CrossRefGoogle Scholar
  117. 115.
    Sydow M, Burchardi H, Ephreim E, Zielmann S, Crozier TA (1994) Long term effects of two different ventilatory modes on oxygenation in acute lung injury. Comparison of airway pressure release ventilation and volume controlled inverse ratio ventilation. Am J Respir Crit Care Med 149: 1550–1556PubMedCrossRefGoogle Scholar
  118. 116.
    Szelip HM (1991) Renal dose dopamin: Fact and fiction. Ann Int med 115: 153–154Google Scholar
  119. 117.
    Tetteroo GW, Wagenvoort JH, Mulder PG, Ince C, Bruining HA (1993) Decreased mortality rate and length of hospital stay in surgical intensive care unit patients with successful selective decontamination of the gut. Crit Care Med 21: 1692–8PubMedCrossRefGoogle Scholar
  120. 118.
    Tharratt RS, Allen RP, Albertson TE (1988) Pressure controlled inverse ratio ventilation in severe adult respiratory failure. Chest 94: 755–762PubMedCrossRefGoogle Scholar
  121. 119.
    Tokioka H, Saito S, Kosaka F (1989) Effect of pressure support ventilation on breathing patterns and respiratory work. Intensive Care Med 15: 491–494PubMedCrossRefGoogle Scholar
  122. 120.
    Tscherne H, Sturm JA, Regel G (1987) Die prognostische Bedeutung der Frühversorgung am Beispiel des Unfallpatienten. Langenbecks Arch Chir 372: 37–42PubMedCrossRefGoogle Scholar
  123. 121.
    Ulrich C, Harinck-de Veerd JE, Bakker NC, Jacz K, Doornbosh I, Die Ridder VA (1989) Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study. Intensive Care Med 15: 424–431PubMedCrossRefGoogle Scholar
  124. 122.
    Van Dalen R (1991) Selective decontamination in ICU patients: benefits and doupts. In: Vincent JL (ed) Update of intensive care and emergency medicine, Vol 14. Springer, Berlin Heidelberg New York Tokyo, pp 379–386Google Scholar
  125. 123.
    Van Golde LM, Batenburg JJ, Robertson B (1988) The pulmonary surfactant system: biochemical aspects and functional significance. Physiol Rev 68: 374–455PubMedGoogle Scholar
  126. 124.
    Van Os JP, Roumen RM, Schoots FJ, Heystraten FM, Goris RJ (1994) Is early osteosynthesis safe in multiple trauma patients with severe thoracic trauma and pulmonary contusion? J Trauma 36: 495–8PubMedCrossRefGoogle Scholar
  127. 125.
    Van Uffelen R, Saene HKF van, Fidler V, Lowenburg A (1984) Oropharyngeal flora as a source of bacteria colonizing the lower airways in patients on artificial ventilation. Intensive Care Med 10: 233–237PubMedGoogle Scholar
  128. 126.
    Vassar MJ, Perry CA, Holcroft JW (1990) Analysis of potential risks associated with 7, 5% sodium chloride resuscitation of traumatic shock. Arch Surg 125: 1309–1315PubMedCrossRefGoogle Scholar
  129. 127.
    Velasco IT, Pontieri V, Rocha-e-Silva M, Lopes O (1980) Hyperosmotic NaCl and severe hemorrhagic shock. Am J Physiol 239: H664-H673Google Scholar
  130. 128.
    Vincent JL (1994) Renal effects of dopamine: can our dream ever come true? Crit Care Med 22: 5–6PubMedCrossRefGoogle Scholar
  131. 129.
    Waldhausen E, Keser G (1991) Lähmungen durch Kohlenydrate unter der Intensivtherapie. Anaesthesist 40: 332–338PubMedGoogle Scholar
  132. 130.
    Walkins WD, Hultmear PC (1982) Thromboxane and pulmonary hypertension following E. coli infusion in sheep. Prostaglandins 23: 273–277Google Scholar
  133. 131.
    Walmrath D, Schneider T, Pilch J, Grimminger F, Seeger W (1993) Aerolized prostacyclin in adult respiratory distress syndrome. Lancet 342: 961–962PubMedCrossRefGoogle Scholar
  134. 132.
    Watling SM, Dasta JF (1994) Prolonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: a review of the literature. Crit Care Med 22: 884–893PubMedCrossRefGoogle Scholar
  135. 133.
    Wetzels JFM, Burke TJ, Schrier RW (1992) Calcium channel blockers: Protective effects in ischaemic acute renal failure. Renal Failure 14: 327–332PubMedCrossRefGoogle Scholar
  136. 134.
    Wiedemann H, Baughman R, de Boisblanc B, Schuster D, Caldwell F, Weg J, Balk R, Jenkinson S, Wiegelt J, Tharratt R, Horton J, Pattishall E, Long W (1992) A multicen-sored trial in human sepsis induced ARDS of an aerolized synthetic surfactant (Exosurf). Am Rev Respir Dis 145: A184Google Scholar
  137. 135.
    Witt NJ, Zochodne DW, Bolton CF, Grand’Maison F, Wells G, Young GB, Sibbald WJ (1991) Peripheral nerve function in sepsis and multiple organ failure. Chest 99: 176–184PubMedCrossRefGoogle Scholar
  138. 136.
    Wysocki M, Delclaux C, Roupie E, Langeron O, Liu N, Herman B, Lemaire F, Brochard L (1994) Additive effect on gas exchange of inhaled nitric oxide and intravenous almitrine bismesylate in the adult respiratory distress syndrome. Intensive Care Med 20: 254–249PubMedCrossRefGoogle Scholar
  139. 137.
    Zochodne DW, Bolton CF, Wells GA, Gilbert JJ, Hahn AF, Brown JD, Sibbald WA (1987) Critical illness polyneuropathy: a complication of sepsis and multiple organ failure. Brain 110: 819–814PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • H. Burchardi
  • M. Sydow

There are no affiliations available

Personalised recommendations