Advertisement

Abriß der Pathophysiologie als Grundlage der Therapie

  • H.-P. Schuster

Zusammenfassung

Der heutige Kenntnisstand über Pathogenese, Pathophysiologie und klinisches Erscheinungsbild der Sepsis kann in einem schematischen Abriß nachgezeichnet werden, welcher die Hauptereignisse des Sepsisprozesses markiert und als Basis für das Verständnis und die Auswahl der Therapie dienen kann (Abb. 2.1).

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Astiz ME, Rackow EC, Falk JL, Kaufmann BS, Weil MH (1987) Oxygen delivery and consumption in patients with hyperdynamic septic shock. Crit Care Med 15: 26–28PubMedCrossRefGoogle Scholar
  2. 2.
    Bihari DJ (1987) Prevention of multiple organ failure in the critically ill. In: Vincent JL (ed) Update in intensive care and emergency medicine. Springer, Berlin Heidelberg New York Tokyo, pp 26–39Google Scholar
  3. 3.
    Bihari D, Smithies M, Gimson A, Tinker J (1987) The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. N Engl J Med 317: 397–404PubMedCrossRefGoogle Scholar
  4. 4.
    Böhm M, Girschik P, Jakobs K-H, Kemkes B, Schanabel P, Erdmann E (1989) Mechanismus der verminderten Katecholaminwirkung im Schock und bei Herzinsuffizienz, Intensivmedizin 26 [Suppl 1]: 55–59Google Scholar
  5. 5.
    Duff JH, Groves AC, McLean APH, La Pointe R, MacLean LD (1969) Defective oxygen consumption in septic shock. Surg Gynecol Obstet 128: 1051–1060PubMedGoogle Scholar
  6. 6.
    Fine J, Frank H, Schweinburg F, Jacob S, Gordon T (1952) The bacterial factor in traumatic shock. NY Acad Sei 55: 429–437CrossRefGoogle Scholar
  7. 6a.
    Hanique G, Dugernier T, Laterre PF, Dougnac A, Roeseler J, Reynaert MS (1994) Significance of pathologic oxygen supply dependency in critically ill patients: comparison between measured and calculated methods. Intensive Care Med 20: 12–18PubMedCrossRefGoogle Scholar
  8. 7.
    Harken AH, Lillo RS, Hufnagel HV (1975) Direct influence of endotoxin on cellular respiration. Surg Gynecol Obstet 140: 858–860PubMedGoogle Scholar
  9. 8.
    Harrison PM, Wendon JA, Gimson AES, Alexander GJM, Williams R (1991) Improvement by acetylcysteine of hemodynamics and oxygen transport in fulminant hepatic failure. N Engl J Med 324: 1852–1957PubMedCrossRefGoogle Scholar
  10. 9.
    Kox WJ, Brydon C (1991) Improvement of tissue oxygenation with enoximone in septic shock. In: Vincent JL (ed) Update in intensive care and emergency, 14. medicine. Springer, Berlin, Heidelberg New York Tokyo, pp 137–143Google Scholar
  11. 10.
    Lefer AM (1974) Myocardial depressant factor in circulatory shock. Klin Wochenschr 52: 358PubMedCrossRefGoogle Scholar
  12. 11.
    Meakins J, Marshall J (1989) The gut as the motor of multiple system organ failure. In: Marston A, Bulkley G, Fiddian-Green R, Haglund U (eds) Splanchnic ischemia and multiple organ failure. Arnold, London, pp 339–348Google Scholar
  13. 12.
    Müller U, Hallström S, Koidel B, Schlag G, Werdan K (1989) Wirkung einer kardiode-pressiven Fraktion (CFD) aus dem Plasma von Hunden im Schock in Herzmuskelzellkulturen. Intensivmedizin 26 [Suppl 1]: 45–49Google Scholar
  14. 13.
    Parillo JE (1986) Cardiovascular dysfunction in humans with septic shock. In: Vincent JL (ed) Update in intensive care medicine, 1. Springer, Berlin Heidelberg New York Tokyo, pp 265–273Google Scholar
  15. 14.
    Parillo JE (1989) The cardiovascular pathophysiology of sepsis. Annu Rev Med 40: 469–485CrossRefGoogle Scholar
  16. 15.
    Parillo JE, Burch C, Shekhamer J, Parker MM, Natanson C, Schuette W (1985) A circulating myocardial depressant substance in humans with septic shocks. Septic shock patients with a reduced ejection fraction have a circulating factor that depress myocardial cell performance. J Clin Invest 76: 1539–1553CrossRefGoogle Scholar
  17. 16.
    Parker MM, Parrillo JE (1983) Septic shock. Hemodynamics and pathogenesis. J Am Med Assoc 250: 3324–3327CrossRefGoogle Scholar
  18. 17.
    Parker MM, Schelhamer JH, Bacharach SL, Green MV, Natanson C, Frederick TM, Damske BA, Parillo JE (1984) Profound but reversible myocardial depression in patients with septic shock. Ann Intern Med 100: 483–490PubMedGoogle Scholar
  19. 18.
    Parker MM, Shelhamer JH, Natanson C, Ailing DW, Parillo JE (1987) Serial cardiovascular variables in survivors and nonsurvivors of human septic shock. Heart rate as an early predictor of prognosis. Crit Care Med 15: 923–929PubMedCrossRefGoogle Scholar
  20. 18a.
    Parker MM, Ognibene FP, Parillo JE (1994) Peak systolic pressure/end systolic volume ratio, a load-independent measure of ventricular function, is reversibly decreased in human septic shock. Crit Care Med 22: 1955–1959PubMedGoogle Scholar
  21. 19.
    Rush BJ, Sori AJ, Murphy TF, Smith S, Flanagen JJ, Machiedor GW (1988) Endotoxine-mia and bacteremia during hemorrhagic shock. Ann Surg 207: 549PubMedCrossRefGoogle Scholar
  22. 20.
    Wilson RF, Thai AP, Kindling PH, Grifka T, Ackerman E, 1965) Hemodynamic measurements in septic shock. Arch surg 91: 121–217CrossRefGoogle Scholar
  23. 21.
    Wolf YG, Gotev S, Prel A, Manny J (1987) Dependence of oxygen consumption on cardiac output in sepsis. Crit Care Med 15: 198–203PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • H.-P. Schuster

There are no affiliations available

Personalised recommendations