Systematik der Therapie bei Sepsis und Multiorganversagen

  • H.-P. Schuster

Zusammenfassung

Die Behandlungsmaßnahmen bei Sepsis und Multiorganversagen können der Kaskade von Pathogenese und Pathophysiologie als Therapiekaskade zugeordnet werden (Abb. 3.1). In der klinischen Praxis sind die einzelnen Behandlungsmaßnahmen jedoch nicht als Stufenschema aufzufassen und anzuwenden, sondern — soweit sinnvoll — miteinander zu kombinieren und in ihrer Kombination frühzeitig einzusetzen.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Bernard GR, Luce JM, Sprung CL, Rinaldo JE, Tate RM, Sibbald WJ, Kariman K, Higgins S, Bradley R, Metz CA, Harris TR, Brigham KL (1987) High-dose corticosteroide in patients with the adult respiratory distress syndrome. N Engl J Med 317: 1565–1570PubMedCrossRefGoogle Scholar
  2. 2.
    Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA, Balk R, and the methylpred-nisolone 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
  3. 3.
    Bone L, Johnson K, Eigelt J, Scheinberg R (1989) Early versus delaped stabilization of femoral fracture stabilization: a prospective randomized study. J Bone Joint Surg [Am] 71:336–340Google Scholar
  4. 4.
    Burchardi H, Sydow M, Crozier TA, Burgdorff J (1990) Organversagen bei Polytrauma-patienten. Einfluß einer frühen Osteosynthese von Frakturen auf Komplikationen. Anästh Intensivther Notfallmed 25: 64–71PubMedCrossRefGoogle Scholar
  5. 5.
    Goris RJA, Gimbere JSF, Mieberk JLM, Schoots FJ, Booy HD (1982) Early osteosynthesis and prophylactic mechanical ventilation in the multitrauma patients. J Trauma 22: 895–903PubMedCrossRefGoogle Scholar
  6. 6.
    Hesselvik F, Brodin B, Carlsson C, Cedergren B, Jorfeldt L, Lieden G (1987) Cryopreci-pitate infusion fails to improve organ function in septic shock. Crit Care Med 15: 475–483PubMedCrossRefGoogle Scholar
  7. 7.
    Johnson K, Cadambi A, Seibert G (1985) Incidence of adult respiratory distress syndrome in patients with multiple musculos heletol injuries: effect of early operative stabilization of fractures. J Trauma 25: 375–384PubMedCrossRefGoogle Scholar
  8. 8.
    Luce JM, Montgomery AB, Marks JD, Turner J, Metz CA, Murray JF (1988) Ineffectiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with septic shock. Am Rev Respir Dis 138: 62–68PubMedCrossRefGoogle Scholar
  9. 9.
    Newman PM, Ramsay G, Ledingham IMcA (1986) Cryoprecipitate replacement of fibronectin in septic shock. Intensive Care med 12: 118 (Abstract)Google Scholar
  10. 10.
    Sprung CL, Caralis PV, Marcial EH, Pierce M, Gelbard MA, Long WM, Duncan RC, Tendier MD, Karpf M (1984) The effects of high-dose corticosteroide in patients with septic shock. A prospective, controlled study. N Engl J Med 311: 1137–1143PubMedCrossRefGoogle Scholar
  11. 11.
    Veterans Administration Systemic Sepsis Cooperative Study Group (1987) Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. N Engl J Med 317: 659–665CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • H.-P. Schuster

There are no affiliations available

Personalised recommendations