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Intensivtherapie bei Sepsis und Multiorganversagen pp 27–72Cite as

Abriß der Pathophysiologie als Grundlage der Therapie

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Zusammenfassung

Der heutige Kenntnisstand über Pathogenese, Pathophysiologie und klinisches Erscheinungsbild der Sepsis kann in einem schematischen Abriß skizziert werden, welcher die Hauptereignisse des Sepsisprozesses markiert und als Basis für das Verständnis und die Auswahl der Therapie dienen kann (Abb. 2-1). Mannigfaltige Stimuli — einschließlich aller Klassen von Mikroorganismen oder auch isolierte bakterielle Toxine wie Endotoxin oder Superantigene — können eine mediatorbedingte Systemerkrankung unter dem klinischen Erscheinungsbild einer Sepsis auslösen (Abb. 2-2). An den Zielzellen entwickeln die Mediatoren des antiinfektiösen Arsenals des Organismus stimulatorische, aber auch toxische Wirkungen und modulieren die Apoptose. Dazu kommt eine direkte Toxizität der bakteriellen Toxine. Auf der Ebene der Organe kann es so zur Organdysfunktion und zur Störung der Organinteraktionen mit einer „Entkopplung der biologischen Oszillatoren“ [23] (s. dazu auch Kap. 1) kommen.

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  1. U. Müller-Werdan
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  2. H.-P. Schuster
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Editors and Affiliations

  1. Städt. Krankenhaus Hildesheim Lehrkrankenhaus, Medizinischen Hochschule Hannover, Weinberg 1, 31134, Hildesheim, Deutschland

    Hans-Peter Schuster

  2. Klinikum Kröllwitz/Innere Medizin II, Martin-Luther-Universität, Ernst-Grube-Str. 40, 06097, Halle /Saale, Deutschland

    Karl Werdan

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Müller-Werdan, U., Schuster, HP. (2000). Abriß der Pathophysiologie als Grundlage der Therapie. In: Schuster, HP., Werdan, K. (eds) Intensivtherapie bei Sepsis und Multiorganversagen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-07962-1_2

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