Zusammenfassung
Mit einer Mortalitätsrate von 50–80% ist die Sepsis eine häufige Todesursache schwerstkranker Patienten. Derzeit wird nicht mehr so eindeutig wie früher eine Störung der zentralen Kreislaufregulation bzw. ein Schockzustand infolge Sepsis für den Tod verantwortlich gemacht. Vielmehr scheint der Tod septischer Patienten hauptsächlich mit der Entwicklung eines multiplen Organversagens („multiple systems organ failure“, MSOF) [7, 24] einherzugehen. Um das MSOF und die zirkulatorischen Konsequenzen einer schweren Infektion zu verstehen, konzentrierte sich die Forschung auf Störungen der Mikrozirkulation, die mit einer Sepsis einhergehen.
Diese Arbeit wurde unterstützt durch Zuwendungen des Medical Research Council of Canada (Nr. MA7339), der Ontario Heart Foundation und der UpJohn Company (Nr. 8244) von Kanada.
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Literatur
Abraham E, Bland RD, Cobo JC, Shoemaker WC (1984) Sequential cardiorespiratory patterns associated with outcome in septic shock. Chest 85 [1]: 75–80
Adachi H, Strauss W, Ochi H, Wagner HN (1977) The effect of hypoxia on the regional distribution of cardiac output in the dog. Chest 39: 314–319
Asher EF, Rowe RL, Garrison RN, Fry DE (1980) Experimental bacteremia and hepatic nutrient blood flow. Circ Shock 20: 43–49
Astiz ME, Rackow EC, Weil MH (1986) Oxygen delivery and utilization during rapidly fatal septic shock in rats. Circ Shock 20 [4]: 281–290
Avila A, Warshawski F, Sibbald W, Finley R, Wells G, Holliday R (1985) Peripheral lymph flow in sheep with bacterial peritonitis: evidence for increased peripheral microvascular permeability accompanying systemic sepsis. Surgery 97 [6]: 685–695
Baker CH, Wilmoth FR (1984) Microvascular responses to E. coli endotoxin with altered adrenergic activity. Circ Shock 12: 165–176
Bell RC, Coalson JJ, Smith JD, Johanson WG (1983) Multiple organ system failure and infection in adult respiratory distress syndrome. Ann Intern Med 99 [3]: 293–298
Bihari D, Smithies M, Gimson A, Tinker J (1987) The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. New Engl J Med 317 [7]: 397–403
Bocking JK, Sibbald WJ, Holliday RL, Scott S, Viidik T (1979) Plasma catecholamine levels and pulmonary dysfunction in sepsis. Surg Gynecol Obstet 148: 715–719
Cadden S, Philip RB, Sibbald WJ (1987) Cardiac beta receptor dysfunction in an animal model of the sepsis syndrome. Crit Care Med 15 [4]: 439 (abstract)
Cain SM (1986) Assessment of tissue oxygenation. Crit Care Clin 2 [3]: 537–550
Calvin JE, Sibbald WJ (in press) Applied cardiovascular physiology in the critically ill with special reference to diastole and ventricular interaction. In: Saunders WB (ed) Textbook of Critical Care (in press)
Carroll GC, Snyder JV (1982) Hyperdynamic severe intravascular sepsis depends on fluid administration cynomolgus monkey. Am J Physiol 243 [1]: R131–141
Chaudry IH (1984) Cellular energetics and ATP-MgCl2 therapy in sepsis. Am J Emerg Med 2 [1]: 38–44
Chaudry IH, Wichterman KA, Baue AE (1979) Effect of sepsis on tissue adenine nucleotide levels. Surgery 85 [2]: 205–211
Chernow B, Roth BL (1986) Pharmacologic manipulation of the peripheral vasculature in shock: clinical and experimental approaches. Circ Shock 18: 141–155
Cryer HM, Garrison RN, Kaebnick HW, Harris PD, Flint LM (1987) Skeletal microcirculatory responses to hyperdynamic Escherichia coli sepsis in unanesthetized rats. Arch Surg 122: 86–92
Dellinger EP, Wertz MJ, Meakins JL, Solomkin JS, Allo MD, Howard RJ et al. (1985) Surgical infection stratification system for intra-abdominal infection. Arch Surg 120: 21–29
Demling RH (1986) Shock and fluids. In: Chernow B, Shoemaker WC (eds) Critical care, state of the art. The Society of Critical Care Medicine 7: 301–352
Duling BR, Klitzman B (1980) Local control of microvascular function: role in tissue oxygen supply. Am Rev Physiol 42: 373–382
Ellman H (1984) Capillary permeability in septic patients. Circ Shock 12: 191–202
Finley RJ (1985) Animal models for the study of sepsis and septic shock. In: Sibbald WJ, Sprung CL (eds) Perspectives on sepsis and septic shock. Society of Critical Care Medicine, Fullerton, pp 11–26
Fish RE, Lang CH, Spitzer JA (1986) Regional blood flow during continuous low-dose endotoxin infusion. Circ Shock 18: 267–275
Fry DE, Perlstein L, Fulton RL, et al. (1980) Multiple system organ failure. Arch Surg 115 [2]: 136–140
Gilbert EM, Haupt MT, Mandanas RY, Huaringa AJ, Carlson RW (1986) The effect of fluid loading, blood transfusion, and catecholamine infusion on oxygen delivery and consumption in patients with sepsis. Am Rev Respir Dis 134: 873–878
Gnidec A, MacDonald JWD, Craig I, Finley R, Sibbald WJ (1984) The effect of aspirin in acute microvascular lung injury (AMI) induced by ZAP. Am Rev Respir Dis 129 [4] Part 2: A105 (abstract)
Groeneveld ABJ, Bronsveld W, Thijs LG (1986) Hemodynamic determinants of mortality in human septic shock. Surgery 99 [2]: 140–153
Grum CM, Simon RH, Dantzker DR, Fox IH (1985) Evidence for adenosine triphosphate degradation in the critically ill patients. Chest 88 [5]: 763–767
Gutierrez G, Pohil RJ (1986) Oxygen consumption is linearly related to 02 supply in critically ill patients. J Crit Care 1 [1]: 45–53
Hammerschmidt DE, Vercellotti GM (1987) Granulocyte as mediators of tissue injury in shock: therapeutic implications. First Vienna shock forum, part A: pathophysiological role of mediators and mediator inhibitors in shock. Liss, New York, pp 19–31
Harris RL, Musher DM, Bloom K, Gathe J, Rice L, Sugerman B, et al. (1987) Manifestations of sepsis. Arch Intern Med 147 [11]: 1895–1906
Heistad DD, Abboud FM (1980) Circulatory adjustments to hypoxia. Circulation 61 [3]: 463–470
Hersche M, Robertson JS, Neal A, Rutledge FS, Cunningham DG, Sibbald WJ (1987) The effects of PEEP on peripheral microvascular fluid flux in hyperdynamic sepsis. Clin Invest Med 10 [4]: B122 (abstract)
Hunter J (1794) A treatise on the blood, inflammation, and gun-shot wounds. Pall Mall, London
Judges D, Sharkey P, Cheung H, Craig I, Driedger AA, Sibbald WJ, Finley RJ (1986) Pulmonary microvascular fluid flux in a large animal model of sepsis: evidence for increased pulmonary endothelial permeability accompanying surgically induced peritonitis in sheep. Surgery 99 [2]: 222–234
Kelbaek H, Harding OJ, Gjorup T, Marving J, Christensen NJ, Godtfredsen J (1987) Effects of autonomic blockade on cardiac function at rest and during upright exercise in humans. J Appl Physiol 63 [2]: 554–557
King EG, Chin WDN (1985) Shock: an overview of pathophysiology and general treatment goals. Crit Care Clin 533–546
Kruse JA, Zaidi SAJ, Carlson RW (1987) Significance of blood lactate levels in critically ill patients with liver disease. Am J Med 83: 77–82
Lefer AM (1987) Interaction between myocardial depressant factor and vasoactive mediators with ischemia and shock. Am J Physiol 252: R193 - R205
Liaw K (1985) Effect of injury, sepsis, and parenteral nutrition in high-energy phosphates in human liver and muscle. J Parenter Enteral Nutr 9: 28–33
McKenna TM, Martin FM, Chernow B, Birglia FA (1986) Vascular endothelium contributes to decreased aortic contractility in experimental sepsis. Circ Shock 19: 267–273
Movat HZ, Cybulsky MI, Colditz IG, Chan MKW, Dinarello CA (1987) Acute inflammation in gram-negative infection: endotoxin, interleukin 1, tumor necrosis factor, and neutrophils. Fed Proc 46: 97–104
Natanson C, Fink MP, Ballantyne HK, MacVittie TJ, Conklin JJ, Parrillo JE (1986) Gram-negative bacteremia produces both severe systolic and diastolic cardiac dysfunction in a canine model that simulates human septic shock. J Clin Invest 78 [1]: 259–270
Nesarajah MS, Matalon S, Krasney JA, Farhi LE (1983) Cardiac output and regional oxygen transport in the acutely hypoxic conscious sheep. Respir Physiol 53: 161–172
Oliphant LD, Walker FL, Linton AL, Sibbald WJ (1987) Multiple systems organ failure (MSOF) in an animal model of hyperdynamic sepsis. Crit Care Med 15 [4]: 377 (abstract)
Parker MM, Shelhamer JH, Bacharach SL, et al. (1984) Profound but reversible myocardial depression in patients with septic shock. Ann Intern Med 100: 483–490
Parker MM, Shelhamer JH, Natanson C, Alling DW, Parrillo 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 [10]: 923–929
Parks DA, Bulkley GB, Granger DN (1983) Role of oxygen free radicals in shock, ischemia and organ preservation. Surgery 94 [3]: 428–432
Parrillo JE, Burch C, Shelhamer JH, Parker MM, Naton C, Schuette W (1985) A circulating myocardial depressant substance in humans with septic shock. Septic shock patients with a reduced ejection fraction have a circulating factor that depresses in vitro myocardial cell performance. J Clin Invest 76 [4]: 1539–1553
Pine RW, Wertz MJ, Lennard ES et al. (1983) Determinants of organ malfunction or death in patients with intra-abdominal sepsis. Arch Surg 118 [2]: 242–249
Pinsky MR, Matuschak GM (1986) Cardiovascular determinants of the hemodynamic response to acute endotoxemia in the dog. J Crit Care 1 [1]: 18–31
Raper R, Rutledge F, Hobson J, Driedger A, Sibbald W (1986) Regional blood flow distribution in high output normotensive sepsis. Clin Invest Med 9 [3]: A23 (abstract)
Raper R, Sibbald WJ, Driedger AA, Gerow K: Relative myocardial depression in normotensive sepsis. (submitted)
Raper RF, Cunningham DG, Driedger AA, Sibbald WJ (1986) The effect of coronary artery disease on the biventricular hemodynamic response to human hyperdynamic sepsis. Chest (in press)
Rashkin MC, Bosken C, Baughman RP (1985) Oxygen delivery in critically ill patients. Relationship to blood lactate and survival. Chest 87: 580–584
Rhodes GR, Newell JC, Shah D, Scovill W, Tauber J, Dutton RE, Powers SR (1978) Increased oxygen consumption accompanying increased oxygen delivery with hypertonic mannitol in adult respiratory distress syndrome. Surgery 84: 490–497
Rutledge F, Raper R, Sibbald W (1987) Abnormalities in coronary and renal blood flow in sepsis. Clin Invest Med 10 [4]: B62 (abstract)
Schaer GL, Fink MP, Parrillo JE (1985) Norepinephrine alone versus norepinephrine plus low-dose dopamine: enhanced renal blood flow with combination pressor therapy. Crit Care Med 13 [6]: 492–496
Schirmer WJ, Schirmer JM, Townsend MC, Fry DE (1987) Imidazole and indomethacin improve hepatic perfusion in sepsis. Circ Shock 21: 253–259
Schuette AH, Huttemeier PC, Hill RD, Watkins WD, Wonders TR, Kong D, Zapol WM (1984) Regional blood flow and pulmonary thromboxane release after sublethal endotoxin infusion in sheep. Surgery 95 [4]: 444–453
Seidenfeld JJ, Pohl DF, Bell RC et al. (1986) Incidence, site and outcome of infections in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 134: 12–16
Shoemaker WC (1987) Pathophysiology, monitoring, outcome prediction, and therapy of shock states. Crit Care Clin 3 [2]: 307–358
Shumaker PT, Wood LDH (1984) Limitations of anaerobic metabolism in critical illness. Chest 85: 453–454
Sibbald WJ, Cunningham DG, Chin WDN (1983) Non-cardiac or cardiac pulmonary edema? A practical approach to clinical differentiation in critically ill patients. Chest 84 [4]: 452–461
Sutherland GR, Cheung HW, Holliday RL, Driedger AA, Sibbald WJ (1986) Hemodynamic adaptation to acute myocardial contusion complicating blunt chest injury. Am J Cardiol 57: 291–297
Townsend MC, Hampton WW, Haybron DM, Shirmer WJ, Fry DE (1986) Effective organ blood flow and bioenergy status in murine peritonitis. Surgery 100: 205–213
Walker JF, Cumming AD, Lindsay RM, Solez K, Linton AL (1986) The renal response produced by nonhypotensive sepsis in a large animal model. Am J Kidney Dis 8 [2]: 88–97
Weber KT, Janicki JS, Shroff S et al. (1981) Contractile mechanics and interaction of the right and left ventricles. Am J Cardiol 47: 686–695
Zelis R, Lee G, Mason DT (1974) Influence of experimental edema on metabolically determined blood flow. Circ Res 34: 482–490
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Sibbald, W.J., Raper, R.F., Bersten, A.D. (1989). Kreislaufveränderungen beim septischen Syndrom. In: Reinhart, K., Eyrich, K. (eds) Sepsis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09869-1_11
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