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Veränderungen im Bereich der Mikrozirkulation bei Sepsis und septischem Schock

  • Chapter
Sepsis

Zusammenfassung

Sepsis und septischer Schock sind durch ein Mißverhältnis zwischen O2-Angebot und O2-Bedarf gekennzeichnet [7]. In der Frühphase ist das Herzzeitvolumen bei erniedrigtem peripherem Gefäßwiderstand normal oder sogar über Normalwerte erhöht. Jedoch besteht eine niedrige arterio-gemischtvenöse O2-Gehaltsdifferenz; sie zeigt an, daß die Extraktion von Sauerstoff aus dem arteriellen Blut vermindert ist. Dieses hyperdyname Stadium, erstmals von Waisbren [39] beschrieben, geht im weiteren Verlauf der Erkrankung in den hypodynamen septischen Schock über. Es wird allgemein angenommen, daß die inadäquate O2-Extraktion und der Übergang vom hyperdynamen in das hypodyname Stadium auf eine Störung der Perfusion im Bereich der Mikrozirkulation zurückzuführen sind [38]. Da die Prognose des hypodynamen septischen Schocks — trotz aller Anstrengungen bei der Behandlung dieser Patienten auf Intensivstationen — unvermindert schlecht ist, erscheint es vordringlich, die Diagnose des septischen Schocks frühzeitiger, d. h. schon im hyperdynamen Stadium zu stellen.

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Authors
  1. K. Meßmer
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  2. U. Kreimeier
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  3. F. Hammersen
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Editors and Affiliations

  1. Universitätsklinikum Steglitz Klinik für Anästhesiologie und operative Intensivmedizin, Freie Universität Berlin, Hindenburgdamm 30, D-1000, Berlin 45, Deutschland

    K. Reinhart  & K. Eyrich  & 

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Meßmer, K., Kreimeier, U., Hammersen, F. (1989). Veränderungen im Bereich der Mikrozirkulation bei Sepsis und septischem Schock. In: Reinhart, K., Eyrich, K. (eds) Sepsis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09869-1_15

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  • DOI: https://doi.org/10.1007/978-3-662-09869-1_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-09870-7

  • Online ISBN: 978-3-662-09869-1

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