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Weiterbildung für Anästhesisten 2002 pp 70–86Cite as

Die akute Lungenarterienembolie

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Zusammenfassung

Trotz nachgewiesener Vorteile verschiedener prophylaktischer Maßnahmen zur Vermeidung einer akuten Thromboembolie der Lunge zählt die Lungenembolie in Deutschland mit etwa 20.000 Todesfällen pro Jahr nach wie vor zu den Haupttodesursachen hospitalisierter Patienten [2]. Die Prävalenz der Lungenembolie bei Autopsien ist in den letzten drei Jahrzehnten unverändert hoch und liegt bei 12–15% der zuvor stationären Patienten [58]. Nur in etwa 30% der autoptisch gesicherten Fälle wird die Diagnose zu Lebzeiten gestellt [42]. Unbehandelt beträgt die Mortalität der Lungenembolie ca. 30%. Unter adäquater Therapie lisst sich die Mortalitätsrate auf 2–8% senken [10,17, 60]. Der Häufigkeitsgipfel der perioperativen Lungenembolie liegt am 3. postoperativen Tag für gefißchirurgische Patienten und am 9. postoperativen Tag in der Allgemeinchirurgie [53].

Charakteristisch für die Lungenembolie ist eine hohe Frühletalität. Innerhalb von 1–2 h nach Symptombeginn ereignen sich 45–90% aller Todesfälle [3,58]. Werden embolische Ereignisse überlebt, besteht das Langzeitrisiko in der Manifestation einer pulmonalen Hypertonie. Diese entsteht durch rezidivierende, oft klinisch inapparent verlaufende kleinere Lungenembolien und/oder durch unzureichende Reperfusion der pulmonalen Strombahn nach Lungenembolie [43].

Die medizinischen Anforderungen, die sowohl die Diagnose als auch die Therapie der Lungenembolie betreffen, können nur interdisziplinär in enger Zusammenarbeit zwischen den Fachdisziplinen und unter genauer Kenntnis der pathophysiologischen Veränderungen bewältigt werden.

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Authors and Affiliations

  1. Klinik für Anaesthesiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Dr. A. Walther

  2. Klinik für Anaesthesiologie, Universitätsklinikum Heidelberg, Deutschland

    Dr. A. Walther & B. W. Böttiger

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  1. Dr. A. Walther
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  2. B. W. Böttiger
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Editors and Affiliations

  1. Klinik für Anästhesiologie, Universität Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Deutschland

    Hubert J. Bardenheuer

  2. Klinik für Anästhesiologie und operative Intensivmedizin Zentralklinikum, Stenglinstraße 2, D-86156, Augsburg, Deutschland

    Helmuth Forst

  3. Klinik für Anästhesiologie, Medizinische Einrichtungen der RWTH Aachen, Pauwelsstraße 30, D-52074, Aachen, Deutschland

    Rolf Rossaint

  4. Service d’Anesthésiologie Centre Hospitalier, Universitaire Vaudois - CHUV, Rue du Bugnon 46, CH-1011, Lausanne, Schweiz

    Donat R. Spahn

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Walther, A., Böttiger, B.W. (2003). Die akute Lungenarterienembolie. In: Bardenheuer, H.J., Forst, H., Rossaint, R., Spahn, D.R. (eds) Weiterbildung für Anästhesisten 2002. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10888-8_5

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  • DOI: https://doi.org/10.1007/978-3-662-10888-8_5

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