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Monitoring im Splanchnikussystem

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Book cover Monitoring in Anästhesie und Intensivmedizin

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Zusammenfassung

Trotz vieler technischer Fortschritte der heutigen Intensivmedizin v. a. auf dem Gebiet der Patientenüberwachung ist die Mortalität bei einem Multiorganversagen in den letzten 20 Jahren nicht entscheidend gesenkt worden [20, 61]. Auch heute noch konzentrieren sich die Bemühungen im Rahmen des Monitorings auf kardiopulmonale Parameter wie z. B. Blutdruck, Herzfrequenz, Herzzeitvolumen und die Überwachung des O2-Transports und O2-Verbrauchs im Gesamtorganismus. Ein wesentliches Charakteristikum dieser Parameter jedoch ist, daß sie nur globale Veränderungen erfassen und regionale Durchblutungs- und Stoffwechselveränderungen nicht berücksichtigen [17, 56, 68, 74]. Aufgrund der großen Bedeutung von regionalen Durchblutungs- und Stoffwechselveränderungen für das Entstehen und den Verlauf septischer Krankheitsbilder und des Multiorganversagens muß allerdings bezweifelt werden, ob globale Parameter die wesentlichen Pathomechanismen dieser Syndrome erfassen und v. a. zu den richtigen Therapieschritten führen. So konnte z. B. in einer großen Metaanalyse gezeigt werden, daß die Erhöhung des Herzzeitvolumens, des globalen O2-Transports und O2-Verbrauchs auf supraphysiologische Werte die Mortalitätsrate von kritisch kranken Patienten nicht verringern konnte [44a].

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Authors
  1. I. F. Tugtekin
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  2. M. Georgieff
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Editors and Affiliations

  1. Universitätsklinik für Anästhesiologie und Intensivmedizin, Auenbruggerplatz 29, A-8036, Graz, Österreich

    Werner F. List  & Helfried Metzler  & 

  2. Institut für Anästhesiologie, Universitätsspital Zürich, Rämistraße 100, CH-8091, Zürich, Schweiz

    Thomas Pasch

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Tugtekin, I.F., Georgieff, M. (1998). Monitoring im Splanchnikussystem. In: List, W.F., Metzler, H., Pasch, T. (eds) Monitoring in Anästhesie und Intensivmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-12541-0_24

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