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Sepsis in der Notfallmedizin

Erkennen und initiale Therapie

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Weiterbildung Notfallmedizin

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Zusammenfassung

Sepsis ist die Folge einer systemischen Reaktion des Organismus auf eine Infektion. Eine frühe Erkennung der Sepsis sollte bereits in der Präklinik, aber spätestens bei Aufnahme in der Notaufnahme erfolgen. Die schwere Sepsis ist durch ein zusätzliches Organversagen definiert, der septische Schock durch einen persistierenden Schock auch nach initialer Volumengabe. Die frühe kausale Therapie mit Abnahme von Blutkulturen und Breitspektrumantibiotika in der ersten Stunde und die frühe supportive zielgerichtete Therapie mit kristalloiden Lösungen in den ersten 6 h senken die Mortalität bei schwerer Sepsis und septischem Schock. Zielparameter der supportiven Therapie sind der mittlere arterielle Blutdruck und die klinischen Zeichen einer adäquaten Gewebeperfusion. Die Therapie sollte durch invasive Monitoringverfahren nicht verzögert werden. Die Laktat-Clearance und die zentralvenöse Sauerstoffsättigung sind gleichrangige Zielparameter und die Verwendung beider Zielparameter ist möglich.

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Author information

Authors and Affiliations

  1. Interdisziplinäres Notfallzentrum mit Rettungsstelle, HELIOS Klinikum Berlin-Buch, Berlin

    C.E. Wrede

  2. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena

    K. Reinhart

Authors
  1. C.E. Wrede
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  2. K. Reinhart
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Editor information

Editors and Affiliations

  1. Klinik für Anästhesiologie, Universitätsklinikum Ulm, 89070, Ulm

    B. Dirks

  2. Interdisziplinäre Rettungsstelle, Uni. med. Berlin, Berlin

    R. Somasundaram

  3. Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen

    C. Waydhas

  4. Medizinische Klinik B, Klinikum Ludwigshafen, Bremserstraße 79, 67063, Ludwigshafen

    U. Zeymer

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Wrede, C., Reinhart, K. (2015). Sepsis in der Notfallmedizin. In: Dirks, B., Somasundaram, R., Waydhas, C., Zeymer, U. (eds) Weiterbildung Notfallmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46523-3_12

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  • DOI: https://doi.org/10.1007/978-3-662-46523-3_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46522-6

  • Online ISBN: 978-3-662-46523-3

  • eBook Packages: Medicine (German Language)

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