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Zusammenfassung

Trotz unbestreitbarer Fortschritte in der Intensivtherapie ist die Mortalität von Traumapatienten mit konsekutiver Funktionseinschränkung von Organsystemen oder schweren, generalisierten Inflammationssyndromen hoch. Dies betrifft besonders die langfristige Morbidität und Mortalität nach (Poly-)Trauma, während das frühe Trauma-assoziierte Versterben überwiegend durch den Schweregrad einer primären Hirnverletzung und durch das Ausmaß des primären Blutverlusts bestimmt wird (Meier et al. 2007). Nach älteren Untersuchungen in den USA (Parrillo et al. 1990) versterben 30–70% der Patienten, die ein solches Inflammationssyndrom im Gefolge eines Schocks, eines schweren Traumas, ausgedehnter Operationen oder lebensbedrohlicher Infektionen erleiden. Durch intensive Forschung in den vergangenen Jahren sind einschneidende wissenschaftliche Einsichten zu den Syndromen »Multiorganversagen « und »Sepsis« gewonnen worden, welche in erheblichem Maße Auswirkungen auf therapeutische Strategien zeigen.

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Literatur

  • Antonelli M, Moreno R, Vincent JL, et al. (1999) Application of SOFA score to trauma patients. Sequential Organ failure Assessment. Intensive Care Med 25: 389–394

    Article  PubMed  CAS  Google Scholar 

  • Barie PS, Hydo LJ, Pieracci FM, et al. (2009) Multiple organ dysfunction syndrome in critical surgical illness. Surg Infect 10: 369–377

    Article  Google Scholar 

  • Bein T (1998) Patientenlagerung – Kinetische Therapie in der Intensivmedizin. Anaesthesist 47: 74–80

    Article  PubMed  CAS  Google Scholar 

  • Bein T (2006) Beatmungsstrategien nach Polytrauma. Intensiv- und Notfallbehandlung 31(2): 52–57

    Google Scholar 

  • Bennett D, Boldt J, Vincent JL (1991) Expert panel: The use of the pulmonary artery catheter. Intensive Care Med 17: I–VIII

    Article  Google Scholar 

  • Brunkhorst FM, Reinhart K (2008) Sepsistherapie – Aktuelle Leitlinien und deren Umsetzung. Chirurg 79: 306–314

    Article  PubMed  CAS  Google Scholar 

  • Cochrane Injuries Group Albumin Reviewers (1998) Human albumin administration in critically ill patients: Systematic review of randomised controlled trials. BMJ 317: 235–240

    Google Scholar 

  • Ertel W, Keel M, Marty D, et al. (1998) Die Bedeutung der Ganzkörperinflammation bei 1.278 Traumapatienten. Unfallchirurg 101: 520–526

    Article  PubMed  CAS  Google Scholar 

  • Flaatten H, Ulvik A (2006) Quality of life after intensive care in trauma patients. Minerva Anestesiol 2006 72: 479–481

    CAS  Google Scholar 

  • Hassoun HT, Kone BC, Mercer DW, Moody FG, Weisbrodt NW, Moore FA (2001) Post-injury multiple organ failure: the role of the gut. Shock 15: 1-10

    Article  PubMed  CAS  Google Scholar 

  • Kellum JA (2008) Acute kidney injury. Crit Care Med 36(4): S141–S145

    Article  PubMed  Google Scholar 

  • Kreymann KG et al. (2006) ESPEN Guidelines on enteral nutrition: intensive care. Clin Nutr 25: 210–223

    Article  PubMed  CAS  Google Scholar 

  • Kudsk KA, Minard G, Wojtysiak SL (1994) Visceral protein response to enteral versus parenteral nutrition and sepsis in patients with trauma. Surgery 116: 516–523

    PubMed  CAS  Google Scholar 

  • Levy B, Pollaert PE, Charpentier C et al. (1997) Comparison of norepinephrine and dobutamine to epinephrine for hemodynamics, lactate metabolism, and gastric tonometric variables in septic shock: A prospective randomized study. Intensive Care Med 23: 282–287

    Article  PubMed  CAS  Google Scholar 

  • Lionetti V, Recchia FA, Ranieri M (2005): Overview of ventilator-induced lung injury mechanisms. Curr Opin Crit Care 11: 82–86

    Article  PubMed  Google Scholar 

  • Marek PE, Corwin HL (2008) Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med 36: 2667–2674

    Article  Google Scholar 

  • Meier J, Habler O (2007) Versorgung des Polytraumas – Die Behandlung auf der Intensivstation. Anästhesiol Intensivmed Notfallmed Schmerzther 10: 724–729

    Article  Google Scholar 

  • Napolitano LM, Ferrer T, McCarter RJ jr, Scalea TM (2000) Systemic inflammatory response syndrome at admission indepently predicts mortality and lenghth of stay in trauma patients. J Trauma 49: 647–652

    Article  PubMed  CAS  Google Scholar 

  • Offner P, Moore E (2000) Risk factors for MOF and pattern of organ failure following severe trauma. In: Baue E, Faist E, Fry D (Hrsg.) Multiple Organ Failure – pathophysiology, prevention, and therapy. Springer Berlin, Heidelberg, New York, Tokio, S. 30–43

    Google Scholar 

  • Pal J, Brown R, Fleiszer D (1989) The value of the Glasgow Coma Scale and Injury Severity Score: Predicting outcome in multiple trauma patients with head injury. J Trauma 29: 746–748

    Article  PubMed  CAS  Google Scholar 

  • Ronco C, Bagshaw SM, Gibney RT, Bellomo R (2008) Outcome comparisons of intermittent and continuous therapies in acute kidney injury: what do they mean? Int J Artif Organs 31: 213–220

    PubMed  CAS  Google Scholar 

  • Schuerholz T, Marx G (2008) Management of sepsis. Minerva Anesthesiol 74: 181–195

    CAS  Google Scholar 

  • Taeger G, Ruchholtz S, Waydhas C, Lewan U, Schmidt B, Nast-Kolb D (2005) Damage control orthopedics in patients with multiple injuries is effective, time saving, and safe. J Trauma 59: 409–416

    Article  PubMed  Google Scholar 

  • The Acute Respiratory Distress Syndrome Network (2000): Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342: 1301–1308

    Article  Google Scholar 

  • Vazquez MG, Rivera-Fernandez R, Perez-Aragon A et al. (1996) Analysis of quality of life in polytraumatized patients two years after discharge from an intensive care unit. J Trauma 41: 326–323

    Article  Google Scholar 

  • Ware LB, Matthay MA (2000) The acute respiratory distress syndrome. N Engl J Med 342: 1334–1349

    Article  PubMed  CAS  Google Scholar 

  • Wilson RF, Tyburski JG, Janning SW (1996) Sepsis in Trauma. In: Wilson RF, Walt AJ (eds) Management of trauma – pitfalls and practice, 2nd edn. Williams & Wilkins, Baltimore, pp 828–866

    Google Scholar 

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Bein, T. (2011). Intensivmedizin. In: Weigel, B., Nerlich, M. (eds) Praxisbuch Unfallchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-10789-4_16

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  • DOI: https://doi.org/10.1007/978-3-642-10789-4_16

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