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Diagnose und Therapie der Sepsis

S2-Leitlinien der Deutschen Sepsis-Gesellschaft e.V. (DSG) und der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI)

Diagnosis and Therapy of Sepsis

Guidelines of the German Sepsis Society Inc. and the German Interdisciplinary Society for Intensive and Emergency Medicine

  • Schwerpunkt: Intensivmedizin
  • Published:
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Zusammenfassung

Nach neuesten Erhebungen des vom BMBF geförderten Kompetenznetzwerkes Sepsis (SepNet) erkranken in Deutschland pro Jahr 75.000 Einwohner (110 von 100.000) an einer schweren Sepsis bzw. einem septischen Schock und 79.000 (116 von 100.000) an einer Sepsis. Mit ca. 60.000 Todesfällen stellen septische Erkrankungen die dritthäufigste Todesursache nach dem akuten Myokardinfarkt dar. Die direkten anteiligen Kosten, die allein für die intensivmedizinische Behandlung von Patienten mit schwerer Sepsis anfallen, liegen bei ca. 1,77 Mrd. €. Etwa 30% des Budgets für Intensivmedizin werden damit in die Behandlung der Sepsis investiert. Im Kontrast hierzu existierten bisher jedoch keine deutschen Leitlinien zur Diagnose und Therapie der schweren Sepsis. Auf Initiative der Deutschen Sepsis-Gesellschaft wurden daher in Anlehnung an die internationalen Empfehlungen des International Sepsis Forum (ISF) und der Surviving Sepsis Campaign (SSC) Leitlinien erarbeitet, welche die Versorgungsstrukturen im deutschen Gesundheitssystem berücksichtigen. Folgende Leitlinienthemen wurden als vorrangig eingestuft: a) Diagnose, b) Prävention, c) kausale Therapie, d) supportive Therapie, e) adjunktive Therapie. Die Leitlinien sind nach einem sorgfältig geplanten und streng eingehaltenen Prozess nach den Vorgaben der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) entstanden.

Abstract

A recent survey conducted by the publicly funded Competence Network Sepsis (SepNet) reveals that severe sepsis and/or septic shock occurs in 75,000 inhabitants (110 out of 100,000) and sepsis in 79,000 inhabitants (116 out of 100,000) in Germany annually. This illness is responsible for approximately 60,000 deaths and ranges as the third most frequent cause of death after acute myocardial infarction. Direct costs for the intensive care of patients with severe sepsis alone amount to approximately 1.77 billion euros, which means that about 30% of the budget in intensive care is used to treat severe sepsis. However, until now German guidelines for the diagnosis and therapy of severe sepsis did not exist. Therefore, the German Sepsis Society initiated the development of guidelines which are based on international recommendations by the International Sepsis Forum (ISF) and the Surviving Sepsis Campaign (SSC) and take into account the structure and organization of the German health care system. Priority was given to the following guideline topics: a) diagnosis, b) prevention, c) causative therapy, d) supportive therapy, e) adjunctive therapy. The guidelines development process was carefully planned and strictly adhered to the requirements of the Working Group of Scientific Medical Societies (AWMF).

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Danksagung.

Unser besonderer Dank gilt Frau PD Dr. I. Kopp und PD Dr. A. Bauhofer, Marburg von der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), welche die Entwicklung der vorliegenden Leitlinien methodisch begleitet haben und Herrn Dr. F. Bloos, Jena, welcher die Redaktionsarbeit begleitet hat.

Das Leitlinienprojekt wurde vom Deutschen Kompetenznetzwerk Sepsis (SepNet), gefördert vom Bundesministerium für Bildung und Forschung (BMBF), Förderkennzeichen: 01KI 0106 unterstützt.

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  1. Deutsche Sepsis-Gesellschaft e.V., c/o Universitätsklinikum Jena, Erlanger Allee 101, 07747 , Jena

    F. M. Brunkhorst

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  1. K. Reinhart
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  2. F. M. Brunkhorst
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Correspondence to F. M. Brunkhorst.

Anmerkung

Leitlinien gelten für Standardsituationen und berücksichtigen die aktuellen wissenschaftlichen Erkenntnisse. Durch die Leitlinien soll die Methodenfreiheit des Arztes nicht eingeschränkt werden. Die vorliegenden Leitlinien wurden von den Autoren mit größter Sorgfalt erarbeitet, dennoch kann für die Richtigkeit — insbesondere von Dosierungsangaben — keine Verantwortung übernommen werden.

Mitglieder der Leitlinienkomitees

Leitung: K. Reinhart, Jena

Redaktion und Koordination: F.M. Brunkhorst, Jena

Moderation: I. Kopp, Marburg, A. Bauhofer, Marburg

Teilnehmer: K. Reinhart, F. M. Brunkhorst, M. Bauer, F. Bloos, H.-G. Bone, H. Gerlach, M. Gründling, G. Kreymann, P. Kujath, G. Marggraf, G. Marx, K. Mayer, A. Meier-Hellmann, C. Peckelsen, C. Putensen, M. Quintel, M. Ragaller, R. Rossaint, F. Stüber, N. Weiler, T. Welte, K. Werdan

Unter Mitwirkung der

Deutschen Gesellschaft für Chirurgie (DGCH; [P.K.]), Deutschen Gesellschaft für Anästhesiologie und Notfallmedizin (DGAI; [R.R.]), Deutschen Gesellschaft für Herz-, Thorax- und Gefäßchirurgie (DGHTG; [G.M]), Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN; [G.K.]), Deutschen Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL), Deutschen Gesellschaft für Ernährungsmedizin (DGEM; [G.K.]), Deutschen Gesellschaft für Neurochirurgie (DGNC), Deutschen Gesellschaft für Neurologie (DGN), Deutschen Gesellschaft für Kardiologie (DGK; [K.W.]), Deutschen Gesellschaft für Innere Medizin (DGIM; [K.W.])

Verabschiedet von den Vorständen der beteiligten Fachgesellschaften am 15.12.2005.

Mit Unterstützung des Kompetenznetzwerkes Sepsis (SepNet), gefördert vom Bundesministerium für Bildung und Forschung (BMBF), Förderkennzeichen: 01 KI 0106.

Hinweis

Das komplette Literaturverzeichnis und der Methodenreport können auf der Homepage der AWMF (http://awmf.org) und der DSG (http://www.sepsis-gesellschaft.de) eingesehen werden.

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Reinhart, K., Brunkhorst, F.M., Bone, H.G. et al. Diagnose und Therapie der Sepsis. Internist 47, 356–373 (2006). https://doi.org/10.1007/s00108-006-1595-x

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