Skip to main content
SpringerLink
Log in

Pathophysiologie der Verbrennungskrankheit

  • Chapter
Verbrennungschirurgie

Zusammenfassung

Ein Verbrennungstrauma mit Beteiligung bereits ≥20 % der Körperoberfläche kann bis zum Multiorganversagen mit fatalen Folgen führen. Es entsteht eine systemische Reaktion u. a. mit signifikanter Flüssigkeitsverschiebung aus dem intravasalen in den interstitiellen Raum und somit eine Ödembildung. Bei der Entstehung eines Verbrennungsschocks spielt neben der Hypovolämie auch die Aktivierung der zahlreichen Mediatoren eine zentrale Rolle. Dieses Kapitel befasst sich hauptsächlich mit systemischen Reaktionen der Verbrennungskrankheit bei schwerverbrannten Patienten. Dabei werden die Mechanismen auf zellulärer Ebene und der Effekt der wichtigsten Mediatoren beschrieben sowie die Auswirkung auf einzelne Organsysteme dargestellt.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 179.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 229.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Arturson G (1996) The plasma kinins in thermal injury. Scand J Clin Lab Invest 107:153–161

    Google Scholar 

  • Arturson G (1996) The pathophysiology of the burn wound and pharmacological treatment. The Rudi Hermans Lecture. In: Burns 22:255–274

    Google Scholar 

  • Baron DM, Metnitz PGH (2009) Metabolische Veränderungen bei Brandverletzungen – Pathophysiologie und Therapie. Anästhesiol Intensivmed Notfallmed Schmerzther 44:494–499

    Google Scholar 

  • Baxter CR, Cook WA, Shires GT (1966) Serum myocardial depressant factor of burn shock. Surg Forum 17:1–2

    Google Scholar 

  • Buhling F, Lieder N, Kuhlmann UC, Waldburg N, Welt T (2007) Tiotropium suppresses acetylcholine-induced release of chemotactic mediators in vitro. Respir Med 101:2386-2394

    Google Scholar 

  • Burch JM, Moore EE, Moore FA (1996) The abdominal compartment syndrome. Surg Clin North Am 76:833–842

    Google Scholar 

  • Cartotto R, Callum J (2012) A review of the use of human albumin in burn patients. J Burn Care Res 33:702–717

    Google Scholar 

  • Chong SJ, Wong YC, Wu J, Tan MH, Lu J, Moochhala SM (2014) Parecoxib reduces systemic inflammation and acute lung injury in burned animals with delayed fluid resuscitation. Int J Inflam. doi: 10.1155/2014/972645. Epub 2014 Jan 21

    Google Scholar 

  • Davis CF, Moore FD Jr, Rodrick ML, Fearon DT, Mannick JA (1987) Neutrophil activation after burn injury: contributions of the classic complement pathway and of endotoxin. Surgery 102:477–484

    Google Scholar 

  • Deitch EA (1990) Intestinal permeability is increased in burn patients shortly after injury. Surgery 107:411–416

    Google Scholar 

  • Demling RH (2005) The burn edema process: current concepts. J Burn Care Rehabil 26:207–227

    Google Scholar 

  • Diao L, Marshall AH, Dai X, Bogdanovic E, Abdullahi A, Amini-Nik S, Jeschke MG (2014) Burn plus lipopolysaccharide augments endoplasmic reticulum stress and NLRP3 inflammasome activation and reduces PGC-1a in liver. Shock 41:138–144

    Google Scholar 

  • Friedl HS, Till GO, Tentz O, Ward PA (1989) Roles of histamine, complement and xanthine oxidase in thermal injury of skin. Am J Pathol 135:203–217

    Google Scholar 

  • Gauglitz GG, Herndon DN, Kamolz LP, Jeschke MG (2009) Die Pathophysiologie von Verbrennungswunden. In: Karnolz LP, Herndon DN, Jeschke MG (Hg) Verbrennungen. Springer Berlin, Heidelberg, New York

    Google Scholar 

  • Gauglitz GG, Williams FN, Herndon DN, Jeschke MG (2011) Burns: where are we standing with propranolol, oxandrolone, recombinant human growth hormone, and the new incretin analogs? Curr Opin Clin Nutr Metab 14:176–181

    Google Scholar 

  • Gelfand JA, Donelan M, Burke JF (1983) Preferential activation and depletion of the alternative complement pathway by burn injury. Ann Surg 198:58–62

    Google Scholar 

  • Goodman-Gilman A, Rall TW, Nies AS, Taylor R (1990) The pharmacological basis of therapeutics. 6th Edn, MacMillan New York

    Google Scholar 

  • Grunwald TB, Garner WL (2008) Acute burns. Plast Reconstr Surg 121:311e–319e

    Google Scholar 

  • Harms B, Bodai B, Demling R (1981) Prostaglandine release and altered microvascular integrity after burn injury. J Surg Res 31:27–28

    Google Scholar 

  • Hettiaratchy S, Dziewulski P (2004) ABC of burns. Pathophysiology and types of burns. BMJ Vol 328

    Google Scholar 

  • Ishitsuka Y, Moriuchi H, Hatamoto K, Yang C, Takase J, Golbidi S, Irikura M, Irie T (2004) Involvement of thromboxane A2 (TXA2) in the early stages of oleic acid-induced lung injury and the preventive effect of ozagrel, a TXA2 synthase inhibitor in guinea-pigs. J Pharm Pharmacol 56:513–520

    Google Scholar 

  • Jackson DM (1953) The diagnosis of the depth of burning. Br J Surg 40:588

    Google Scholar 

  • Jeschke MG, Finnerty CC, Emdad F, Rivero HG, Kraft R, Williams FN, Gamelli RL, Gibran NS, Klein MB, Arnoldo BD, Tompkins RG, Herndon DN (2013) Mild obesity is protective after severe burn injury. Ann Surg 258:1119–1129

    Google Scholar 

  • Jeschke, MG (2013) Clinical review: Glucose control in severely burned patients – current best practice. Critical Care 17:232

    Google Scholar 

  • Kao CC, Garner WL (2000) Acute Burns. Plast Reconstr Surg 101:2482–2493

    Google Scholar 

  • Keck M, Herndon DH, Kamolz LP, Frey M, Jeschke MG (2009) Pathophysiology of Burns. Wien Med Wochenschr 159:327–226

    Google Scholar 

  • Kobayashi L, Costantini TW, Coimbra R (2012) Hypovolemic shock resuscitation. Surg Clin North Am 92:1403–1423

    Google Scholar 

  • Lund T, Wiig H, Reed RK, Aukland K (1987) A ‘new’ mechanism for oedema generation: strongly negative interstitial fluid pressure causes rapid fluid flow into thermally injured skin. Acta Physiol Scand 129:433–435

    Google Scholar 

  • Lund T, Onarheim H, Reed RK (1992) Pathogenesis of edema formation in burn injuries. World J Surg 16:2–9

    Google Scholar 

  • Mace JE et al (2012) Differential expression of the immunoinflammatory response in trauma patients: Burn vs. non-burn. Burns 38:599–606

    Google Scholar 

  • Mandell SP, Gibran NS (2014) Early Nutrition for Burn Injury. Adv Wound Care (New Rochelle) 3:64–70

    Google Scholar 

  • Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, Glass P, Lipman J, Liu B, McArthur C, McGuinness S, Rajbhandari D, Taylor CB, Webb SA (2012) CHEST Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med 367:1901–1911

    Google Scholar 

  • Ono I, Gunji H, Hasegawa T, Harada H, Kaneko F, Matsuzaki M (1993) Effects of a platelet activating factor antagonist on oedema formation following burns. Burns 19:202–207

    Google Scholar 

  • Ottomann C, Hartmann B (2004) Die Pathophysiologie des Verbrennungstraumas. Intensivmed 41:380–387

    Google Scholar 

  • Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Åneman A, Madsen KR, Møller MH, Elkjær JM, Poulsen LM, Bendtsen A, Winding R, Steensen M, Berezowicz P, Søe-Jensen P, Bestle M, Strand K, Wiis J, White JO, Thornberg KJ, Quist L, Nielsen J, Andersen LH, Holst LB, Thormar K, Kjældgaard AL, Fabritius ML, Mondrup F, Pott FC, Møller TP, Winkel P, Wetterslev J (2012) 6S Trial Group; Scandinavian Critical Care Trials Group. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. N Engl J Med 367:124–134

    Google Scholar 

  • Rawlingson A, Greenacre SA, Brain SD (2000) Generation of peroxynitrite in localised, moderate temperature burns. Burns 26:223–227

    Google Scholar 

  • Samuelsson A, Farnebo S, Magnusson B, Anderson C, Tesselaar E, Zettersten E, Sjöberg F (2012) Implications for burn shock resuscitation of a new in vivo human vascular microdosing technique (microdialysis) for dermal administration of noradrenaline. Burns 38:975–983

    Google Scholar 

  • Schwacha MG (2003) Macrophages and post-burn immune dysfunction. Burns 29:1–14

    Google Scholar 

  • Shirani KZ, Pruitt BA Jr, Mason AD (1987) The influence of inhalation injury and pneumonia on burn mortality. Ann Surg 205:82–87

    Google Scholar 

  • Song J1, Finnerty CC, Herndon DN, Boehning D, Jeschke MG (2009) Severe burn-induced endoplasmic reticulum stress and hepatic damage in mice. Mol Med 15:316–320

    Google Scholar 

  • Teot L, Otmann S, Brancati A, Mittermayr R. Burn wound healing: Pathophysiology. In: Kamolz LP et al. (ed). Handbook of Burns. Springer, Wien

    Google Scholar 

  • Ungureanu-Longrois D, Balligand JL, Kelly RA, Smith TW (1995) Myocardial contractile dysfunction in the systemic inflammatory response syndrome – role of a cytokine-inducible nitric oxide synthase in cardiac myocytes. J Mol Cell Cardio 27:155–167

    Google Scholar 

  • Williams FN, Branski LK, Jeschke MG, Herndon, DN (2011) What, how, and how much should patients with burns be fed?, Surgical Clinics of North America 91:609–629

    Google Scholar 

  • Wiig H, Rubin K, Reed RK (2003) New and active role of the interstitium in control of interstitial fluid pressure: potential therapeutic consequences. Acta Anaesthesiol Scand 47:111–121

    Google Scholar 

  • Wolfe RR, Durkot MJ, Allsop JR et al (1979) Glucose metabolism in severely burned patients.Metabolism 28:1031–1039

    Google Scholar 

  • Yamamoto Y1, Sousse LE, Enkhbaatar P, Kraft ER, Deyo DJ, Wright CL, Taylor A, Traber MG, Cox RA, Hawkins HK, Rehberg SW, Traber LD, Herndon DN, Traber DL (2012) γ-tocopherol nebulization decreases oxidative stress, arginase activity, and collagen deposition after burn and smoke inhalation in the ovine model. Shock 38:671–676

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Plastische Chirurgie und Handchirurgie, Universitätsspital Zürich, Rämistrasse 100, CH-8091, Zürich

    Dr. med. Richard M. Fakin, Dr. med. Merlin Guggenheim & Prof. Dr. med. Pietro Giovanoli

  2. Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum Referenzzentrum für Gliedmaßentumoren, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum Ruhr-Universität-Bochum, Bürkle-de-la-Camp-Platz 1, D-44789, Bochum

    Dr. med. Christoph Wallner & Univ. Prof. Dr. med. Marcus Lehnhardt

Authors
  1. Dr. med. Richard M. Fakin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dr. med. Merlin Guggenheim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dr. med. Christoph Wallner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Univ. Prof. Dr. med. Marcus Lehnhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Prof. Dr. med. Pietro Giovanoli
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. BG-Universitätsklinikum Bergmannsheil Bochum, Bochum, Deutschland

    Marcus Lehnhardt

  2. Unfallkrankenhaus Berlin, Berlin, Deutschland

    Bernd Hartmann

  3. Klinikum Nürnberg, Nürnberg, Deutschland

    Bert Reichert

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Fakin, R.M., Guggenheim, M., Wallner, C., Lehnhardt, M., Giovanoli, P. (2016). Pathophysiologie der Verbrennungskrankheit. In: Lehnhardt, M., Hartmann, B., Reichert, B. (eds) Verbrennungschirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54444-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54444-6_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54443-9

  • Online ISBN: 978-3-642-54444-6

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation