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Strategien in der Intensiv- und Notfallmedizin für Patienten mit schwerer Herzinsuffizienz

Strategies in intensive care and emergency medicine for patients with acute heart failure

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Neues aus Kardiologie und Rhythmologie

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Der kardiogene Schock stellt eine der häufigsten Todesursachen in der Intensiv- und Notfallmedizin der westlichen Welt dar. In über 80% der Fälle liegt diesem ursächlich eine Myokardischämie zugrunde. Neben der schnellstmöglichen und kompletten Revaskularisation beim akuten Myokar dinfarkt müssen weitergehende intensiv-und notfallmedizinische Maßnahmen darauf abzielen, durch Wiederherstellen eines suffizienten Kreislaufes die Organperfusion zu erhalten, um so einem Multiorgandysfunktionssyndrom vorzubeugen. Pharmakologische Maßnahmen können dies in der Akutphase über eine Anhebung des arteriellen Mitteldrucks bewirken, haben jedoch in der Regel eine Steigerung des myokardialen Sauerst offverbrauchs zur Folge, weshalb mechanische Kreislaufunter-stützungssysteme hier frühzeitig zum Einsatz kommen sollten. Durch eine optimale Versorgung von Patienten im kardiogenen Schock kann so die Mortalität von über 75% auf unter 40% gesenkt werden. Zukünftig werden mobile und einfach zu bedienende Kreislaufunterstützungssysteme noch schneller bei Notfall-und intensivmedizinischen Patienten zum Einsatz kommen, um Patienten frühzeitig hämodynamisch stabilisieren zu können und so weitergehende diagnostische und therapeutische Maßnahmen im kardiogenen Schock zu ermöglichen.

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Authors and Affiliations

  1. Klinik für Innere Medizin I, Erlanger Allee 101, 07747, Jena, Germany

    Priv.-Doz. Dr. med. Di. disc. pol. Markus Ferrari

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  1. Priv.-Doz. Dr. med. Di. disc. pol. Markus Ferrari
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  1. Medizinische Klinik II Marienhospital Herne, Klinikum der Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne

    Hans-Joachim Trappe

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Ferrari, M. (2008). Strategien in der Intensiv- und Notfallmedizin für Patienten mit schwerer Herzinsuffizienz. In: Trappe, HJ. (eds) Neues aus Kardiologie und Rhythmologie. Steinkopff. https://doi.org/10.1007/978-3-7985-1886-5_8

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  • DOI: https://doi.org/10.1007/978-3-7985-1886-5_8

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-7985-1885-8

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