0000000000121844
AUTHOR
Thomas Standl
Die Definitionen der Schockformen
Der hypovolamische Schock ist ein Zustand unzureichender Durchblutung vitaler Organe mit konsekutivem Missverhaltnis von Sauerstoff-Angebot und -Verbrauch infolge intravasalen Volumenmangels mit kritisch verminderter kardialer Vorlast; er wird in vier spezielle Formen unterteilt (hamorrhagischer Schock, hypovolamischer Schock im engeren Sinne, traumatisch-hamorrhagischer Schock und traumatisch-hypovolamischer Schock). Der kardiogene Schock ist durch eine primare, kritische Verminderung der kardialen Pumpleistung mit konsekutiver inadaquater Sauerstoff-Versorgung der Organe bedingt. Der anaphylaktische Schock ist eine akute Verteilungstorung des Blutvolumens im Sinn des distributiven Schocks…
Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe
Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurenc…
Forderungen und Erwartungen an einen optimalen Volumenersatz
A volume replacement should compensate a reduction in the intravascular volume and counteract a hypovolemia so that hemodynamics and vital functions can be maintained. For this therapy, a physiologically-based solution comprising both osmotically and colloid osmotically active components should be administered. A consensus is proposed for this purpose which takes into consideration the following aspects: The optimum colloid, the questionable use of albumin, the physiological electrolyte pattern encompassing sodium, potassium, chloride and phosphate and their contributions to osmolality, an eventual addition of glucose, the physiological acid-base status with bicarbonate or alternately with …