Kardiale Hämodynamik bei Schock
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- 作者：Dr. A. Kersten
- 关键词：SchlüsselwörterIntensivmedizin ; Intensivmedizinisches Outcome ; Herzkontraktilität ; Herzzeitvolumen ; Ventrikelfunktion
- 刊名：Medizinische Klinik
- 出版年：2016
- 出版时间：October 2016
- 年：2016
- 卷：111
- 期：7
- 页码：590-595
- 全文大小：213 KB
- 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Internal Medicine
Medicine/Public Health, general - 出版者：Urban & Vogel
- ISSN：1615-6722
- 卷排序：111
文摘
In caring for critically ill patients, a sophisticated approach to treating hemodynamic instability in acute circulatory failure is a major concern of modern critical care. Depending on the form of shock—distributive, cardiogenic, hypovolemic or obstructive, with the possibility of overlapping forms of shock—preload, afterload, cardiac output, and contractility are altered in various ways. Modern critical care uses hemodynamic monitoring and bedside echocardiography in addition to clinical evaluation to treat the underlying cause and sequelae of shock. Fluid therapy taking volume responsiveness and need for volume into account, vasopressor therapy taking microcirculatory derangement into account, and therapy using inotropes, sometimes in combination with vasodilators are the cornerstones of critical care treatment in this regard. Preload, afterload, cardiac output, and contractility must thereby be evaluated and treated in a patient- and situation-specific manner.