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Der septische Patient

Patients with sepsis

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Zusammenfassung

Die Sepsis ist nach wie vor eine der Haupttodesursachen auf nichtkardiologischen Intensivstationen. Mit der neuen Definition wird der Fokus der Betrachtung mehr auf die Organdysfunktion gelegt. Der Sepsis-related-organ-failure-assessment(SOFA)-Score ist dabei ein Marker für das Ausmaß der Organdysfunktion. Die Diagnose der Sepsis ist weitgehend klinisch zu stellen. Ein frühes Warnsignal ist dabei eine akute Veränderung der Bewusstseinslage der Patienten. Die mikrobiologische Diagnostik ist essenziell und muss umgehend mit mindestens 2 Paar Blutkulturen erfolgen. Therapeutisch muss sofort (innerhalb von maximal einer Stunde) eine adäquate Antibiotikatherapie eingeleitet werden. Gleichzeitig ist die frühe Kreislauftherapie von herausragender Bedeutung. Eine Flüssigkeitstherapie mit Überinfusion sollte allerdings unbedingt vermieden werden, da dies einen negativen Einfluss auf das Outcome septischer Patienten hat.

Abstract

Sepsis is still the leading cause of mortality in noncardiac intensive care units. The new definition of sepsis emphasizes the importance of organ dysfunction. The Sepsis-related Organ Failure Assessment (SOFA) score is an indicator for organ dysfunction. The diagnosis of sepsis is for the most part made on clinical parameters with an altered mental status being a very sensitive indicator. Microbiological work-up is essential and two sets of blood cultures are the recommended minimum. Management includes prompt initiation of adequate antibiotic treatment and swift fluid resuscitation. Overinfusion is to be avoided as this itself can have a negative impact on patient outcome.

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Authors and Affiliations

  1. Klinik für Notfall- und Intensivmedizin, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467, Potsdam, Deutschland

    M. Oppert

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M. Oppert gibt an, dass er Beraterhonorare von Brahms/Thermofischer und MSD sowie Vortragshonorare von Brahms, MSD und Bayer Vital erhalten hat.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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K.-F. Bodmann, Eberswalde

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Oppert, M. Der septische Patient. Med Klin Intensivmed Notfmed 111, 290–294 (2016). https://doi.org/10.1007/s00063-016-0162-z

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  • DOI: https://doi.org/10.1007/s00063-016-0162-z

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