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Die Anaesthesiologie
Erschienen in: Der Anaesthesist 1/2013

01.01.2013 | Leitthema

Aspekte der perioperativen Behandlung von Diabetespatienten

verfasst von: PD Dr. G. Pestel, D. Closhen, A. Zimmermann, C. Werner, M.M. Weber

Erschienen in: Die Anaesthesiologie | Ausgabe 1/2013

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Zusammenfassung

Diabetes mellitus ist in Deutschland eine Volkskrankheit. Aufgrund der diabetischen Folgeerkrankungen (Makroangiopathie, Mikroangiopathie und Neuropathie) bedürfen Diabetespatienten einer intensiveren anästhesiologischen Betreuung in der perioperativen Phase im Vergleich zu Nichtdiabetespatienten. Eine sorgfältige, ausführliche Anamnese mit Erfassung des diabetesbedingten perioperativen Gefährdungspotenzials (Herz-Kreislauf-Erkrankungen, Gastroparese, Neuropathie, „Stiff-joint“-Syndrom) hat nach derzeitigem Wissensstand wahrscheinlich größere Bedeutung als eine spezifische Medikamenten- oder Verfahrenswahl. Das intraoperative anästhesiologische Management diabeteskranker Patienten fokussiert sich in besonderem Maß auf die Erhaltung der hämodynamischen Stabilität, perioperative Infektionsprophylaxe und Kontrolle der Glucosehomöostase. Wurde noch vor einigen Jahren das Erzwingen einer strikten Normoglykämie mithilfe forcierter Insulintherapie propagiert, erkennen neuere Studien hierin ein Risikopotenzial. Die optimierte perioperative Behandlung von Diabetespatienten sollte daher den gewünschten Blutzuckerspiegel klar benennen, bewährte Therapiealgorithmen vorhalten und eine engmaschige Überwachung mit ggf. umgehender Modifikation der Behandlung ermöglichen.
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Metadaten
Titel
Aspekte der perioperativen Behandlung von Diabetespatienten
verfasst von
PD Dr. G. Pestel
D. Closhen
A. Zimmermann
C. Werner
M.M. Weber
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Die Anaesthesiologie / Ausgabe 1/2013
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-012-2089-y

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