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Anästhesiol Intensivmed Notfallmed Schmerzther 2020; 55(10): 635-642
DOI: 10.1055/a-1011-2078
Leitlinien in der Praxis

Leitlinien in der Praxis: der herzchirurgische Patient in der intensivmedizinischen Versorgung

S3-Guideline Intensive Care Therapy of Cardiac Surgery Patients – a Practical Approach
David Sander
,
Fabian Dusse
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Zusammenfassung

Die S3-Leitlinie zur intensivmedizinischen Versorgung herzchirurgischer Patienten – Hämodynamisches Monitoring und Herz-Kreislauf [1] vereint aktuelles Wissen zu Empfehlungen für das hämodynamische Monitoring und die differenzierte Kreislauftherapie bei herzchirurgischen Intensivpatienten. Zudem werden anzustrebende Zielparameter der Kreislauftherapie, Behandlungsstrategien bei Links- und Rechtsherzinsuffizienz sowie klare Handlungsempfehlungen nach diversen Eingriffen in diesem Patientenkollektiv aufgezeigt.

Abstract

The current S3-Guideline for intensive care therapy in patients after cardiac surgery provides a wealth of information and recommendations ranging from monitoring to treatment options for various perioperative clinical situations. This article focuses on the most relevant information applicable to every-day critical care practice, covering important aspects of general and advanced monitoring, goal directed hemodynamic therapy and treatment principles for perioperative left and right heart failure.

Kernaussagen

  • Gemischt-venöse und/oder zentralvenöse Sättigung in Zusammenschau mit Laktatwert bewerten.

  • Ein erweitertes Monitoring sollte mit einer zielorientierten Therapie verbunden sein.

  • Künstliche Kolloide und Albumin spielen eine wichtige Rolle in der Volumenersatztherapie.

  • Levosimendan kann eine schwere Hypotonie bedingen.

  • Die Therapie der Rechtsherzinsuffizienz stützt sich auf adäquaten Perfusionsdruck, Kontraktilitätsverbesserung und Senkung eines erhöhten pulmonalvaskulären Widerstandes (PVR).

Schlüsselwörter

hämodynamisches Monitoring - postoperative Überwachung - Intensivmedizin - Leitlinie - Herzchirurgie

Key words

hemodynamic monitoring - postoperative monitoring - intensive care medicine - guideline - cardiac surgery


Publication History

Article published online:
14 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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