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Die Anaesthesiologie
Erschienen in: Die Anaesthesiologie 2/2008

01.02.2008 | Intensivmedizin

Mikrozirkulation beim Intensivpatienten

Von der Physiologie zur Klinik

verfasst von: Dr. H. Knotzer, W. Hasibeder

Erschienen in: Die Anaesthesiologie | Ausgabe 2/2008

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Zusammenfassung

Die Mikrozirkulation ist in ihrer Anatomie und Physiologie ein in sich abgeschlossenes, einzigartiges Organsystem im menschlichen Körper. Es ist der Ort, an dem der Gasaustausch und die Versorgung der Zellen mit Nährstoffen stattfinden. Er ist aber auch der Ort, der im Rahmen eines Schockgeschehens verschiedene pathologische Veränderungen erfährt und damit die Sauerstoffversorgung zu den einzelnen Geweben und Zellen gefährdet. Bei einer systemischen Inflammation kommt es so z. B. zu einem heterogenen mikrozirkulatorischen Blutfluss, interstitieller Gewebsödembildung, veränderter Viskosität, Leukozytenaktivierung, Störung des Koagulationssystems und zu einem Zusammenbruch der endothelialen Barrierefunktion, die unweigerlich zu Einschränkungen im Sauerstofftransport zu den einzelnen Zellen und Geweben führen. Wird ein solcher Pathomechanismus nicht durchbrochen, so mündet das Versagen der Mikrozirkulation unweigerlich in einer Dysfunktion von Organsystemen. In diesem Übersichtsartikel soll neben einer kurzen Beschreibung der Physiologie der Mikrozirkulation und der Interaktion zwischen Makro- und Mikrozirkulation eine Darstellung der mikrozirkulatorischen Veränderungen durch einen systemisch inflammatorischen Respons beleuchtet werden. Schließlich werden verschiedene Therapieoptionen beschrieben, die experimentell zu einer Verbesserung der mikrozirkulatorischen Dysfunktion führen können.
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Metadaten
Titel
Mikrozirkulation beim Intensivpatienten
Von der Physiologie zur Klinik
verfasst von
Dr. H. Knotzer
W. Hasibeder
Publikationsdatum
01.02.2008
Verlag
Springer-Verlag
Erschienen in
Die Anaesthesiologie / Ausgabe 2/2008
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-007-1300-z

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