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01.04.2005 | Notfallmedizin

Präklinisches Management von Rückenmarkverletzungen

verfasst von: M. Bernhard, A. Gries, P. Kremer, A. Martin-Villalba, B. W. Böttiger

Erschienen in: Die Anaesthesiologie | Ausgabe 4/2005

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Zusamenfassung

Von den jeweils mehr als 10.000 Patienten, die jährlich in den USA und in Europa eine Rückenmarkverletzung (RMV) erleiden, sterben ca. 20% bereits vor Aufnahme in die Klinik. Weil bis zu 25% der RMV erst nach dem initialen Ereignis entstehen bzw. aggraviert werden, ist das präklinische Management wichtig. Hierzu gehören: Untersuchung des Patienten, Immobilisation der Wirbelsäule, Atemwegsmanagement unter strenger Indikationsstellung, kardiovaskuläre Stabilisierung mit Aufrechterhaltung eines mittleren arteriellen Drucks (MAP) über 90 mmHg sowie Stabilisierung einer Blutglukosekonzentration im Normbereich. Aus evidenzbasierter Sicht ist unbekannt, ob zusätzliche spezielle Therapiemaßnahmen von Nutzen sind. Bisher konnte nicht überzeugend belegt werden, dass Methylprednisolon (MPS) oder andere Substanzen einen klinisch wichtigen Benefit haben. Auch aktuelle US-amerikanische Stellungnahmen unterstützen nicht mehr die Therapie mit MPS bei RMV im prähospitalen Setting. Darüber hinaus ist unbekannt, ob die therapeutische Hypothermie oder andere pharmakologische Interventionen positiv wirken. Koordination und Durchführung weiterer klinischer Studien scheinen notwendig, um das Outcome der Patienten weiter zu verbessern.

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Titel: Präklinisches Management von Rückenmarkverletzungen
verfasst von: M. Bernhard
A. Gries
P. Kremer
A. Martin-Villalba
B. W. Böttiger
Publikationsdatum: 01.04.2005
Verlag: Springer-Verlag
Erschienen in: Die Anaesthesiologie / Ausgabe 4/2005
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI: https://doi.org/10.1007/s00101-005-0807-4

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