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Erschienen in: Der Unfallchirurg 9/2017

22.08.2017 | Pflege | CME

Viskoelastizitätsbasierte Therapie beim blutenden Schwerverletzten

verfasst von: Prof. Dr. Marc Maegele, Michael Caspers, Herbert Schöchl

Erschienen in: Die Unfallchirurgie | Ausgabe 9/2017

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Zusammenfassung

Die unkontrollierte Blutung ist die führende vermeidbare Todesursache bei Patienten mit Mehrfachverletzung. Inzwischen wird die traumainduzierte Koagulopathie als eigenständiges, das Überleben beeinflussendes Krankheitsbild angesehen. Schwer blutende Traumapatienten werden häufig mit klassischen Blutprodukten in prädefinierten Verhältnissen behandelt („damage control resuscitation“). Möglicherweise ist der viskoelastizitätsbasierte und zielwertorientierte Ansatz vorzuziehen. Viskoelastizitätsbasierte Diagnostik und Therapie ermöglichen die qualitative Untersuchung aus Vollblut und liefern therapeutisch nutzbare Hinweise auf Initiierung, Dynamik und Nachhaltigkeit der Gerinnselbildung. Aufgrund einfacher Handhabung und zeitnaher Ergebnisse bieten sie sich als „Point-of-care“-Verfahren an. Im vorliegenden Beitrag werden die klinischen Fragestellungen zum Einsatz viskoelastischer Verfahren und aktuelle Expertenempfehlungen unter Berücksichtigung der Literatur dargestellt.
Fußnoten
1
Modifiziert in Abhängigkeit der aktuellen Literatur; Expertengremium der Konsensuskonferenz: EXTEM A10 ≥ 40 mm, EXTEM A5 ≥ 30 mm, EXTEM MCF ≥ 50 mm.
 
2
Modifiziert in Abhängigkeit der aktuellen Literatur; Expertengremium der Konsensuskonferenz: EXTEM A10 < 40 mm, EXTEM A5 < 30 mm, EXTEM MCF < 50 mm.
 
3
Modifiziert in Abhängigkeit der aktuellen Literatur; Expertengremium der Konsensuskonferenz: EXTEM A10 < 40 mm, EXTEM A5 < 30 mm, EXTEM MCF < 50 mm.
 
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Metadaten
Titel
Viskoelastizitätsbasierte Therapie beim blutenden Schwerverletzten
verfasst von
Prof. Dr. Marc Maegele
Michael Caspers
Herbert Schöchl
Publikationsdatum
22.08.2017
Verlag
Springer Medizin
Schlagwort
Pflege
Erschienen in
Die Unfallchirurgie / Ausgabe 9/2017
Print ISSN: 2731-7021
Elektronische ISSN: 2731-703X
DOI
https://doi.org/10.1007/s00113-017-0397-z

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