Bei Patienten mit entzündlich-rheumatischen Erkrankungen können sich schwere Organmanifestationen entwickeln, die eine Behandlung auf einer Intensivstation (ICU) erforderlich machen. Das frühzeitige Erkennen eines drohenden Organversagens ist von größter Bedeutung für das Outcome und die langfristige Prognose. In diesem Beitrag werden intensivmedizinisch relevante Organmanifestationen hinsichtlich der Diagnostik und Therapie vorgestellt.
Abstract
Several inflammatory rheumatic diseases can severely affect any organ system and require immediate intervention and intensive care admission. The early detection of impending organ failure and the underlying rheumatic disease is of paramount importance for the prognosis and outcome of affected patients. Therefore, a thorough knowledge of the potential life threatening organ manifestations of systemic rheumatic diseases is of particular interest for clinicians working in intensive care. This paper provides an overview of diagnostic steps and therapy of organ manifestations in critically ill patients with underlying systemic rheumatic diseases. The presentation of the relevant systemic rheumatic diseases is structured according to the most important organ systems, i. e. the respiratory system, the kidney and the cardiovascular system. Furthermore, there is a focus in this paper on macrophage activation syndrome (MAS) as a potentially lethal complication of several rheumatic diseases and the catastrophic antiphospholipid syndrome (CAPS) as a rare cause of multi organ failure.
Schlüsselwörter
Intensivmedizin - entzündlich-rheumatische Systemerkrankungen - Organmanifestationen
Key words
intensive care - inflammatory rheumatic diseases - organ manifestations
