Einfluss der Kardioanästhesie auf das Patientenoutcome

Martina Nowak-Machen

doi:10.1055/s-0042-118830

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Table of Contents

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52(07/08): 498-511
DOI: 10.1055/s-0042-118830

Topthema

Georg Thieme Verlag KG Stuttgart · New York

Einfluss der Kardioanästhesie auf das Patientenoutcome

Impact of Cardiac Anaesthesia on Patient Outcome

Martina Nowak-Machen

Abstract

Zusammenfasssung

Die Kardioanästhesie ist ein hoch technisierter, subspezialisierter Bereich der Anästhesiologie. Die Verbesserung des Patientenoutcomes wurde untersucht für hämodynamisches Management durch zielgerichtete Therapie, Nierenprotektion durch ischämische Fernpräkonditionierung, Myokardprotektion durch pharmakologische Präkonditionierung mittels volatiler Anästhetika, Neuroprotektion durch Nahinfrarotspektrometrie und perioperative Echokardiografie.

Abstract

The perioperative management of complex patients in a highly technical and subspecialized environment is the domain of the cardiac anesthesiologist. Evidence suggests that hemodynamic management using goal directed hemodynamic therapy (GDHT) improves patient outcome. Organ protection remains a main concern during cardiac surgery using extracorporeal circulation. Mortality can be decreased when remote ischemic preconditioning techniques (RIPC) are being used. Neurological outcomes can be improved with near-infrared-spectometry (NIRS), volatile anesthetics increase myocardial protection through preconditioning and perioperative echocardiography increases overall patient survival.

Schlüsselwörter

Hämodynamik - Nierenprotektion - Myokardprotektion - Neuroprotektion - Echokardiografie - Herzchirurgie

Key words

hemodynamic management - kidney - myocardial protection - neurological outcome - echocardiography - cardiac surgery

Full Text

References

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