Zusammenfassung
Die akute, nicht beherrschbare Blutung ist bei polytraumatisierten Patienten in der Initialphase nach dem Trauma eine führende Todesursache. Eine schon präklinisch initiierte Volumentherapie kann dabei primär den Kreislauf stabilisieren und sekundäre, ischämiebedingte Spätschäden wie Organversagen vermeiden, jedoch auch eine bestehende Blutung verstärken. In den letzten Jahren wird über Art, Zeitpunkt und Menge der Volumentherapie sowie über den Stellenwert künstlicher Sauerstoffträger kontrovers diskutiert. Dieser Beitrag gibt einen Überblick über den aktuellen Stand der Diskussion zur präklinischen Volumentherapie bei polytraumatisierten Patienten.
Abstract
Acute, uncontrollable bleeding in the initial phase of trauma is a leading cause of death of polytraumatised patients. Volume therapy initiated before reaching hospital can not only primarily stabilise the circulation and so prevent secondary damage such as organ failure due to ischemia but also intensify an existing hemorrhage. In recent years there has been controversial discussion about the nature, time and amount of volume therapy and about the value of artificial oxygen transporters. This article presents a survey of the currrent status of preclinical volume therapy for polytraumatised patients.
Schlüsselwörter:
Präklinische Volumentherapie - Polytrauma - Small-volume-resuscitation - permissive Hypotension - Volumenersatzmittel
Keywords:
Preclinical volume therapy - polytrauma - small-volume resuscutation - permissive hypotension - fluid replacement media
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Dr. med. Bernd Donaubauer
Wissenschaftlicher Mitarbeiter an der Klinik für Anästhesiologie und operative Intensivmedizin an derCharité - Universitätsmedizin Berlin, Campus Virchow-Klinikum.
Email: bernd.donaubauer@charite.de
PD Dr. med. Thoralf Kerner
Oberarzt der Klinik für Anästhesiologie und operative Intensivmedizin an der Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum.
Email: thoralf.kerner@charite.de
Prof. Dr. med. Udo Kaisers
Stellvertretender Klinikdirektor der Klinik für Anästhesiologie und operative Intensivmedizin an der Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum.
