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Erschienen in: Wiener klinisches Magazin 5/2014

01.11.2014 | Intensivmedizin

Akzidentelle Hypothermie

verfasst von: Anne Schmidt, Dr. Hermann Brugger, PD, Dr. Gabriel Putzer, Dr. Peter Paal, PD, MBA, EDAIC, EDIC

Erschienen in: Wiener klinisches Magazin | Ausgabe 5/2014

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Zusammenfassung

Bei Patienten mit schwerer akzidenteller Hypothermie besteht bis heute Unsicherheit in der Wahl der optimalen Behandlung und des Zielkrankenhauses. In dieser Arbeit werden Empfehlungen für die prä- und innerklinische Versorgung und den Transport von akzidentell hypothermen Patienten vorgestellt. Fortschritte in der Behandlung und Verfügbarkeit von neuen Erwärmungstechniken haben die Prognose von Patienten mit akzidenteller Hypothermie deutlich verbessert. Patienten mit einer Körperkerntemperatur von ≥ 28 °C und stabiler Hämodynamik sollen minimalinvasiv aktiv extern erwärmt werden. Bei instabiler Hämodynamik (Blutdruck systolisch < 90 mmHg, ventrikuläre Arrhythmie, Körperkerntemperatur < 28 °C) soll ebenfalls minimalinvasiv und aktiv extern erwärmt werden, jedoch in einem Krankenhaus mit der Möglichkeit einer venoarteriellen extrakorporalen Membranoxygenierung (va ECMO) oder Herz-Lungen-Maschine (HLM). Bei Herzstillstand soll eine invasive Erwärmung durchgeführt werden, wobei die va ECMO der HLM vorgezogen werden sollte. Hypotherme Patienten sollen direkt in eine Klinik mit einer dem Schweregrad entsprechenden Therapiemöglichkeit transportiert werden, um Komplikationen vorzubeugen und das Überleben zu verbessern.
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Metadaten
Titel
Akzidentelle Hypothermie
verfasst von
Anne Schmidt
Dr. Hermann Brugger, PD
Dr. Gabriel Putzer
Dr. Peter Paal, PD, MBA, EDAIC, EDIC
Publikationsdatum
01.11.2014
Verlag
Springer Vienna
Erschienen in
Wiener klinisches Magazin / Ausgabe 5/2014
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI
https://doi.org/10.1007/s00740-014-0005-6

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