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Zielorientierte Volumen- und Kreislauftherapie

Konzepte, Indikationen und Risiken

Goal-directed hemodynamic therapy

Concepts, indications and risks

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Zusammenfassung

Zielorientierte Volumen- und Kreislauftherapie sowie damit verbundene Therapiealgorithmen geraten zunehmend in den Interessenfokus des Anästhesiologen und des Intensivmediziners. Metaanalysen von Studien, die solche algorithmusgestützten, perioperativen, hämodynamischen Therapiestrategien mit der bisherigen klinischen Praxis verglichen, haben eine Reduktion der postoperativen Morbidität gezeigt. In diesem Übersichtsbeitrag werden grundsätzliche Konzepte der zielorientierten Volumen- und Kreislauftherapie sowie das Prinzip der bisher angewendeten Therapiealgorithmen vorgestellt und diskutiert. Ferner wird die Frage beleuchtet, wie diese Behandlungsstrategien konkret in die klinische Praxis übertragen werden können, und ob eine solche Implementierung ggf. auch Risiken bergen kann.

Abstract

Goal-directed hemodynamic therapy is becoming increasingly more interesting for anesthesiologists and intensive care physicians. Meta-analyses of studies evaluating perioperative therapy algorithms demonstrated a reduction of postoperative morbidity compared to the previous clinical practices. In this review article the basic concepts of goal-directed hemodynamic therapy and the principles of previously employed therapy algorithms are described and discussed. Furthermore, the questions of how these therapy strategies can be transferred into daily clinical practice and whether these therapeutic approaches might even bear risks for patients are elucidated.

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  1. Klinik und Poliklinik für Anästhesiologie, Zentrum für Anästhesiologie und Intensivmedizin, Martinistr. 52, 20246, Hamburg, Deutschland

    S.A. Haas EDIC, B. Saugel, C.J. Trepte & D.A. Reuter

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  1. S.A. Haas EDIC
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D. Reuter und B. Saugel sind Mitglieder des Medical Advisory Board der Firma Pulsion.

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Haas, S., Saugel, B., Trepte, C. et al. Zielorientierte Volumen- und Kreislauftherapie. Anaesthesist 64, 494–505 (2015). https://doi.org/10.1007/s00101-015-0035-5

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