Zusammenfassung
Die Sepsis und der septische Schock sind in der Intensivmedizin häufige Krankheitsbilder mit einer relevant hohen Morbidität und Mortalität. In der aktuellen Revision der Leitlinien zur Diagnostik und Therapie der Sepsis sind sinnvolle Revisionen der Definitionen des Krankheitsbildes und der Therapieempfehlungen beschlossen worden, was auch für den Pathologen von Interesse ist. Wenn Patienten an einer Sepsis oder einem septischen Schock nach z. T. sehr intensiver und invasiver Therapie versterben, ist es für den Pathologen anspruchsvoll, die vielen pathologischen Befunde in den richtigen klinischen Kontext zu setzen. In diesem Übersichtsartikel werden die aktuellen Definitionen und pathophysiologischen Konzepte des Syndroms Sepsis übersichtlich dargestellt und die konkrete Vorstellung des behandelnden Intensivmediziners von einer zielführenden Zusammenarbeit vor, während und nach einer Autopsie erläutert.
Abstract
Sepsis and septic shock are frequent conditions of patients in the intensive care unit. Recent guidelines adjusted the diagnostic criteria for sepsis and septic shock as well as the recommendations for sepsis treatment, which together is important for the intensivist as well as for the pathologist. Patients who die from septic shock despite invasive and intense therapies display various pathological findings that have to be placed in a reasonable clinical context, which is challenging for the pathologist without close cooperation with the former caring clinician. This short review gives an overview of recent definitions, the pathophysiology and treatment recommendations for sepsis and septic shock and discusses the importance of interdisciplinary cooperation between the pathologist and intensivist in the autopsy of a patient.
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