Zusammenfassung
Die Sepsis geht in der Regel mit einer Anzahl von metabolischen Störungen einher: Erhöhte Plasmalaktatkonzentration, metabolische Azidose, verstärkte Glykolyse und ein abnormer „transportabhängiger“ Sauerstoffverbrauch. Es bestehen heute zwei Hypothesen zur Erklärung dieser Veränderungen:
-
a)
Die zelluläre Hypoxie resultiert aus einer pathologisch veränderten Mikrozirkulation.
-
b)
Es besteht eine primäre Störung im zellulären Energiestoffwechsel.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Annat G, Viale JP, Percival C, Froment M, Motin J (1986) Oxygen delivery and uptake in the adult respiratory distress syndrome: lack of relationship when measured independently in patients with normal blood lactate concentrations. Am Rev Resp Dis 133: 999–1001
Dhainaut JF, Huyghebaert MF, Monsallier JF (1987) Coronary hemodynamics and myocardial metabolism of lactate, free fatty acids, glucose an ketones in patients with septic shock. Circulation 75: 533–541
Hochtkiss RS, Long RC, Hall JR (1989) An in vivo examination of rat brain during sepsis with 31P-NMR spectroscopy. Am J Physiol 257: C1055–C1061
Hotchkiss RS, Song SK, Ling CS, Ackerman JJ, Karl IE (1990) Sepsis does not alter red blood cell glucose metabolism or Na+ concentration: a 2H–22Na-NMR study. Am J Physiol 258: R21–R31
Hotchkiss RS, Song SK, Neil JJ (1991) Sepsis does not impair tricarboxylic acid cycle in the heart. Am J Physiol 260: C50–C57
Hotchkiss RS, Karl IE (1992) Reevalution of the role of cellular hypoxia and bionergetic failure in sepsis. JAMA 267: 1503–1510
Jahoor F, Shangraw RE, Miyoshi H, Wallfish H, Herndon DN, Wolfe RR (1989) Role of insulin and glucose oxidation in mediating the protein catabolism of burns and sepsis. Am J Physiol 257: E323–E331
Mohsenifar Z, Jasper AC, Koerner SK (1988) Relationship between oxygen uptake and oxygen delivery in patients with pulmonary hypertension. Am Rev Respir Dis 138: 69–73
Shoemaker WC, Appel PL, Kram HB (1988) Tissue oxygen debt as a determinant of lethal and nonlethal postoperative organ failure. Crit Care Med 16: 1117–1120
Shumacker PT, Samsel RW (1990) Oxygen supply and consumption in the adult respiratory distress syndrome. Clin Chest Med 11: 715–722
Song SK, Hotchkiss RS, Karl IE, Ackerman JJH (1993) Concurrent quantification of tissue metabolism and blood flow via 2H/31P NMR in vivo. III. Alteration of muscle blood flow and metabolism during sepsis. Magn Reson Med (in press)
Tresadern JC, Threlfall CJ, Wilford K, Irving MH (1988) Muscle adenosine 5’triphosphate and creatine phosphate concentration in relation to nutritional status and sepsis in man. Clin Sci 75: 233–242
Vary TC, Siegel JH, Nakatani T, Sato T, Aoyama H (1986) Effect of sepsis on activity of pyruvate dehydrogenase complex in skeletal muscle and liver. Am J Physiol 250: E634–E640
Vary TC, Siegel JH, Fall BD, Morris JH (1988) Metabolic effects of partial reversal of pyruvate dehydrogenase activity by dichloroacetate in sepsis. Circ Shock 24: 3–18
Williams AJ, Mohsenifar Z (1989) Oxygen supply dependency in patients with obstructive sleep apnea and its reversal after therapy with nasal continuous positive airway pressure. Am Rev Resp Dis 140: 1308–1311
Wilmore DW, Goodwin CW, Pruitt BA (1980) Effect of injury and infection on visveral metabolism and circulation. Ann Surg 192: 491–504
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1994 Springer-Verlag/Wien
About this paper
Cite this paper
Hotchkiss, R.S. (1994). Pathophysiologie der Azidose bei Sepsis. In: Kleinberger, G., Lenz, K., Ritz, R., Schneeweiß, B., Schuster, HP., Waldhäusl, W. (eds) Metabolismus. Intensivmedizinisches Seminar, vol 7. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9342-6_6
Download citation
DOI: https://doi.org/10.1007/978-3-7091-9342-6_6
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-82538-9
Online ISBN: 978-3-7091-9342-6
eBook Packages: Springer Book Archive