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Querschnittlähmung: Akutbehandlung und Rehabilitation

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Die Intensivmedizin

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Zusammenfassung

Eine Querschnittlähmung (QSL) ist Folge einer Schädigung der motorischen und sensiblen Bahnen des Rückenmarks und des vegetativen Nervensystems. Im Rahmen der Akutbehandlung wird meistens eine intensivmedizinische Behandlung notwendig. Bereits in dieser Phase muss eine integrierte und individualisierte Rehabilitation stattfinden, um einerseits Komplikationen bestmöglich zu verhindern und andererseits gute Voraussetzungen für die grösstmögliche Funktionsfähigkeit („expected outcome“) zu schaffen.

Neben der Stabilisation der neuromuskulären Funktionen sind besondere Behandlungsprinzipien im Rahmen der Querschnittlähmung zu berücksichtigen. Insbesondere die Beeinträchtigung der vegetativen Funktionen in der spinalen und neurogenen Schockphase. Aus diesem Grund ist ein querschnittspezifisches Management von Hypotonie, Bradykardie, Hypothermie, Hypoventilation, reduziertem Hustenstoß und erschwerter Sekretexpektoration mit Bronchokonstriktion und Hypersekretion, Blasenfunktionsstörung, Gastro- und Kolonparese notwendig.

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Authors and Affiliations

  1. Schweizer Paraplegiker-Zentrum Nottwil, Nottwil, Schweiz

    Michael Baumberger, Luca Brendebach, Peter Felleiter & Anke Scheel-Sailer

  2. Rehab Basel, Basel, Schweiz

    Franz Michel

  3. Grosswangen, Schweiz

    Hans Georg Koch

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  1. Michael Baumberger
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  2. Franz Michel
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  3. Luca Brendebach
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  4. Hans Georg Koch
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  5. Peter Felleiter
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  6. Anke Scheel-Sailer
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Correspondence to Michael Baumberger .

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Editors and Affiliations

  1. Klinik für Anästhesiologie, RWTH Aachen Universitätsklinikum Aachen, Aachen, Deutschland

    Gernot Marx

  2. Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lübeck, Deutschland

    Elke Muhl

  3. Dir. der Klinik fuer Anaesthesie Intensivmed. und Schmerzther., Frankfurt, Hessen, Deutschland

    Kai Zacharowski

  4. Medizinische Klinik 1, Universitätsklinikum Frankfurt, Frankfurt am Main, Hessen, Deutschland

    Stefan Zeuzem

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Baumberger, M., Michel, F., Brendebach, L., Koch, H.G., Felleiter, P., Scheel-Sailer, A. (2022). Querschnittlähmung: Akutbehandlung und Rehabilitation. In: Marx, G., Muhl, E., Zacharowski, K., Zeuzem, S. (eds) Die Intensivmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54675-4_58-2

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  1. Latest

    Querschnittlähmung: Akutbehandlung und Rehabilitation
    Published:
    14 December 2022

    DOI: https://doi.org/10.1007/978-3-642-54675-4_58-2

  2. Original

    Querschnittlähmung: Akutbehandlung und Rehabilitation
    Published:
    01 April 2015

    DOI: https://doi.org/10.1007/978-3-642-54675-4_58-1

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