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Unterstützung bei Leberversagen

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Die Intensivmedizin

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Zusammenfassung

Das akute Leberversagen (ALV), das chronische Leberversagen (CLV) und das akut-auf-chronische Leberversagen (ACLV) sind Krankheitsbilder, die in der Intensivmedizin häufig vorkommen und mit einer hohen Mortalität von 60–90% assoziiert sind (Bower et al. 2007). Trotz unterschiedlicher Ursachen und individueller zeitlicher Verläufe bieten die Patienten in fortgeschrittenen Stadien ähnliche Symptome und Komplikationen. Dazu zählen (Chen et al. 2013; Grace u. Angus 2013; Khsashab et al. 2007):

- die hepatische Enzephalopathie (HE),

- der Ikterus mit Hyperbilirubinämie,

- die Koagulopathie mit Mangel an Gerinnungsfaktoren auf dem Boden einer gestörten Proteinsynthese,

- Aszites,

- gastrointestinale Blutungen,

- das hepatorenale Syndrom (HRS),

- das hepatopulmonale Syndrom und

- die portopulmonale Hypertonie.

In der Folge können systemische Infektionen oder ein Multiorganversagen auftreten, was häufig zum Tod der Patienten führt.

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Authors and Affiliations

  1. Medizinische Klinik 1, Klinik für Gastroenterologie, Hepatologie, Pneumologie und Endokrinologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/M., Deutschland

    Dr. med. Dominik Bergis

  2. Medizinische Klinik 1 - Gastroenterologie, Hepatologie, Pneumologie und Endokrinologie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/M., Deutschland

    Prof. Dr. med. Jörg Bojunga

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  1. Dr. med. Dominik Bergis
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  2. Prof. Dr. med. Jörg Bojunga
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Editors and Affiliations

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

    Gernot Marx

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

    Elke Muhl

  3. Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Goethe-Universität Frankfurt, Frankfurt, Hessen, Germany

    Kai Zacharowski

  4. Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt, Germany

    Stefan Zeuzem

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Bergis, D., Bojunga, J. (2015). Unterstützung bei Leberversagen. In: Marx, G., Muhl, E., Zacharowski, K., Zeuzem, S. (eds) Die Intensivmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54953-3_40

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  • DOI: https://doi.org/10.1007/978-3-642-54953-3_40

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