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Schwere Sepsis und septischer Schock

Leitliniengerechte Kreislauftherapie

Severe sepsis and septic shock

Guidelines for hemodynamic therapy

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Zusammenfassung

Die schwere Sepsis und der septische Schock haben eine zunehmende Inzidenz und unverändert hohe Mortalität. Der Zeitfaktor ist für das Fortschreiten des Organversagens und damit für die Prognose entscheidend. Eine frühzeitige, an der zentralvenösen Sauerstoffsättigung orientierte Kreislauftherapie geht mit einer signifikanten Mortalitätsreduktion einher. Dies gilt auch für die Applikation von niedrig dosiertem Hydrokortison beim septischen Schock, sofern eine relative Nebennierenrindeninsuffizienz vorliegt. Das deutsche Kompetenznetzwerk Sepsis (SepNet) untersucht zurzeit weitere klinisch relevante Fragestellungen.

Abstract

Severe sepsis and septic shock have an increasing incidence but an unchanged mortality. It has been demonstrated that the time until the start of supportive therapy affects the progress of multiorgan failure and patient outcome. Early goal-directed therapy guided by central venous oxygen saturation is associated with a significant reduction in mortality, as is the use of low-dose hydrocortisone in patients with septic shock and proven relative adrenal insufficiency. The German Competence Network Sepsis (SepNet) is currently studying further relevant questions.

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Authors and Affiliations

  1. Klinik für Anästhesiologie und Intensivtherapie, Friedrich-Schiller-Universität, Erlanger Allee 101, 07742 , Jena, Deutschland

    F. M. Brunkhorst & K. Reinhart

  2. Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, HELIOS-Klinikum Erfurt GmbH, Erfurt, Deutschland

    A. Meier-Hellmann

Authors
  1. F. M. Brunkhorst
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  2. A. Meier-Hellmann
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  3. K. Reinhart
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Corresponding author

Correspondence to F. M. Brunkhorst.

Additional information

Mit Unterstützung des Kompetenznetzes Sepsis (SepNet), gefördert vom Bundesministerium für Bildung und Forschung (BMBF), Förderkennzeichen: 01KI 0106

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Brunkhorst, F.M., Meier-Hellmann, A. & Reinhart, K. Schwere Sepsis und septischer Schock. Notfall Rettungsmed 9, 535–541 (2006). https://doi.org/10.1007/s10049-006-0848-5

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  • DOI: https://doi.org/10.1007/s10049-006-0848-5

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