Hochdosierte Thiopentalinfusion bei zerebraler Dysfunktion nach extrakorporalem Kreislauf

  • K. Wiedemann
  • G. Jürs
  • C. Krier
  • A. Assmus
Conference paper
Part of the Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine book series (A+I, volume 194)

Zusammenfassung

Zerebrale Ischämie als Komplikation von Eingriffen unter extrakorporalem Kreislauf kann sich als postoperative zerebrale Dysfunktion zeigen, vom sogenannten Durch-gangssyndrom bis zum tiefen Koma, mit Krampfanfällen oder Herdsymptomatik. Die Häufigkeitsangaben schwanken von 7% bis 44% unmittelbar nach dem Eingriff für vorübergehende und 1,6 bis 23% für bleibende neurologische Schäden (Slogoff et al. [17], Barash [3]). Es gibt sogar Hinweise, daß schlicht alle kardiochirurgischen Eingriffe mit zerebraler Beeinträchtigung verbunden sind (Aberg et al. [1]). Ursachen sind globale inkomplette Ischämie durch prolongierte Hypotension (Malone et al. [11]) oder fokale Ischämie durch Luft- und Partikelembolie (Brierly [6], Slogoff et al. [17]). Zerebrale Hyperaktivität in Krampfanfällen nach extrakorporalem Kreislauf kann mit fortschreitender Substratverarmung und Laktatansammlung, vor allem aber Kalziumanhäufung, zu Schadensmustern ähnlich dem nach globaler kompletter Ischämie führen (Meldrum et al. [12]).

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Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • K. Wiedemann
  • G. Jürs
  • C. Krier
  • A. Assmus

There are no affiliations available

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