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Extrakorporale Zirkulation Heute pp 81–87Cite as

Extravaskuläres Lungenwassser nach Vorfüllung der Herz-Lungen-Maschine mit 4% Humanalbumin

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Zusammenfassung

Im Rahmen herzchirurgischer Eingriffe unter EKZ ist postoperativ regelhaft eine Zunahme des extravasalen Lungenwassers (EVLW) mit Beeinträchtigung des pulmonalen Gasaustausches zu beobachten (10, 14). Offensichtlich werden durch das chirurgische Trauma sowie durch den Kontakt des Blutes mit unphysiologischen Oberflächen Prozesse initiiert, die über kapilläre Permeabilitätsstörungen zum Austritt von Wasser in das Interstitium führen (6, 8, 9). In diesem Zusammenhang muß auch der Vorfüllung der HLM eine erhebliche Bedeutung beigemessen werden. Die Hämodilution zu Beginn der EKZ kann in Abhängigkeit von der Zusammensetzung des Primevolumens zu einem erheblichen Abfall der Proteinkonzentration im Plasma führen und über die damit verbundene Reduktion des Kolloidosmotischen Druckes (KOD) die Entwicklung eines Lungenödems zusätzlich begünstigen (1, 11, 13).

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Literatur

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Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Herzchirurgie, Universität zu Köln, Joseph-Stelzmann-Straße 9, 5000, Köln 41, Deutschland

    Priv. Doz. Dr. med. H. Korb, J. Böck, A. Borowski & E. R. de Vivie

  2. Zentrum Anästhesie, Rettungs- und Intensivmedizin, Universität Göttingen, Deutschland

    A. Hoeft, U. Mehlhorn & H. Stephan

Authors
  1. Priv. Doz. Dr. med. H. Korb
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  2. J. Böck
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  3. A. Hoeft
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  4. A. Borowski
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  5. U. Mehlhorn
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  6. H. Stephan
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  7. E. R. de Vivie
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Editor information

Editors and Affiliations

  1. Chirurgische Klinik und Poliklinik, Abt. Thorax- und Kardiovaskularchirurgie, Heinrich-Heine-Universität, Moorenstraße 5, 4000, Düsseldorf, Deutschland

    C. J. Preuße  & H. D. Schulte  & 

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© 1991 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt

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Korb, H. et al. (1991). Extravaskuläres Lungenwassser nach Vorfüllung der Herz-Lungen-Maschine mit 4% Humanalbumin. In: Preuße, C.J., Schulte, H.D. (eds) Extrakorporale Zirkulation Heute. Steinkopff. https://doi.org/10.1007/978-3-642-85401-9_7

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  • DOI: https://doi.org/10.1007/978-3-642-85401-9_7

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-85402-6

  • Online ISBN: 978-3-642-85401-9

  • eBook Packages: Springer Book Archive

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