Summary
Thoracic trauma, central depression of respiration in head injuries, and aspiration of blood or stomach contents are the most frequent causes of posttraumatic respiratory insufficiency. „Shock lung“, a rare complication in patients who receive adequate treatment, is produced by 4 main pathophysiologic alterations: damage to the pulmonary capillary endothelium, vasoconstriction, aggregation of thrombocytes, decreased content of alveolar surfactant. There are several therapeutic procedures that can lead to further damage to the lung.
Electron-microscope studies of sequential lung biopsies provide information about the development of ultrastructural alterations.
Zusammenfassung
Thoraxverletzungen, zentrale Atemstörungen beim schweren Schädelhirntrauma und Aspiration von Blut oder Mageninhalt sind die häufigsten Ursachen einer respiratorischen Insuffizienz beim Mehrfach verletzten. Die Diagnose „Schocklunge“ sollte streng per exclusionem gestellt werden. Vier pathophysiologische Hauptveränderungen führen zu diesem seltenen Krankheitsbild: Zunahme der Capillarpermeabilität bei geschädigter Capil-larwand, Vasoconstriction, Thrombocytenaggregate und herabgesetzter Surfactantgehalt. Manche therapeutischen Maßnahmen sind zusätzlich schädigend.
Elektronenmikroskopische Untersuchungen an Lungenbiopsien geben Einblick in den Ablauf der morphologischen Veränderungen.
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Glinz, W. (1974). Respiratorische Insuffizienz beim Mehrfachverletzten. In: Junghanns, H. (eds) Verhandlungen der Deutschen Gesellschaft für Chirurgie. Langenbecks Archiv für Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-38063-5_25
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