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Intensivtherapie, Hirndruck- und Blutdruck-Management bei kindlichem Schädel-Hirn-Trauma

  • M. U. Schuhmann
  • E. Heimberg
Chapter

Zusammenfassung

Das intensivmedizinische Management von Kindern mit schwerem Schädel-Hirn-Trauma ist nur in enger Kooperation und Abstimmung von Kinderneurochirurgie und pädiatrischer Intensivmedizin möglich. Aufgabe der Kinderneurochirurgie darf dabei nicht nur die Anlage von Hirndrucksonden, Entfernung von raumfordernden Hämatomen und ggf. Dekompressionskraniektomien sein, sondern es sollten täglich 1–2 interdisziplinäre Visiten zur Erhebung des aktuellen Status und Festlegung des weiteren Vorgehens erfolgen. Die Grenzwerte für intrakraniellen Druck (ICP) und zerebralen Perfusionsdruck (CPP), die eine therapeutische Intervention erfordern, sind altersentsprechend und situationsentsprechend festzulegen. Die Therapie sollte anhand der gültigen internationalen Leitlinien zur Behandlung des schweren Schädel-Hirn-Traumas erfolgen. Die Grundprinzipien des Managements von ICP, CPP und idealerweise Optimierung des CPP nach Autoregulationsparametern ist auch auf andere Krankheitsbildern mit akutem zerebralen Insult (z. B. Blutung oder Hypoxie/Ischämie) übertragbar.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  1. 1.Bereich Pädiatrische Neurochirurgie, Klinik für NeurochirurgieUniversitätsklinikum TübingenTübingenDeutschland
  2. 2.Pädiatrische IntensivmedizinKlinik für Kinder- und Jugendmedizin, Universitätsklinikum TübingenTübingenDeutschland

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