Zusammenfassung
In der Folge von Traumen, Sepsis oder Operationen ereignen sich vorhersagbare und gut erkennbare physiologische und metabolische Veränderungen, die sowohl den Glukose- wie auch den Fett- und Eiweißstoffwechsel betreffen: erhöhter Grundumsatz, Eiweißabbau, negative Stickstoffbilanz, Insulinresistenz, erhöhte Insulinsekretion, gesteigerte Lipolyse und Streßhyperglykämie. Diese Veränderungen können in zwei unterschiedliche Perioden eingeteilt werden, nämlich in die (a) hypodyname Phase („ebb-phase“), die unmittelbar nach Erkrankungsbeginn einsetzt, nur kurz andauert und durch den Abfall von Blutdruck, Herzzeitvolumen und Sauerstoffverbrauch gekennzeichnet ist und die (b) hyperdyname Phase („flow-phase“), die mit einem „Hypermetabolismus“ einhergeht, mit erhöhtem „Cardiac output“, mit negativer Stickstoffbilanz und Hyperglykämie.
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Ratheiser, K. (1994). Metabolismus bei Sepsis — Pathophysiologie. In: Kleinberger, G., Lenz, K., Ritz, R., Schneeweiß, B., Schuster, HP., Waldhäusl, W. (eds) Metabolismus. Intensivmedizinisches Seminar, vol 7. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9342-6_5
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DOI: https://doi.org/10.1007/978-3-7091-9342-6_5
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