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Die Echokardiographie im perioperativen und intensivmedizinischen Bereich pp 168–180Cite as

Die Rolle der Echokardiographie bei der Abklärung eines hämodynamisch instabilen Patienten

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Zusammenfassung

In der Differentialdiagnostik einer akuten hämodynamischen Instabilität bei Patienten auf der Intensiv- oder Notfallstation kommt der Echokardiographie eine überragende Bedeutung zu. Die echokardiographischen Befunde lassen sich vereinfachend vier Problemkreisen zuordnen: der erniedrigten Vorlast, dem linksventrikulären oder rechtsventrikulären Versagen sowie dem biventrikulären Herzversagen. Mit dem Bild einer erniedrigten Vorlast gehen am häufigsten eine relative oder absolute Hypovolämie, eine Perikardtamponade sowie eine Obstruktion des linksventrikulären Ausflusstraktes einher. Wichtigste Ursachen des linksventrikulären Versagens sind die akute Myokardischämie, die Myokarditis sowie ein dekompensiertes linksseitiges Klappenvitium. Das rechtsventrikuläre Versagen wird am häufigsten durch eine akute Lungenembolie oder eine rechtsseitige Myokardischämie verursacht. Das biventrikuläre Herzversagen kann bei einer globalen Myokardischämie, einer dilatativen Kardiomyopathie, einem stumpfen Thoraxtrauma und auch bei einer Sepsis auftreten. Dieser Übersichtsartikel behandelt die Rolle der Echokardiographie in der Differentialdiagnostik der hämodynamischen Instabilität.

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Authors and Affiliations

  1. Department Anästhesie, Universitätsspital Basel, 4031, Basel, Switzerland

    Dr. D. Bolliger, Prof. Dr. K. Skarvan, Prof. Dr. M. D. Seeberger & Priv.-Doz. Dr. M. Filipovic

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  1. Dr. D. Bolliger
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  2. Prof. Dr. K. Skarvan
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  3. Prof. Dr. M. D. Seeberger
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  4. Priv.-Doz. Dr. M. Filipovic
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Correspondence to D. Bolliger .

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  1. Departement Anästhesie, Universitätsspital Basel, Spitalstr. 21, 4031, Basel

    Manfred D. Seeberger

  2. Ordinarius für Herz- und Thoraxchirurgie, Universitätsspital Basel, Spitalstr. 21, 4031, Basel

    Hans-Reinhard Zerkowski

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Bolliger, D., Skarvan, K., Seeberger, M.D., Filipovic, M. (2006). Die Rolle der Echokardiographie bei der Abklärung eines hämodynamisch instabilen Patienten. In: Seeberger, M.D., Zerkowski, HR. (eds) Die Echokardiographie im perioperativen und intensivmedizinischen Bereich. Steinkopff. https://doi.org/10.1007/978-3-7985-1608-3_22

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