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Volumenmanagement, enterale Ernährung und Schmerztherapie bei akuter Pankreatitis

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Book cover Erkrankungen des Pankreas

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Zusammenfassung

Patienten mit sowohl milder als auch schwerer akuter Pankreatitis haben einen deutlich gesteigerten Flüssigkeitsbedarf, der durch isotone Vollelektrolytlösungen (Ringer) ausgeglichen werden sollte. Prognostisch entscheidend ist die Volumengabe innerhalb der ersten 24 Stunden, wobei bei Herzgesunden zwischen 2500 und 4000 ml Kristalloide infundiert werden sollten. Eine frühenterale Ernährung ist eine wesentliche Komponente der Therapie bei akuter Pankreatitis und ist bei allen Schweregraden sinnvoll, sofern keine Kontraindikationen vorliegen. Durch eine überbrückende parenterale Zusatzernährung kann eine vollkalorische Bilanz erreicht werden. Bei der Schmerztherapie der akuten Pankreatitis empfiehlt sich ähnlich dem WHO-Stufenschema der Tumorschmerztherapie eine gestaffelte Gabe von Schmerztherapeutika, wobei mit NSAID begonnen werden kann. Wenn die alleinige Gabe von Nicht-Opioiden nicht ausreicht, sollten mittelstark bzw. stark wirkende Opioid-Analgetika eingesetzt werden.

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Authors and Affiliations

  1. Klinik für Innere Medizin A, Universitätsmedizin Greifswald Ernst-Moritz-Arndt-Universität, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland

    Ali A. Aghdassi & Julia Mayerle

Authors
  1. Ali A. Aghdassi
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  2. Julia Mayerle
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Correspondence to Ali A. Aghdassi .

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Editors and Affiliations

  1. Abt. Allgemeine- und Visceralchirurgie, Universitätsklinikum Ulm, Germany

    Hans G. Beger

  2. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Germany

    Markus W. Büchler

  3. Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle, Sachsen-Anhalt, Germany

    Henning Dralle

  4. Klinik und Poliklinik für Innere Medizin, Universitätsmedizin Greifswald, Germany

    Markus M. Lerch

  5. und Hepatologie (KGHI), Universitätsklinikum Magdeburg, Germany

    Peter Malfertheiner

  6. FB Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig, Sachsen, Germany

    Joachim Mössner

  7. ehemals Klinikum der Stadt Ludwigshafen gGmbH, Rheinland-Pfalz, Germany

    Jürgen F. Riemann

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Aghdassi, A., Mayerle, J. (2013). Volumenmanagement, enterale Ernährung und Schmerztherapie bei akuter Pankreatitis. In: Beger, H., et al. Erkrankungen des Pankreas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37964-2_6

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  • DOI: https://doi.org/10.1007/978-3-642-37964-2_6

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-37963-5

  • Online ISBN: 978-3-642-37964-2

  • eBook Packages: Medicine (German Language)

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