Die Bedeutung Der Adrenergen Blockade Für Den Haemorrhagischen Schock
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Wenn die umfassenden neuen Erkenntnisse der letzten Jahre auf dem Gebiet der Schockpathophysiologie auch fUr die Behandlung zahlreicher Schockzustande tiefgreifende Wandlungen und Verbesserungen erbracht haben, so sind wir von einer endgultigen Lasung der vielfaltigen Probleme des Schocks jedoch noch weit entfernt. Ohne Zweifel gelingt es mit den und Transfusion sehr haufig, wirksame Hilfe zu leisten. Mitteln der Infusion Vor schwierige und z. T. noch ungelaste Aufgaben stellen uns hingegen die sich allmahllch entwickelnden, uber langere Zeitraume anhaltenden Schockzustande, die MOORE (272) treffend als die Gruppe der "old and late" bezeichnet hat. Bei der Behandlung dieser komplizierten Krankheitsbilder, die u. a. durch schwer diagnostizierbare Kreislaufschiiden, unstillbare Blu- tungen und septische Infektionen hervorgerufen werden, divergieren die Meinungen, und es prallen vielfach entgegengesetzte Therapieformen auf- einander. Der klinischen Schockforschung sind wegen der Natur des Schock- geschehens Grenzen gesetzt. Es verwundert daher nicht, daB die wesent- lichen Erkenntnisse auf diesem Gebiet bisher aus dem Tierexperiment heraus gewonnen worden sind. Mit seiner Hilfe gelingt es, Extremsituationen zu untersuchen, die in der Klinik als Finalstadien gelten, da sie einer therapeutischen Beeinflussung nicht mehr zuganglich sind. In diesen Situ- ationen treten jedoch pathophysiologische Phiinomene in Erscheinung, die von grundsatzlicher Bedeutung fur das allgemeine Schockgeschehen sind. Diese klinisch schwer faBbaren Veranderungen bilden vielfach die Ursache fUr die Entstehung irreparabler Schaden, und der irreparable Schock stellt heute das zentrale Problem der Schockforschung dar.
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