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Massivtransfusionen: Hämostase Und Schocklunge by H. Harke

Massivtransfusionen: Hämostase Und Schocklunge

by H. Harke
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Book cover type: Paperback
  • ISBN13: 9783540114673
  • Binding: Paperback
  • Subject: N/A
  • Publisher: Springer
  • Publisher Imprint: Springer
  • Publication Date:
  • Pages: 198
  • Original Price: EUR 51.39
  • Language: German
  • Edition: N/A
  • Item Weight: 350 grams
  • BISAC Subject(s): Anesthesiology

Die Substitution gro er Blutverluste durch Konservenblut führt immer wieder zu schweren pulmonalen und renalen Funktionsstö- rungen oder zu einer hämorrhagischen Diathese in der posttrans- fusionellen Phase. Zahlreiche Arbeitsgruppen haben sich bereits in der Vergangenheit mit diesen Problemen befa t. Desungeachtet verdient die vorliegende Untersuchung wegen der Komplexität des Untersuchungsplanes grö te Beachtung. Aufgrund des bisherigen Erkenntnisstandes waren Fortschritte für die Prophylaxe oder Therapie posttransfusioneller Krankheitszustände nur zu erwarten, wenn die Beobachtung der zellulären und plasmatischen Gerin- nungsqualitäten der Blutkonserve mit Messungen des Gerinnungs- systems, des Fibrinolyse-und Inhibitorensystems sowie des throm- bozytären Systems im Blut des Patienten verknüpft wurden. Dies hat der Autor konsequent verfolgt. Dabei ergaben sich zunächst wichtige systematische Ergebnisse über die lagerungsbedingte Beein- trächtigung von Blutkonserven und die prinzipiellen Folgen einer Massivtransfusion für den Patienten. Darüber hinaus wurde der Ver- such gemacht, durch Zusatz von Aprotinin zur Blutkonserve die speziellen Nebenwirkungen einer Bluttransfusion zu verhindern. Aprotinin senkt die Aggregationsneigung der Thrombozyten im Konservenblut beträchtlich, wie die Ergebnisse zeigen. Offen- sichtlich ist es im wesentlichen diesem Umstand zuzuschreiben, da zum Beispiel der Pulmonalarterienwiderstand, der funktionelle Totraum und das intrapulmonale Shuntvolumen nach Applikation von Aprotinin-Konserven weniger beeinträchtig werden als nach ACD-Blut. Auch in anderer Hinsicht blieben die Untersuchungen nicht darauf beschränkt, eine klinische Fragestellung nur durch experimentell gewonnene Analogieschlüsse zu beantworten, son- dern es wurde angestrebt, die zunächst experimentell gewonnenen Schlu folgerungen in die Praxis umzusetzen und durch klinische Beobachtungsreihen zu erhärten. Dies ist in vielen Punkten gelun- gen und zeichnet die Arbeit in hervorragender Weise aus.

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