Perinatale Atmung: Physiologische Grundlagen Und Therapeutische Konsequenzen
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Es gibt keine dramatischere physiologische Funktionsanderung im Le ben des Menschen und der Saugetiere als die Umstellung von Kreislauf und Atmung beim 'Obergang vom intrauterinen zum extrauterinen Leben. Da hiervon in erster Linie der Atemgastransport und nicht die Zellatmung betroffen ist, solI insbesondere iiber die Anderung des Gas transportes wahrend der Perinatal zeit berimtet werden. Unser An liegen ist eine Smilderung der Hauptprobleme, ohne eine vollstandige Besprechung des Gebietes anzustreben. Ausfiihrliche Darstellungen von Teilgebieten mit reichem Tatsachenmaterial liegen vor (ASSALI, 1968; BARTELS, 1970; BARTELS und WULF, 1965; DAWES, 1968; METCALFE, BARTELS und MOLL, 1967; MOLL und BARTELS, 1971; RIEGEL, 1965; SMITH, 1959). Eine Einteilung des Steffes ergibt sich durch die Untersmiede des Gas austausches in der Placenta und in der Lunge. Der Sauerstolf, den der Fetus braucht, kann nur iiber die Atemwege der Mutter, das miitter liche Blut und die Placenta in das fetale Blut transportiert werden. Wir werden deshalb zuerst iiber den Gastransport im miitterlichen und fetalen Organismus sprechen und die Besonderheiten, die dabei fiir miitterliches und fetales Blut gelten, behandeln. Weiterhin wird der 'Obertritt der Gase in der Placenta geschildert und schlieBlim die Ventilation und ihre Regulation dargestellt. Die Kenntnis der physiologismen Vorgange bei der Umstellung von placentarer zur Lungenatmung ist eine Voraussetzung fiir die Behand lung der gestorten Funktion. Deshalb solI auf therapeutisme Folgerun gen, die sim aus der Besprechung der physiologischen Befunde ergeben, in einem abschlieBenden Kapitel hingewiesen werden."
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