Zusammenfassung
Die Sepsis ist beim Brandverletzten die häufigste Todesursache während des intensivmedizinischen Aufenthaltes. Aufgrund der ausgedehnten Veränderungen physiologischer Parameter im Rahmen der Verbrennungskrankheit ist ihr Erkennen schwierig und die Definition unterliegt Besonderheiten, die dargestellt werden. Die Möglichkeiten und Grenzen der Diagnostik einer Sepsis und deren zielorientierte Therapie sind aufgezeigt. Als Folge einer Sepsis kann es zum Multiorganversagen kommen. Die Pathophysiologie, Häufigkeiten und Therapien der einzelnen Organdysfunktionen werden dargestellt. Da beim Brandverletzten eine systemische Pilzinfektion als Ursache eine Sepsis nicht selten ist und weitreichende therapeutische und prognostische Konsequenzen hat, wird auf dieses Krankheitsbild gesondert eingegangen.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Apple J, Hunt, JL, Wait M, Purdue G (2002) Delayed presentations of aortic valve endocaarditis in patients with thermal injury. J Trauma 52:406–409
ARDS Network Investigators (2000) Ventilation with lower tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 354:1775–1786
Asmussen S, Maybauer DM, Frase JF, Jennings K, George S, Keiralla A, Maybauer MO (2013) Extracorporal membrane oxygenation in burn and smoke inhalation injury. Burns 39:429–435
Bafadhel M, Claek TW Reid C, Medina MJ, Batham S, Barer MR, Nicholson KG, Brightling CE (2011) Procalcitonin and C-reactive protein in hospitalizes adult patients with community-acquired pneumonia or exacerbration of asthma or COPD. Chest 139:1410–1418
Barati M, Alinejad F, Ali Bahar M, Tabrisi MS, Shamshiri AR, Bodouhi N, Karimi H (2008) Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn cases. Burns 34:770–774
Barret JP, Jeschke MG, Herndon DN (2001) Fatty infiltration of the liver in severely burned pediatric patients: Autopsy findings and clinical implications. J Trauma 51:736–739
Bloemsma GC, Dokter J, Boxma H, Oen IMMH (2008) Mortality and causes of death in a burn centre. Burns 34:1103–1107
Bordes J, Lacroix G, Esnault P, Goutorbe P, Cotte J, Dantzer E, Meaudre E (2014) Comparison of the Berlin definition with the american european consensus definition for acute respiratory distress syndrome in burn patients. Burns 40:562–567
Cartotto R, McGibney K, Smith T, Abadir A (2007) Vaspressin for the septic burn patient. Burns 33:441–451
Cook R, Cook D, Tilley J, Lee K, Marshall J (2001) Canadian Critical Trials Group. Multiple organ dysfunction: Baseline and serial component scores. Crit Care Med 29:2046–2050
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL et al (2013) Surviving Sepsis Campaign: International Guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 41:580–637
Drost AC, Burleson DG, Cioffi WG, Jordan BS, Mason AD, Pruitt BA (1993) Plasma cytokines following thermal injury and their relationship with patient mortalitiy, burn size, and time postburn. J Trauma 35:335–339
Elke G, Weiler N (2013) Glutamin und Antioxidantien. In: Kluge S, Markewitz A, Muhl E, Putensen C, Quintel M, Sybrecht GW (Eds.) DIVI-Jahrbuch 2013/2014, S83–89
Fitzwater J, Purdue GF, Hunt JL, O’Keefe GE (2003) The risk factors and time course of sepsis and organ dysfunction after burn trauma. J Trauma 54:959–966
Gallager JJ, Branski LK, Williams-Bouyer N, Villareal C, Herndon DN (2012) Treatment of infection in burns. In: Herndon DN (Ed.) Total Burn Care, 4th Edition. Elsevier, London, Sydney, New York, S137–156
Gauglitz GG, Shahrokhi S, Jescke MG (2012) Treatment of infections in burns. In: Jeschke MG, Kamolz LP, Skjöberg F, Wolf SE (Eds.) Handbook of Burns – Acute Burn Care. Volume 1. Springer Heidelberg, Berlin New York, S221–240
Greenhalgh DG, Saffle JR, Holmes JH et al. (2007) American burn association consensus conference to define sepsis and infections in burns. J Burn Care Res 28:776–779
Katz T, Wasiak J, Cleland H, Padiglione A (2014) Incidence of non-candidal fungal infections in severe burn injury: An australian perspective. Burns 40: 881-886
Kim GH, Oh KH, Yoon JW, Koo JW, Kim HJ, Chae DW, Noh JW, Kim JH, Park YK (2003) Impact of burn size and initial serum albumin level on acute renal failure occurring in major burn. Am J Nephrol 23:55–60
Mariano F, Gangemi EN, Bergamo D, Hollo Z, Stella M, Triolo G (2010) Burn and acute kidney failure. In: Jörres A, Ronco C, Kellum JA Eds.) Managment of acute kidney problems. Springer, Berlin, Heidelberg, S429–437
Mozingo DW, Pruitt BA (2014) Infection of burn wounds. In: Jarvis WR (Ed.) Bennett & Brachman´s Hospital Infection. 6th Edition. Lippincott Williams & Wilkins, Philadelphia, Baltimore, New York, S. 552–560
Murphey ED, Sherwood ER, Toliver-Kinsky, T (2012) The immunological response and strategies for intervention. In: Herndon DN (Ed.) Total Burn Care, 4th Edition. Elsevier, London, Sydney, New York, S265–276
Myburgh JA Mythen MG (2013) Resuscitation fluids. N Engl J Med 369:1243–1251
Nguyen LN, Nguyen TG (2009) Characteristics and outcomes of multiple organe dysfunction syndrome among severe-burn patients. Burns 35:510–515
Owen CC, Jain R (2005) Acute acalculous cholecystitis. Curr Treat Options Gastroenterol 8:99–104
Ramzy PI, Herndon DN, Wolf SE, Irtun O, Barret JP, Ramirez RJ, Heggers JP (1998) Comparison of wound culture and bronchial lavage in the severely burned child: Implication for antimicrobial therapie. Arch Surg 133:1275–1280
Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M for the Early Goal-Directed Therapy Collaborative Group (2001) Early goal directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377
Rogers AD, Deal C, Argent AC, Hudson DA, Rode H (2014) Ventilator associated pneumonia in major paediatric burns. Burns, in press
Shlipak MG, Matsushita, Ärnlöv J, Inker JA, Katz R, Polkinghorne KR, Dietrich Rothenbacher D, et al. (2013) Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med 369:932–943
Silver CLC, Rossi LA, Canini SRM, Goncalves N, Furuya RK (2014) Site of catheter insertion in burn patients and infection. A systemic review. Burns 40:365–373
The ProCESS Investigators (2014) A randomized trial of protocol-based care for early septic shock. N Engl J MEd. 370:1683–1693
Yeo SF, Wong B (2002) Current status of nonculture methods for diagnosis of invasive fungal infections. Clin Microbiol Rev 3:465–484
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Martens, D. (2016). Sepsis. In: Lehnhardt, M., Hartmann, B., Reichert, B. (eds) Verbrennungschirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54444-6_17
Download citation
DOI: https://doi.org/10.1007/978-3-642-54444-6_17
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-54443-9
Online ISBN: 978-3-642-54444-6
eBook Packages: Medicine (German Language)