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Schock im Kindesalter

Shock in infants and children

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Zusammenfassung

Die klinischen Zeichen und Symptome des Schocks bei Neugeborenen und Kindern sind oft viel subtiler als bei Erwachsenen. Kinder können im Vergleich zu Erwachsenen einen Schock länger kompensieren, bis es zu einem abrupten, oft irreversiblen Kreislaufversagen bis hin zum Herzstillstand kommt. Die häufigste Ursache für einen verspäteten Beginn der Schocktherapie ist die mangelnde Fähigkeit Gesundheitsdienstleistender, das kritisch kranke Kind im Schock frühzeitig zu erkennen. Promptes Erkennen eines Schocks bei Kindern trägt maßgeblich zu einem optimalen Therapieerfolg bei, ist aber nicht immer offensichtlich. Klinische Untersuchung und Erfahrung, Bauchgefühl und die richtige und wiederholte Interpretation der Vitalparameter (Abb. 1) sind essenziell, um die verschiedenen Schockursachen zu unterscheiden und die adäquate Therapie zu veranlassen.

Abstract

The clinical signs and symptoms of shock in newborns and children are often more subtle compared to adults. Recurring, avoidable factors for optimal outcome include failure of health care workers to recognize shock at the time of presentation. Children are able to compensate a shock state for longer periods than adults resulting in a sudden, sometimes irreversible, cardiopulmonary collapse. Different forms of shock, their therapy, and frequent errors are depicted and illustrated with practical examples. Early recognition of shock in children is crucial for optimal outcome but is not always obvious. Clinical experience, gut feeling, and careful and repeated interpretation of the vital parameters are essential to recognize and effectively treat the various forms of shock.

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Authors and Affiliations

  1. Notfallzentrum für Kinder und Jugendliche, Inselspital, 3010, Bern, Schweiz

    R. Löllgen

  2. Kinderklinik, Kantonsspital Graubünden, Chur, Schweiz

    L. Szabo

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  1. R. Löllgen
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  2. L. Szabo
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Correspondence to R. Löllgen.

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R. Löllgen und L. Szabo geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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O. Heinzel, Tübingen

F. Hoffmann, München

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Löllgen, R., Szabo, L. Schock im Kindesalter. Med Klin Intensivmed Notfmed 110, 338–345 (2015). https://doi.org/10.1007/s00063-015-0035-x

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  • DOI: https://doi.org/10.1007/s00063-015-0035-x

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