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Glasgow Coma Score für den Patienten mit Schädel-Hirn-Trauma

Glasgow Coma Scale in traumatic brain injury

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Zusammenfassung

Der Glasgow Coma Score (GCS) wird auch heute noch, 30 Jahre nach seiner Erstbeschreibung, weltweit verwendet, um komatöse Zustände zu quantifizieren. Die Evaluation dreier Komponenten, der okulären, motorischen und verbalen Antwort auf einen auditiven oder nozizeptiven Stimulus, erlaubt die Einteilung eines Schädel-Hirn-Traumas in 3 Schweregrade, erleichtert die Informationsübermittlung und ermöglicht eine Verlaufsbeobachtung. Als Triage-Instrument darf der initiale GCS verwendet werden, sein prognostischer Wert für das Outcome nach Schädel-Hirn-Trauma ist jedoch noch immer nicht eindeutig definiert. Bis heute ungelöst ist der Problemfall der Beurteilung eines sedierten, relaxierten und/oder intubierten Patienten. Nach wie vor fehlt ein Konsensus für die in solchen Fällen angewandten Pseudoscores, was eine der Hauptkritiken am GCS ist.

Abstract

Even 30 years after its first publication the Glasgow Coma Scale (GCS) is still used worldwide to describe and assess coma. The GCS consists of three components, the ocular, motor and verbal response to standardized stimulation, and is used as a severity of illness indicator for coma of various origins. The GCS facilitates information transfer and monitoring changes in coma. In addition, it is used as a triage tool in patients with traumatic brain injury. Its prognostic value regarding the outcome after a traumatic brain injury still lacks evidence. One of the main problems is the evaluation of the GCS in sedated, paralysed and/or intubated patients. A multitude of pseudoscores exists but a universal definition has yet to be defined.

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  1. Département d’anesthésie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne-CHUV

    C. Heim, P. Schoettker & D. R. Spahn

  2. Département d’anesthésie, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon, 1011 , Lausanne-CHUV, Schweiz

    C. Heim

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  1. C. Heim
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Correspondence to C. Heim.

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Heim, C., Schoettker, P. & Spahn, D.R. Glasgow Coma Score für den Patienten mit Schädel-Hirn-Trauma. Anaesthesist 53, 1245–1256 (2004). https://doi.org/10.1007/s00101-004-0777-y

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