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Anästhesie bei geriatrischen Patienten

Teil 1: Alter, Organfunktion und typische Erkrankungen

Anesthesia for geriatric patients

Part 1: age, organ function and typical diseases

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An Erratum to this article was published on 15 December 2015

Zusammenfassung

Aufgrund der demografischen Entwicklung wird sich der Anteil der über 80-Jährigen in Deutschland in den nächsten 30 Jahren von heute 4 Mio. auf ca. 10 Mio. mehr als verdoppeln. Dies wird zu einer Zunahme an multimorbiden, chronisch-kranken Patienten führen. Auch wenn ältere Menschen nicht von Erkrankungen betroffen sind, reagieren sie auf die perioperativen Veränderungen der Homöostase, die pharmakologischen Interventionen und die operativen Prozeduren viel empfindlicher als jüngere Patienten. Die Erholung nach einem operativen Eingriff ist oft verlängert und resultiert nicht immer in einer „Restitutio ad integrum“. In Teil 1 dieses Weiterbildungsbeitrags werden die Zusammenhänge zwischen Alter und Organfunktion dargestellt und zudem typische Erkrankungen besprochen, die perioperativ bei der Versorgung geriatrischer Patienten bedeutsam sind. Die Besonderheiten von Anästhetika und Anästhesieführung im Alter werden in Teil 2 dargestellt.

Abstract

Due to demographic changes in the population of industrial nations the number of elderly patients undergoing elective or emergency procedures will rise significantly in the coming years. Anesthesia for geriatric patients is challenging for the anesthesiologist in many ways: with increasing age numerous physiological changes occur which all lead to a subsequent reduction of physical performance and compensatory capacity of the organism, in many cases additionally aggravated by chronic illness. Subsequently, these age-dependent changes (with or without  chronic illness) increase the risk for admission to intensive care units, perioperative death, treatment costs and a prolonged length of hospital stay. Therefore, subtle preoperative assessment and tailored anesthetic management are essential in elderly patients. Part 1 of this continuous education article covers the influence of age on organ functions and describes typical comorbidities which are of high relevance for the perioperative care of geriatric patients. The special features of anesthetic agents and anesthesia management in the elderly will be presented in part 2.

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Interessenkonflikt

Die Autoren weisen auf folgende Beziehungen hin: A.H. und S.L. haben keine Industriekontakte mit potenziellem Interessenkonflikt. W.W. hat für die Firmen Aspect, AstraZeneca, Baxter, B. Braun Melsungen, Dräger, Essex Pharma, Fresenius, GlaxoSmithKline, Narcotrend Monitortechnik, Storz, Transmed u. a. Vorträge gehalten und/oder Consulting durchgeführt.

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  1. Klinik für Anästhesiologie und Intensivmedizin, Klinikum Lünen – St.-Marien-Hospital, 44534, Lünen, Deutschland

    A. Herminghaus DESA, S. Löser & W. Wilhelm

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  1. A. Herminghaus DESA
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  2. S. Löser
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  3. W. Wilhelm
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Correspondence to A. Herminghaus DESA.

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Ein Erratum zu diesem Beitrag ist unter http://dx.doi.org/10.1007/s00101-015-0116-5 zu finden.

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Herminghaus, A., Löser, S. & Wilhelm, W. Anästhesie bei geriatrischen Patienten. Anaesthesist 61, 163–176 (2012). https://doi.org/10.1007/s00101-012-1978-4

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