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Intensivmedizin up2date 2010; 6(3): 201-212
DOI: 10.1055/s-0029-1244235
Internistische Intensivmedizin

© Georg Thieme Verlag KG Stuttgart · New York

Respiratorische Viren

Barbara  M.  Hauptmeier, Gernot  Rohde
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Publication History

Publication Date:
10 August 2010 (online)

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Kernaussagen

  • Die Bedeutung einer viralen Beteiligung bei Infektionen auf der Intensivstation wird durch die verbesserte Diagnostik (PCR) zunehmend erkannt. Die Dunkelziffer bleibt jedoch aufgrund der nur selten durchgeführten Diagnostik hoch.

  • Die wichtigsten respiratorischen Viren sind Influenza A und B, HSV, VZV, RSV, Rhinoviren, Corona-Viren (SARS) und Hanta-Viren. Als Risikofaktoren sind zu nennen: schwere internistische Erkrankungen, besonders COPD, Komplikationen im postoperativen Verlauf, Wintermonate, angeborene und erworbene Immunsuppression (HSV, VZV und CMV).

  • Zur Diagnostik eignet sich respiratorisches Material (Nasen und Rachenabstriche, induziertes Sputum, spontanes Sputum, Trachealsekret, BAL), das entsprechend schnell und in einem geeigneten Medium transportiert werden muss. In den letzen Jahren hat sich die PCR zum viralem Nachweis durchgesetzt. Sie zeichnet sich aus durch eine hohe Sensitivität und Spezifität. Schnelltests können nur bei der Influenza und auch hierbei nur bedingt empfohlen werden.

  • Die Therapieoptionen sind immer noch sehr begrenzt. Zugelassene Medikamente liegen nur für Infektionen durch Influenza- sowie Herpes-Viren vor.

  • Zur Prophylaxe der vorwiegend aerogen übertragenen Viren wird das Tragen eines Mundschutzes, eine strikte Händehygiene sowie die Impfung gegen Influenza empfohlen.

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Prof. Dr. G. Rohde

Maastricht University Medical Center
Department of Respiratory Medicine

Postbus 5800
6202AZ Maastricht
Niederlande

Email: g.rohde@mumc.nl