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DOI: 10.1055/s-0033-1344184
Notfallüberwachung beim kardiogenen Schock während Intra- und Interhospitaltransport
Publication History
Publication Date:
08 July 2013 (online)
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Abstract
The transport of critically ill patients confers an increased risk for the occurrence of complications. Therefore the exspected benefits have to be higher than the exspected rates of complications. In particular, patients in cardiogenic shock due to myocardial infarction have a very high mortality rate, so the transport should be pursued with the aim of early revascularization to reduce mortality. This can be performed intrahospitally to the cathlab or interhospitally to the next reachable hospital with catheterization opportunities. Therefore in addition to the ECG the monitoring of the patients has to be done using invasive pressure monitoring und pulse oximetry. Extracorporal assist systems are posing particular challenges, since these systems could lead to major complications caused by larger cannulas. However, these systems do not require a more extensive monitoring but above all more personal effort. Hemodynamic monitoring systems do not provide any advantages and are not necessary during the transport. Careful monitoring should lead to a minimal complication rate inside the hospital and a low complication rate for transports between hospitals.
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Literatur
- 1 Durairaj L, Will JG, Torner JC et al. Prognostic factors for mortality following interhospital transfers to the medical intensive care unit of a tertiary referral center. Crit Care Med 2003; 31: 1981-1986
- 2 Beckmann U, Gillies DM, Berenholtz SM et al. Incidents relating to the intra-hospital transfer of critically ill patients. An analysis of the reports submitted to the Australian Incident Monitoring Study in Intensive Care. Intensive Care Med 2004; 30: 1579-1585
- 3 Miedema MD, Newell MC, Duval S et al. Causes of Delay and Associated Mortality in Patients transferred With ST-Segment–Elevation Myocardial Infarction. Circulation 2011; 124: 1636-1644
- 4 Werdan K, Ruß M, Buerke M et al. Deutsch-österreichische S3-Leitlinie „Infarktbedingter kardiogener Schock – Diagnose, Monitoring und Therapie“. Kardiologe 2011; 5: 166-244
- 5 Hochman JS, Sleeper LA, Webb JG et al. for the SHOCK Investigators Early Revascularization Improves Long-Term Survival for Cardiogenic Shock Complicating Acute Myocardial Infarction. JAMA 2006; 295: 2511-2515
- 6 Löw M, Jaschinski U. Innerklinischer Transport des kritisch kranken Patienten. Anaesthesist 2009; 58: 95-108
- 7 Warren J, Fromm RE, Orr RA et al. Guidelines for the inter- and intrahospital transport of critically ill patients. Crit Care Med 2004; 32: 256-262
- 8 Wiese CHR, Bartels U, Fraatz W et al. Innerklinische Transporte von kritisch kranken Patienten: Eine besondere Herausforderung in der klinischen Versorgung. Anästh Intensivmed 2008; 49: 125-133
- 9 Papson JP, Russel KL, Taylor DM. Unexpected events during the intrahospital transport of critically ill patients. Acad Emerg Med 2007; 4: 574-577
- 10 Waydhas C. Intrahospital Transport of critically ill patients. Crit Care 1999; 3: R83-R89
- 11 Luecke T, Pelosi P. Positive end-expiratory pressure and cardiac output. Critical Care 2005; 9: 607-621
- 12 Ehrlich JR, Nattel S, Hohnloser SH. Atrial fibrillation and congestive heart failure: specific considerations at the intersection of two common and important disease sets. J Cardiovasc Electrophysiol 2002; 13: 399-405
- 13 Thiele H, Zeymer U, Neumann FJ et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 2012; 367: 1287-1296
- 14 Philipp A, Arlt M, Amann M et al. First experience with the ultra compact mobile extracorporeal membrane oxygenation system Cardiohelp in interhospital transport. Interactive CardioVascular and Thoracic Surgery 2011; 12: 978-981
- 15 Warren J, Fromm RE, Orr RA et al. Guidelines for the inter- and intrahospital transport of critically ill patients. Crit Care Med 2004; 32: 256-262