{"id":14173,"date":"2021-09-03T04:34:55","date_gmt":"2021-09-03T02:34:55","guid":{"rendered":"http:\/\/news-papers.eu\/?p=14173"},"modified":"2021-09-02T21:56:12","modified_gmt":"2021-09-02T19:56:12","slug":"14173","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=14173","title":{"rendered":"Point of Care Diagnostik beim Kreislaufstillstand"},"content":{"rendered":"<p style=\"text-align: justify;\">Blutgasanalysen (BGA) sind bedingt durch die erforderlichen Ger\u00e4te eine Ausnahme in der pr\u00e4hospitalen Notfallmedizin, dabei ist die unmittelbare und patientennahe (Point-of-Care[POC]-) \u00a0Bestimmung der BGA vielerorts Standard in der klinischen Akut- und Intensivmedizin.<\/p>\n<p style=\"text-align: justify;\">Kollegen um Tobias Gr\u00fcbl und Clemens Kill haben bei 98 von 263 Patienten im pr\u00e4hospitalen Kreislaufstillstand eine meist ven\u00f6se Blutprobe durch ein portables BGA-Ger\u00e4t (Alere epoc\u00ae) an der Einsatzstelle analysiert und folgende Befunde erhoben:<\/p>\n<blockquote><p><a href=\"https:\/\/www.siemens-healthineers.com\/en-ca\/blood-gas\/blood-gas-systems\/epoc-blood-analysis-system\" target=\"_blank\" rel=\"noopener\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"14179\" data-permalink=\"https:\/\/news-papers.eu\/?attachment_id=14179\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?fit=1354%2C1436&amp;ssl=1\" data-orig-size=\"1354,1436\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"SIEMENS epoc\" data-image-description=\"\" data-image-caption=\"\" data-medium-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?fit=283%2C300&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?fit=966%2C1024&amp;ssl=1\" class=\"alignright size-medium wp-image-14179\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc-283x300.png?resize=283%2C300\" alt=\"\" width=\"283\" height=\"300\" srcset=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?resize=283%2C300&amp;ssl=1 283w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?resize=966%2C1024&amp;ssl=1 966w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?resize=768%2C815&amp;ssl=1 768w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?resize=750%2C795&amp;ssl=1 750w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?w=1354&amp;ssl=1 1354w\" sizes=\"auto, (max-width: 283px) 100vw, 283px\" \/><\/a>62 Patienten hatten eine schwere Azidose (pH &lt; 7.2 + BE &lt; \u2212 5 mmol\/l)<\/p>\n<p>Diese schwere Azidose war h\u00e4ufiger bei Patienten mit unbeobachtetem Kollaps nachzuweisen (76% vs. 54%; p = 0.054).<\/p>\n<p>61 dieser Patienten wurden mit Na-BiCarbonat gepuffert.<\/p>\n<p>Bei 17 Patienten konnten deutliche Abweichungen des Kaliumspiegels ermittelt werden.<\/p>\n<p>Dabei zeigten Patienten mit Hypokali\u00e4mie initial h\u00e4ufiger einen defibilierbaren Herzrhythmus, w\u00e4hrend Patienten mit einem nicht-defibrillierbaren Herzrhythmus h\u00e4ufiger einer Hyperkali\u00e4mie aufwiesen.<\/p>\n<p>14 Patienten mit Hypokali\u00e4mie wurde pr\u00e4hospital Kaliumchlorid appliziert; die Patienten mit Hyperkali\u00e4mie wurden pr\u00e4hospital nicht therapiert.<\/p>\n<p>Im Durchschnitt wurde die gesamte pr\u00e4hospitale Versorgungszeit durch POC-BGA nur 6 Minuten verl\u00e4ngert (60 vs. 54 Minuten).<\/p>\n<p>Insgesamt \u00fcberlebten bis zur Krankenhausentlassung 21 % der Patienten; dabei konnte ein Unterschied f\u00fcr die Patienten mit POC-BGA gegen\u00fcber den Patienten ohne POC-BGA gesehen werden (mit POC-BGA 30% vs. ohne POC-BGA 16%, p = 0.01).<\/p><\/blockquote>\n<p style=\"text-align: justify;\">Der gesamte Beitrag ist im Scandinavian Journal of Trauma Resuscitation and Emergency Medicine (SJTREM) open access nachzulesen.<\/p>\n<blockquote><p><span class=\"csl-entry\">Gruebl, T., Ploeger, B., Wranze-Bielefeld, E., Mueller, M., Schmidbauer, W., Kill, C., Betz, S. <\/span><\/p>\n<p><span class=\"csl-entry\">Point-of-care testing in out-of-hospital cardiac arrest: a retrospective analysis of relevance and consequences<\/span><\/p>\n<p><span class=\"csl-entry\"><i>Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2021;<\/i> <i>29:<\/i> 128<\/span><\/p><\/blockquote>\n<p style=\"text-align: justify;\">Insgesamt sind die Fallzahlen noch zu gering, um diese Ergebnisse nachdr\u00fccklich zu bewerten. Allerdings l\u00e4sst sich vermuten, dass mit technisch einfacheren M\u00f6glichkeiten Kalium, pH und Basendefizit an der Einsatzstelle zu bestimmen, die Anwendung zunehmen k\u00f6nnte und Patienten davon profitieren w\u00fcrden.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Blutgasanalysen (BGA) sind bedingt durch die erforderlichen Ger\u00e4te eine Ausnahme in der pr\u00e4hospitalen Notfallmedizin, dabei ist die unmittelbare und patientennahe (Point-of-Care[POC]-) \u00a0Bestimmung der BGA vielerorts Standard in der klinischen Akut- [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":14179,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[137],"tags":[139,2153],"class_list":["post-14173","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-reanimatologie","tag-cpr","tag-poc"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/09\/SIEMENS-epoc.png?fit=1354%2C1436&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/s7fR2g-14173","jetpack-related-posts":[{"id":19670,"url":"https:\/\/news-papers.eu\/?p=19670","url_meta":{"origin":14173,"position":0},"title":"Normokapnie bereits pr\u00e4hospital verbessert Outcome bei Patienten mit schwerem Sch\u00e4del-Hirn-Trauma","author":"Bj\u00f6rn Hossfeld","date":"Juni 5, 2025","format":false,"excerpt":"Das schwere Sch\u00e4del-Hirn-Trauma (SHT) z\u00e4hlt weltweit zu den h\u00e4ufigsten Todesursachen. 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