{"id":16057,"date":"2022-11-08T04:40:01","date_gmt":"2022-11-08T03:40:01","guid":{"rendered":"http:\/\/news-papers.eu\/?p=16057"},"modified":"2022-11-04T21:46:10","modified_gmt":"2022-11-04T20:46:10","slug":"reduzierte-volumentherapie-bei-sepsis-moeglich","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=16057","title":{"rendered":"Reduzierte Volumentherapie bei Sepsis m\u00f6glich ?"},"content":{"rendered":"<p style=\"text-align: justify\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"1451\" data-permalink=\"https:\/\/news-papers.eu\/?attachment_id=1451\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?fit=640%2C480&amp;ssl=1\" data-orig-size=\"640,480\" 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=\"Sepsis\" data-image-description=\"\" data-image-caption=\"\" data-medium-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?fit=300%2C225&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?fit=640%2C480&amp;ssl=1\" class=\"size-medium wp-image-1451 alignright\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?resize=300%2C225\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?w=640&amp;ssl=1 640w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>Die Fl\u00fcssigkeitstherapie bei Sepsis ist eine Herausforderung, und in Bezug auf die intraven\u00f6sen (IV) Volumina herrscht klinische Uneinigkeit. Die Autoren der nachfolgenden Studie wollten herausfinden, ob ein 24-Stunden-Protokoll zur Beschr\u00e4nkung der intraven\u00f6sen Fl\u00fcssigkeitszufuhr bei erwachsenen Patienten mit Sepsis ohne Schock, die in die Notaufnahme eingeliefert werden, durchf\u00fchrbar ist.<\/p>\n<blockquote><p><strong>Jessen MK, et al.\u00a0Restrictive fluids versus standard care in adults with sepsis in the emergency department (REFACED): A multicenter, randomized feasibility trial. Acid Emerg Med 2022; 29: 1172-1184<\/strong><\/p><\/blockquote>\n<p style=\"text-align: justify\">Bei der REFACED-Sepsis-Studie handelt es sich um eine multizentrische, randomisierte, offene Machbarkeitsstudie, bei der Sepsis-Patienten ohne Schock einer 24-st\u00fcndigen restriktiven, kristallinen intraven\u00f6sen Fl\u00fcssigkeitsverabreichung oder der Standardversorgung zugewiesen wurden. In der Gruppe mit restriktiver intraven\u00f6ser Fl\u00fcssigkeitsgabe waren Fl\u00fcssigkeitsbolusgaben nur dann erlaubt, wenn vordefinierte Kriterien f\u00fcr Hypoperfusion vorlagen. Die Standardbehandlung lag im Ermessen des behandelnden Teams. Der prim\u00e4re Endpunkt war das Gesamtvolumen der intraven\u00f6sen kristalloiden Fl\u00fcssigkeit 24 Stunden nach der Randomisierung. Zu den sekund\u00e4ren Ergebnissen z\u00e4hlten das Gesamtfl\u00fcssigkeitsvolumen, die Durchf\u00fchrbarkeit und die patientenzentrierten Ergebnisse.<\/p>\n<p style=\"text-align: justify\">Ergebnisse:<\/p>\n<ul style=\"text-align: justify\">\n<li>In die prim\u00e4re Analyse wurden 123 Patienten einbezogen (61 Patienten mit restriktiver Behandlung und 62 Patienten mit Standardbehandlung).<\/li>\n<li>Insgesamt wurden 32 % (95 % Konfidenzintervall [KI] 28 %-37 %) der in Frage kommenden Patienten, die alle Einschlusskriterien und keine Ausschlusskriterien erf\u00fcllten, eingeschlossen.<\/li>\n<li>Nach 24 Stunden betrug das mittlere (\u00b1SD) IV-Kristalloid-Fl\u00fcssigkeitsvolumen 562 (\u00b11076) ml im Vergleich zu 1370 (\u00b11438) ml in der restriktiven Gruppe im Vergleich zur Standardbehandlung (mittlere Differenz -801 ml, 95% CI -1257 bis -345 ml, p = 0,001).<\/li>\n<li>Protokollverst\u00f6\u00dfe traten bei 21 (34 %) Patienten in der Gruppe mit restriktiver Fl\u00fcssigkeitszufuhr auf. Es gab keine Unterschiede zwischen den Gruppen in Bezug auf unerw\u00fcnschte Ereignisse, den Einsatz von mechanischer Beatmung oder Vasopressoren, akutes Nierenversagen, Aufenthaltsdauer oder Mortalit\u00e4t.<\/li>\n<\/ul>\n<p style=\"text-align: justify\">Schlussfolgerungen: Ein Protokoll, das die Verabreichung kristalloider Fl\u00fcssigkeiten in der Notaufnahme bei Patienten mit Sepsis einschr\u00e4nkt, f\u00fchrte zu einer Verringerung des Fl\u00fcssigkeitsvolumens \u00fcber 24 Stunden im Vergleich zur Standardbehandlung. Eine k\u00fcnftige Studie, die auf patientenzentrierte Ergebnisse ausgerichtet ist, erscheint machbar.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Die Fl\u00fcssigkeitstherapie bei Sepsis ist eine Herausforderung, und in Bezug auf die intraven\u00f6sen (IV) Volumina herrscht klinische Uneinigkeit. Die Autoren der nachfolgenden Studie wollten herausfinden, ob ein 24-Stunden-Protokoll zur Beschr\u00e4nkung [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":1451,"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":[57],"tags":[67,74],"class_list":["post-16057","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sepsis","tag-sepsis","tag-volumentherapie"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?fit=640%2C480&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-4aZ","jetpack-related-posts":[{"id":14524,"url":"https:\/\/news-papers.eu\/?p=14524","url_meta":{"origin":16057,"position":0},"title":"Surviving Sepsis Campaign Guideline 2021 &#8211; Teil 8","author":"Michael Bernhard","date":"Oktober 24, 2021","format":false,"excerpt":"Nun zu Teil 8\u00a0der\u00a0Surviving Sepsis Campaign Guideline 2021 ist am 02.10.2021 publiziert worden: Evans L, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. This article is co\u2010published in the journals Intensive Care Medicine (https:\/\/doi.org\/10.1007\/s00134\u2010021\u201006506\u2010y) and Critical Care Medicine (https:\/\/doi.org\/10.1097\/CCM.0000000000005337). (PDF) Hier ganz frisch\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"Sepsis","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":15324,"url":"https:\/\/news-papers.eu\/?p=15324","url_meta":{"origin":16057,"position":1},"title":"Neue internationale Sepsis-Leitlinien 2021 &#8211; Eine Zusammenfassung","author":"Michael Bernhard","date":"April 7, 2022","format":false,"excerpt":"In der Fachzeitschrift An\u00e4sthesiologie & Intensivmedizin gibt es im OPEN ACCESS Format immer wieder sehr lesenswerte Artikel. Hier ein Artikel zum Update der Surviving Sepsis Campaign aus dem Oktober\u00a02021 zur Behandlung von Sepsis und septischem Schock. Der vorliegende Artikel fasst die wichtigsten Vera\u0308nderungen zusammen und stellt sie der Vorga\u0308ngerversion der\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":13646,"url":"https:\/\/news-papers.eu\/?p=13646","url_meta":{"origin":16057,"position":2},"title":"Sepsiskriterien zu unspezifisch?","author":"Michael Bernhard","date":"Mai 12, 2021","format":false,"excerpt":"Eine effektive Sepsistherapie h\u00e4ngt von n\u00fctzlichen Kriterien f\u00fcr eine schnelle und fr\u00fche Identifizierung der in Frage kommenden Patienten ab. Diese Kriterien sollten zuverl\u00e4ssig die Entlassungsdiagnose Sepsis vorhersagen und sicherstellen, dass Interventionen bei denjenigen ausgel\u00f6st werden, die sie ben\u00f6tigen, w\u00e4hrend potenziell sch\u00e4dliche Interventionen bei denjenigen vermieden werden, die sie nicht ben\u00f6tigen.\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":553,"url":"https:\/\/news-papers.eu\/?p=553","url_meta":{"origin":16057,"position":3},"title":"Die neue Definition der Sepsis und des septischen Schocks &#8211; Teil 2","author":"Michael Bernhard","date":"Februar 26, 2016","format":false,"excerpt":"K\u00fcrzlich sind wir auf die neue Definition der Sepsis und des septischen Schocks der 3. internationalen Consensuskonferenz SEPSIS-3 eingegangen (hier). Nachfolgend greifen wir weitere Punkte aus dieser Publikation auf. Singer M, et al. The third international consensus conference definitions for sepsis and septic shock (Sepsis-3). JAMA\u00a02016; 315: 801-810 Warum brauchte\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":14412,"url":"https:\/\/news-papers.eu\/?p=14412","url_meta":{"origin":16057,"position":4},"title":"Surviving Sepsis Campaign Guideline 2021: Kernaussagen Teil 2","author":"Michael Bernhard","date":"Oktober 8, 2021","format":false,"excerpt":"Nun zu Teil 2 der\u00a0Surviving Sepsis Campaign Guideline 2021 ist am 02.10.2021 publiziert worden: Evans L, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. This article is co\u2010published in the journals Intensive Care Medicine (https:\/\/doi.org\/10.1007\/s00134\u2010021\u201006506\u2010y) and Critical Care Medicine (https:\/\/doi.org\/10.1097\/CCM.0000000000005337). 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Epidemiology, management, and outcome of infection, sepsis, and septic shock in a German emergency department (EpiSEP study). Front. Med. 9:9979922; \u00a0https:\/\/doi.org\/10.3389\/fmed.2022.997992 ist Teil eines eBOOKs zum Thema \"Infections\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?fit=640%2C480&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?fit=640%2C480&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/04\/BK2.jpg?fit=640%2C480&ssl=1&resize=525%2C300 1.5x"},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/16057","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=16057"}],"version-history":[{"count":1,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/16057\/revisions"}],"predecessor-version":[{"id":16058,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/16057\/revisions\/16058"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/1451"}],"wp:attachment":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=16057"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=16057"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=16057"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}