{"id":6196,"date":"2018-01-02T04:15:51","date_gmt":"2018-01-02T03:15:51","guid":{"rendered":"http:\/\/news-papers.eu\/?p=6196"},"modified":"2017-11-07T21:56:34","modified_gmt":"2017-11-07T20:56:34","slug":"leberverletzungen-bei-der-reanimation-der-schwangeren","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=6196","title":{"rendered":"Blitzlicht: Leberverletzungen bei der Reanimation der Schwangeren"},"content":{"rendered":"<p style=\"text-align: justify;\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"6203\" data-permalink=\"https:\/\/news-papers.eu\/?attachment_id=6203\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/12\/akten-e1510088103113.jpg?fit=300%2C185&amp;ssl=1\" data-orig-size=\"300,185\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;5.6&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS 650D&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;109&quot;,&quot;iso&quot;:&quot;1600&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"akten\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/12\/akten-e1510088103113.jpg?fit=1024%2C633&amp;ssl=1\" class=\"size-medium wp-image-6203 alignright\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/12\/akten.jpg?resize=300%2C185\" alt=\"\" width=\"300\" height=\"185\" \/>Die kardiopulmonale Reanimation der Schwangeren ist mit rund 0,002% ein sehr seltenes Ereignis. Auf welche Verletzungsfolgen bei der Reanimation muss man Acht geben? <strong>Timothy R. Cox<\/strong> und Kollegen aus Baltimore (USA) haben dies nun in einer retrospektiven Fallserie evaluiert:<\/p>\n<blockquote><p><strong>Cox TR et al.\u00a0Liver lacerations as a complication of CPR during pregnancy. Resuscitation 2017, online<\/strong><\/p><\/blockquote>\n<hr \/>\n<p style=\"text-align: justify;\"><strong>Reanimationsbedingte Leberverletzungen<\/strong>\u00a0werden <strong>in der Normalbev\u00f6lkerung<\/strong> mit <strong>0,5-2,9%<\/strong> angegeben. Verletzungen der Leber im Rahmen der Reanimation in der Peripartalphase sind bisher aber nicht gut untersucht worden. Die schwangerschaftsassoziierten Ver\u00e4nderungen der Frau lassen hier aber vermuten, dass m\u00f6glicherweise eine h\u00f6here Verletzungsinzidenz vorliegt.<\/p>\n<p style=\"text-align: justify;\">Die Autoren identifizierten in einer Datenbank von 2011-2016 alle F\u00e4lle mit einem Herzkreislaufstillstand (HKS) in der Peripartalphase (11\/9408; 0,12%) in einem Krankenhaus (Alter: 24-39 Jahren, teils mit erheblichen Komorbidit\u00e4ten). In 7\/11 F\u00e4llen (64%) konnte ein Wiedereintritt einen spontanen Kreislauffunktion (ROSC) erreicht werden. Die Ursachen des HKS waren vielf\u00e4ltig:<\/p>\n<ul>\n<li>Atemstillstand bei Pr\u00e4eklampsie\u00a0(n=1)<\/li>\n<li>Lungenembolie (n=2)<\/li>\n<li>Blutung (n=2)<\/li>\n<li>TTP-HUS (Thrombozytopenische Pupura &#8211; H\u00e4molytisch ur\u00e4misches Syndrom)\u00a0(n=1)<\/li>\n<li>Zn. Autounfall\u00a0(n=1)<\/li>\n<li>Peritonitis\/Sepsis\u00a0(n=1)<\/li>\n<li>Aortendissektion\u00a0(n=1)<\/li>\n<li>HELLP Syndrom (n=1)<\/li>\n<li>unklar\u00a0(n=1)<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Interessanterweise erlitten 3 der 7 Patientinnen mit ROSC eine klinisch signifikante Leberverletzung (43%). Die Gesamtletalit\u00e4t der reanimierten Frauen betrug 82% (9\/11). Auch auch nach ROSC betrug die Letalit\u00e4t immer noch 72% (5\/7).\u00a0Diese Studie verdeutlicht eindr\u00fccklich die hohe Letalit\u00e4t im Rahmen des peripartalen Herzkreislaufstillstandes. Limitiert wird die Studie dadurch, dass aus einer Fallserie mit 11 Patienten keine kausalen R\u00fcckschl\u00fcsse gezogen werden kann. Dennoch sollte man\u00a0nach Reanimationsma\u00dfnahmen bei Frauen in der Peripartalphase proaktiv nach Leberverletzungen gefahnden.<\/p>\n<hr \/>\n<p><strong><a href=\"https:\/\/twitter.com\/news_papers_eu?refsrc=email&amp;s=11\" target=\"_blank\" rel=\"noopener\">News-Papers.eu auf TWITTER<\/a>\u00a0 \u00a0 \u00a0 \u00a0\u00a0<a href=\"http:\/\/news-papers.eu\/follow\" target=\"_blank\" rel=\"noopener\">Follow news-papers.eu<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Die kardiopulmonale Reanimation der Schwangeren ist mit rund 0,002% ein sehr seltenes Ereignis. Auf welche Verletzungsfolgen bei der Reanimation muss man Acht geben? Timothy R. Cox und Kollegen aus Baltimore [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":6203,"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},"_wpas_customize_per_network":false},"categories":[137],"tags":[1243,138,972],"class_list":["post-6196","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-reanimatologie","tag-peripartalphase","tag-reanimation","tag-schwangerschaft"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/12\/akten-e1510088103113.jpg?fit=300%2C185&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-1BW","jetpack-related-posts":[{"id":6938,"url":"https:\/\/news-papers.eu\/?p=6938","url_meta":{"origin":6196,"position":0},"title":"Reanimation der Schwangeren: Wie gemacht?","author":"Michael Bernhard","date":"M\u00e4rz 27, 2018","format":false,"excerpt":"Karin Becke und Kollegen stellen die Reanimation der Schwangeren in einem Open Access Beitrag in An\u00e4sthesiologie&Intensivmedizin dar: Becke K, et al. Die kardiopulmonale Reanimation der Schwangeren. An\u00e4sth Intensivmed 2018; 59: 12-22 (PDF) Der Beitrag fasst zusammen: M\u00fcttersterblichkeit Ursachen des Kreislaufstillstandes Leitlinien zur kardiopulmonalen Reanimation Pr\u00e4vention Allgemeine Aspekte Basisma\u00dfnahmen Erkennen des\u2026","rel":"","context":"In &quot;Reanimatologie&quot;","block_context":{"text":"Reanimatologie","link":"https:\/\/news-papers.eu\/?cat=137"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/Schwanger.jpg?fit=817%2C648&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/Schwanger.jpg?fit=817%2C648&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/Schwanger.jpg?fit=817%2C648&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/Schwanger.jpg?fit=817%2C648&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":11832,"url":"https:\/\/news-papers.eu\/?p=11832","url_meta":{"origin":6196,"position":1},"title":"CPR der schwangeren Patientin","author":"Bj\u00f6rn Hossfeld","date":"Juli 27, 2020","format":false,"excerpt":"Die kardiopulmonale Reanimation einer schwangeren Frau stellt ein a\u0308u\u00dferst seltenes Ereignis dar. Zudem sind aufgrund der schwangerschaftsbedingten physiologischen Vera\u0308nderungen Modifikationen der lebensrettenden Ma\u00dfnahmen erforderlich. Weiterhin mu\u0308ssen bei dieser Patientengruppe spezielle Ursachen des Kreislaufstillstandes bedacht werden. Fu\u0308r alle mit schwangeren Patientinnen konfrontierten A\u0308rzte ist es daher wesentlich, potenziell kritische Verla\u0308ufe der\u2026","rel":"","context":"In &quot;Geburtshilfliche und gyn\u00e4kologische Notf\u00e4lle&quot;","block_context":{"text":"Geburtshilfliche und gyn\u00e4kologische Notf\u00e4lle","link":"https:\/\/news-papers.eu\/?cat=197"},"img":{"alt_text":"CPR","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/CPR-Video.png?fit=1200%2C615&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/CPR-Video.png?fit=1200%2C615&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/CPR-Video.png?fit=1200%2C615&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/CPR-Video.png?fit=1200%2C615&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/CPR-Video.png?fit=1200%2C615&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":8621,"url":"https:\/\/news-papers.eu\/?p=8621","url_meta":{"origin":6196,"position":2},"title":"Gutes Neues Jahr und R\u00fcckblick auf 2018","author":"Michael Bernhard","date":"Januar 1, 2019","format":false,"excerpt":"NEWS-PAPERS.EU\u00a0w\u00fcnscht allen Leserinnen und Lesern ein Gutes Neues Jahr, viel Gl\u00fcck, Erfolg und vor allem Gesundheit in 2019. NEWS-PAPERS.EU dankt Allen, die uns im letzten Jahr unterst\u00fctzt haben und die NEWS-PAPERS.EU zu dem machen was es ist: ein engagierter Blog \u00fcber interessante wissenschaftliche Erkenntnisse in der pr\u00e4hospitalen und innerklinischen Akut-\u2026","rel":"","context":"In &quot;R\u00fcckblick&quot;","block_context":{"text":"R\u00fcckblick","link":"https:\/\/news-papers.eu\/?cat=1576"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/01\/Rueckblick2018.jpg?fit=1200%2C398&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/01\/Rueckblick2018.jpg?fit=1200%2C398&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/01\/Rueckblick2018.jpg?fit=1200%2C398&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/01\/Rueckblick2018.jpg?fit=1200%2C398&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/01\/Rueckblick2018.jpg?fit=1200%2C398&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":12627,"url":"https:\/\/news-papers.eu\/?p=12627","url_meta":{"origin":6196,"position":3},"title":"Natriumkarbonat (NaBi) bei der kardiopulmonalen Reanimation","author":"Michael Bernhard","date":"Dezember 12, 2020","format":false,"excerpt":"Gibt man Natriumkarbonat (NaBi) bei einer kardiopulmonalen Reanimation? Wu KH et al.\u00a0EFFECTIVENESS OF SODIUM BICARBONATE ADMINISTRATION ON MORTALITY IN CARDIAC ARREST PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Emerg Med 2020, https:\/\/doi.org\/10.1016\/j.jemermed.2020.08.012 In den Leitlinien zur kardiopulmonalen Reanimation von 2010 wird die routinem\u00e4\u00dfige Verwendung von Natriumbikarbonat (NaBi) bei Patienten mit\u2026","rel":"","context":"In &quot;Reanimatologie&quot;","block_context":{"text":"Reanimatologie","link":"https:\/\/news-papers.eu\/?cat=137"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/10\/NaBi.jpg?fit=900%2C1200&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/10\/NaBi.jpg?fit=900%2C1200&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/10\/NaBi.jpg?fit=900%2C1200&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/10\/NaBi.jpg?fit=900%2C1200&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":3803,"url":"https:\/\/news-papers.eu\/?p=3803","url_meta":{"origin":6196,"position":4},"title":"Adrenalin bei der Reanimation: Was bringt\u00b4s ?","author":"Michael Bernhard","date":"Juni 6, 2017","format":false,"excerpt":"Brit Long schrieb gerade zusammen mit Alex Koyfman einen \u00dcbersichtsartikel zur Frage \"Was bringt Adrenalin bei der kardiopulmonalen Reanimation?\": Long B, et al. Emergency Medicine Myths: Epinephrine in Cardiac Arrest. J Emerg Med 2017;\u00a0http:\/\/dx.doi.org\/10.1016\/ j.jemermed.2016.12.020 Kaum ein Thema wird so kontrovers diskutiert wie die Gabe von dem Sympthatomimetikum und Katecholamin\u2026","rel":"","context":"In &quot;Reanimatologie&quot;","block_context":{"text":"Reanimatologie","link":"https:\/\/news-papers.eu\/?cat=137"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/IMG_2850.jpg?fit=1200%2C675&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/IMG_2850.jpg?fit=1200%2C675&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/IMG_2850.jpg?fit=1200%2C675&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/IMG_2850.jpg?fit=1200%2C675&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/IMG_2850.jpg?fit=1200%2C675&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":9768,"url":"https:\/\/news-papers.eu\/?p=9768","url_meta":{"origin":6196,"position":5},"title":"TEE bei Reanimation","author":"Michael Bernhard","date":"August 4, 2019","format":false,"excerpt":"Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz: Nach langen Jahren in der Kardioan\u00e4sthesie und mit der M\u00f6glichkeit im Schockraum bei Patienten, die unter Reanimation aufgenommen werden, ein TEE (trans\u00f6sophageale Echokardiographie) durchf\u00fchren zu k\u00f6nnen, bin ich davon \u00fcberzeugt, dass der Einsatz des TEE bei der kardiopulmonalen Reanimation in den kommenden\u2026","rel":"","context":"In &quot;Reanimatologie&quot;","block_context":{"text":"Reanimatologie","link":"https:\/\/news-papers.eu\/?cat=137"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/07\/TEE2-300x169.jpeg?resize=350%2C200","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/6196","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=6196"}],"version-history":[{"count":7,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/6196\/revisions"}],"predecessor-version":[{"id":6204,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/6196\/revisions\/6204"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/6203"}],"wp:attachment":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6196"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6196"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6196"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}