{"id":745,"date":"2016-03-08T05:22:13","date_gmt":"2016-03-08T04:22:13","guid":{"rendered":"http:\/\/news-papers.eu\/?p=745"},"modified":"2016-03-07T10:09:18","modified_gmt":"2016-03-07T09:09:18","slug":"osborn-wave-bei-hypothermie","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=745","title":{"rendered":"„Osborn Wave“ bei Hypothermie"},"content":{"rendered":"

In der aktuellen Jahreszeit kann sich das Wetter ja manchmal nicht wirklich entscheiden wie es sein will. Vor allem wird es nachts empfindlich kalt. Aber nicht nur in den Wintermonaten, sondern auch in der \u00fcbrigen Zeit des Jahres kann der Notfallmediziner pr\u00e4hospital und in der Klinik mit hypothermen Patienten konfrontiert werden.<\/p>\n

Anbei ein entsprechendes EKG bei einem Patienten mit Hypothermie<\/strong>. Was f\u00e4llt auf ?<\/p>\n

\"Osbornwave1\"<\/p>\n

EKG:<\/strong>\u00a0Vorhofflimmern, deutliche erh\u00f6hter J-Punkt in den Ableitungen V4-V6 (sog. Osborn wave, auch als „hypothermer Kamelh\u00f6cker“ bezeichnet).<\/p>\n

Vitalwerte des Patienten:<\/strong> RR 89\/41 mmHg, Hfr 71 bpm, SpO2 nicht messbar (bei Hypothermie), Blasentemperatur 26,1\u00b0C<\/p>\n

\n

Ein paar Punkte zur Osborn-Wave:<\/strong><\/p>\n

    \n
  • Erstbeschreibung 1938 von Tomszewski, Osborn beschrieb 1953 die klinische Relevanz<\/li>\n
  • bezeichnet die J-Punkt Erh\u00f6hung\/Anhebung zu Beginn der ST-Strecke im Rahmen der Hypothermie<\/li>\n
  • wird als klinischer Marker (aber nicht pathognomonisch) f\u00fcr eine klinische Hypothermie betrachtet (Junttila MJ, et al. Eur Heart Journal<\/strong>\u00a02012)<\/li>\n
  • tritt ab Temperaturen < 32-33\u00b0C auf (Gussak I et al., J Eletrocardiol<\/strong> 1995, Chhabra L, et al. Ther\u00a0Hypothermia\u00a0Temp Manag<\/span>.<\/strong>\u00a02013)<\/li>\n
  • findet sich in bis zu 80% der hypothermen Patienten im Temperaturbereich von 21-28 \u00b0C (Urdang MS, et al. Ann Emerg Med<\/strong> 2009)<\/li>\n
  • je hypothermer ein Patient ist, desto h\u00e4ufig tritt eine Osborn-Wave auf (Vassallo SU et al., Acad Emerg Med<\/strong> 1999).<\/li>\n
  • hat keine prognostische Relevanz<\/li>\n
  • Weitere Differentialdiagnosen bei Osborn-Wave: Hypercalz\u00e4mie, Sch\u00e4del-Hirntrauma, Subarachnoidalblutung, Brugada-Syndrom, u.a.<\/li>\n<\/ul>\n
    \n

    Weiterf\u00fchrende Literatur:<\/strong><\/p>\n

      \n
    • Chhabra L, et al. Electrocardiographic Changes in Hypothermia:\u00a0A Review. Ther\u00a0Hypothermia\u00a0Temp Manag\u00a0<\/span><\/strong>2013; 3: 54-62<\/li>\n
    • Gussak I, et al.\u00a0ECG phenomenon\u00a0called the J wave: history, pathophysiology, and\u00a0clinical significance. J Electrocardiol\u00a0<\/strong>1995;28:49\u201358<\/li>\n
    • Hoffmann M, et al. Hypothermer „Kamelh\u00f6cker“ – Die Osborn-Welle. Schweiz Med Forum<\/strong> 2006; 6: 907<\/li>\n
    • Junttila MJ, et al. Clinical significance of variants of J-points and\u00a0J-waves: early repolarization patterns and risk. Eur Heart J<\/strong> 2012; 33: 2639\u20132644<\/li>\n
    • Rolfast CL, et al. Electrocardiographic changes in therapeutic hypothermia, Crit Care<\/strong> 2012; 16: R100<\/li>\n
    • Urdang MS, et al. ECG Analysis in Accidental Urban Hypothermia.\u00a0Ann Emerg Med<\/strong>\u00a02009; 54: S141<\/li>\n
    • Vassallo SU et al., A Prospective Evaluation of the Electrocardiographic\u00a0Manifestations of Hypothermia. Acad Emerg Med<\/strong> 1999; 6: 1121-1126<\/li>\n<\/ul>\n
      \n

       <\/p>\n","protected":false},"excerpt":{"rendered":"

      In der aktuellen Jahreszeit kann sich das Wetter ja manchmal nicht wirklich entscheiden wie es sein will. Vor allem wird es nachts empfindlich kalt. Aber nicht nur in den Wintermonaten, […]<\/p>\n","protected":false},"author":2,"featured_media":824,"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":[105],"tags":[107,106,108],"class_list":["post-745","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hypothermie","tag-ekg","tag-hypothermie","tag-osborn-wave"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/03\/Bildschirmfoto-2016-03-06-um-11.01.20.png?fit=1194%2C860&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-c1","jetpack-related-posts":[{"id":10311,"url":"https:\/\/news-papers.eu\/?p=10311","url_meta":{"origin":745,"position":0},"title":"Therapeutische Hypothermie bei nicht defibrillierbarem Rhythmus?","author":"Michael Bernhard","date":"Oktober 4, 2019","format":false,"excerpt":"Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz: Eine weitere Studie, die ich beim HAI zum Thema \u201etargeted temperature management\u201c vorgestellt habe, war der HYPERION trial. Nun wurden die Ergebnisse im New England Journal of Medicine publiziert. Lascarrou JB et al. 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