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78 Z. Rechtsmedizin 1 (1976)

handle is hein.journals/injlegame78 and id is 1 raw text is: Zeitschrift fur Z. Rechtsmedizin 78, 1-12 (1976) Rechtsmedizin ©by Springer-Verlag 1976 Ubersichtsreferat - Review Article Zur Pathomorphologie der Intensivbehandlung* Ch. Mittermayer* und H. Joachim Pathologisches Institut (,,Ludwig-Aschoff-Haus) der Univ. und Institut fur Rechtsmedizin Albertstrale 19, D-7800 Freiburg unter Mitarbeit von: H. U. Dodt, H. Grimm, M. Hagedorn, M. Hirschauer, H. Horinek, H. Ivens, R. Jenkins, P. Kaden, P. Ostendorf, U. Riede, W. Vogel, W. Zimmermann. Pathomorphology of Intensive Care Treatment Summary. The pathologic consequences of intensive care treatment are mani- fested locally and generally. Local disturbances due to intensive care therapy are as follows: blood vessel injury, thromboembolism caused by catheterization, tracheal stenosis following tracheostomy and, most important, sepsis. The more general pathologic results of intensive care treatment are essentially brought about by shock. Shock- kidney plays a subordinate role today because ist is a reversible state of renal insufficiency. In contrast, shock-lung leads to death in about 50 % of the cases. The pathohistologic features of the initial stages are microthrombosis, perivascular edema and endothelial damage. These three characteristics are already apparent before hospital admission and institution of treatment. It is not yet clear to what extent the therapy augments the pathologic changes or leads to clinically mani- fested symptoms. Zusammenfassung. Die Pathologie der Intensivtherapie umfat lokale und allge- meine Folgen: Unter den lokalen Folgen finden sich Gefafverletzungen, Thromboembolismus, Trachealstenosen nach Tracheostoma und als wichtigstes die Sepsis. Die allgemeinen Folgen der Intensivtherapie werden im wesentlichen durch Schock hervorgerufen. Die Schocknieren spielen heute eine untergeordnete, weil durch Therapie iiberbruckbare, Rolle. Dagegen fuhren Schocklungen in etwa 50 % * Nach einem Referat gehalten am 24.9.1975 anlallich der 54. Jahrestagung der Deutschen Gesellschaft fur Rechtsmedizin in Frankfurt.

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