{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T03:00:21Z","timestamp":1700017221345},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:00:00Z","timestamp":1592265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:00:00Z","timestamp":1592265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinik M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Anaesthesist"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Hypersensitivit\u00e4tsreaktionen geh\u00f6ren zu den am meisten gef\u00fcrchteten Nebenwirkungen von CT-Kontrastmitteln. Bronchospasmus und Lungen\u00f6dem sind bekannte Erscheinungsformen, wobei Letzteres deutlich seltener auftritt. Bei Anaphylaxie k\u00f6nnen zahlreiche Mechanismen zum kardialen Versagen mit konsekutivem Lungen\u00f6dem f\u00fchren. Im Gegensatz dazu ist beim nichtkardialen Lungen\u00f6dem (NCPE) die kardiale Funktion nicht beeintr\u00e4chtigt. Das nichtkardiale Lungen\u00f6dem ist ein seltenes Ph\u00e4nomen, allerdings mit m\u00f6glicherweise t\u00f6dlichem Outcome. Es wird \u00fcber den Fall eines NCPE bei einem 48-j\u00e4hrigen Mann berichtet, der eine elektive Koronar-CT erhalten hat. Nach Gabe von jodiertem CT-Kontrastmittel entwickelte der Patient ein fulminantes Lungen\u00f6dem, welches trotz rascher Intervention zu einer schweren Hypox\u00e4mie mit kurzem Kreislaufstillstand f\u00fchrte. Eine fr\u00fche echokardiographische Untersuchung nach R\u00fcckkehr des spontanen Kreislaufs zeigte eine intakte Herzfunktion. Neben dem globalen Atemversagen bot der Patient eine ausgepr\u00e4gte Acidose mit erh\u00f6hten Lactat- und H\u00e4moglobinspiegeln. Nach Intubation kam es zu einer weiteren Verschlechterung des pulmonalen Gasaustausches, wobei die kardiale Pumpfunktion stets ausreichend war. Sechs Stunden nach dem ersten Ereignis wurde eine venoven\u00f6se extrakorporale Membranoxygenierungstherapie (ECMO) initiiert. Mithilfe der ECMO-Unterst\u00fctzung konnten wir die Invasivit\u00e4t der mechanischen Beatmung reduzieren und die Volumensubstitution intensivieren. Im weiteren Verlauf verbesserten sich die Mikrozirkulationsst\u00f6rung und die Lungenfunktion, und die ECMO-Unterst\u00fctzung konnte nach 70\u00a0Stunden beendet werden. Der Patient konnte am 9.\u00a0Tag extubiert und nach weiteren 4\u00a0Tagen ohne neurologische Residuen auf die Normalstation verlegt werden.<\/jats:p>","DOI":"10.1007\/s00101-020-00804-8","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T12:02:35Z","timestamp":1592308955000},"page":"579-582","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Schweres nichtkardiales Lungen\u00f6dem durch Permeabilit\u00e4tsst\u00f6rung nach i.v.-CT-Kontrastmittel-Gabe mit konsekutiver venoven\u00f6ser extrakorporaler Membranoxygenierung"],"prefix":"10.1007","volume":"69","author":[{"given":"B.","family":"Poros","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Katchanov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Curta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Weig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,6,16]]},"reference":[{"key":"804_CR1","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1136\/archdischild-2018-314867","volume":"104","author":"K Anagnostou","year":"2019","unstructured":"Anagnostou\u00a0K, Turner\u00a0PJ (2019) Myths, facts and controversies in the diagnosis and management of anaphylaxis. 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F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. F\u00fcr Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, \u00fcber die Patienten zu identifizieren sind, liegt von ihnen und\/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}