{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T05:29:17Z","timestamp":1748755757341,"version":"3.37.3"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017590","name":"Universit\u00e4tsklinikum Essen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Anaesthesist"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Sowohl eine vorbestehende Antikoagulation als auch pr\u00e4disponierende Vorerkrankungen f\u00fcr Thromboembolien stellen ein h\u00e4ufiges Problem bei Patienten mit Sepsis dar, wenngleich der Umgang mit diesen Rahmenbedingungen von den aktuellen nationalen und internationalen Leitlinien f\u00fcr Sepsis und septischen Schock nicht adressiert wird. Ein Ziel der hier vorliegenden deutschlandweiten Umfrage war es, den Umgang von Intensivmedizinern mit derartigen Problemen zu eruieren.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methoden<\/jats:title>\n                <jats:p>Von Oktober 2019 bis Mai 2020 f\u00fchrten wir eine deutschlandweite Umfrage unter \u00e4rztlichen Leitern von Intensivstationen zum Thema Antikoagulation und medikament\u00f6ser Thromboseprophylaxe bei Sepsis und Sepsis-induzierter Koagulopathie durch. Ein Fokus war hierbei, das Vorgehen bei Patienten mit vorbestehender Indikation zur therapeutischen Antikoagulation sowie bei vorbekannter Heparin-induzierter Thrombopenie Typ\u00a0II (HIT-II) (akut-symptomatisch vs. Jahre zur\u00fcckliegend) zu eruieren.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Die Umfrageergebnisse zeigen, dass auf den meisten der teilnehmenden Intensivstationen eine vorbestehende Antikoagulation gr\u00f6\u00dftenteils mit niedermolekularen Heparinpr\u00e4paraten oder unfraktioniertem Heparin fortgef\u00fchrt wird. Bei bekannter HIT-II wird Argatroban bevorzugt, unabh\u00e4ngig davon, ob es sich um eine Jahre zur\u00fcckliegende oder eine akut-symptomatische HIT-II handelt. Eine hohe Variabilit\u00e4t besteht bei der Festlegung der Zielwerte f\u00fcr die Antikoagulation, wobei diese gr\u00f6\u00dftenteils deutlich \u00fcber dem Bereich einer reinen ven\u00f6sen Thromboembolie(VTE)-Prophylaxe zu liegen kommen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Schlussfolgerung<\/jats:title>\n                <jats:p>Die Datenlage zur Fortf\u00fchrung einer \u00fcber die reine VTE-Prophylaxe hinausgehenden Antikoagulation mit konsekutiv erh\u00f6htem Blutungsrisiko bei Patienten mit Sepsis und septischem Schock ist eingeschr\u00e4nkt, und Therapieentscheidungen unterliegen in vielen F\u00e4llen einer individuellen Abw\u00e4gung des Behandlungsteams. Die Ergebnisse unserer Umfrage implizieren die Notwendigkeit einer systematischen Aufarbeitung dieses Themenfeldes, um die auf vielen Intensivstationen gelebte Praxis mit der gebotenen Evidenz zu unterlegen.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00101-021-01011-9","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T15:03:26Z","timestamp":1628175806000},"page":"193-200","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Praxis der medikament\u00f6sen Thromboseprophylaxe und Antikoagulation bei Patienten mit Sepsis und vorbestehender Antikoagulation oder Heparin-induzierter Thrombozytopenie Typ II \u2013 Ergebnisse einer deutschlandweiten Umfrage auf Intensivstationen","Practice of pharmaceutical thrombosis prophylaxis and anticoagulation in patients with sepsis and pre-existing anticoagulation or heparin-induced type II thrombocytopenia\u2014Results of a nationwide survey in German intensive care units"],"prefix":"10.1007","volume":"71","author":[{"given":"Thomas","family":"Schmoch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Brenner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Becker-Pennrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludwig Christian","family":"Hinske","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus A.","family":"Weigand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef","family":"Briegel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"M\u00f6hnle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"SepNet Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"issue":"6","key":"1011_CR1","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1001\/jamacardio.2016.2181","volume":"1","author":"AJ Walkey","year":"2016","unstructured":"Walkey\u00a0AJ, Quinn\u00a0EK, Winter\u00a0MR, McManus\u00a0DD, Benjamin\u00a0EJ (2016) Practice patterns and outcomes associated with use of anticoagulation among patients with atrial fibrillation during sepsis. 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T.\u00a0Brenner: Vortrags- & Vorsitzhonorare: Baxter Deutschland GmbH, Sch\u00f6chl medical education GmbH, Boehringer Ingelheim Pharma GmbH, CSL Behring GmbH, Astellas Pharma GmbH, B.\u00a0Braun Melsungen AG, MSD Sharp & Dohme GmbH; Advisory Boards & Beratert\u00e4tigkeit: Baxter Deutschland GmbH. P.\u00a0M\u00f6hnle: Erstattung von Kongressgeb\u00fchren, Reise- und \u00dcbernachtungskosten, Vortragshonorare: Bayer, Biotest, CSL Behring, Novo Nordisk, Pfizer, Roche, Shire\/Takeda, SOBI; Advisory Board: CSL Behring. M.A.\u00a0Weigand: Vortragshonorare: GE-Healthcare, Gilead, K\u00f6hler Chemie, MSD Sharp & Dohme, Pfizer Pharma, Boehringer Ingelheim; Advisory Boards: B.\u00a0Braun, Gilead, MSD Sharp & Dohme, Shionogi. A.\u00a0Becker-Pennrich, L.C.\u00a0Hinske und J.\u00a0Briegel geben an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}