{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:26:46Z","timestamp":1763458006605},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Wir pr\u00e4sentieren den Fall einer leicht adip\u00f6sen 39-j\u00e4hrigen Patientin mit dem schweren Verlauf einer COVID-19-Pneumonie. Die Patientin wurde aus einem Krankenhaus der Regelversorgung mit Verdacht auf eine COVID-19-Pneumonie zugewiesen. Initial bestand die klinische Symptomatik aus Dysurie und Fieber. Im R\u00f6ntgen-Thorax zeigte sich ein bilaterales Infiltrat. Im CT-Thorax fanden sich beidseits fortgeschrittene COVID-19-typische Ver\u00e4nderungen. Best\u00e4tigt wurde die COVID-19-Infektion durch eine positive SARS-CoV-2-PCR aus dem Nasen-Rachen-Abstrich. Bei progredientem ARDS mit respiratorischer Ersch\u00f6pfung wurde die Patientin intubiert und invasiv beatmet. Unter einem Verdacht auf eine bakterielle Superinfektion leiteten wir eine empirische antibiotische Therapie ein. Es wurde mit Dexamethason begonnen zu behandeln. Zus\u00e4tzlich wurde ASS und gewichtsadaptiertes halbtherapeutisches niedermolekulares Heparin in die Therapie mit aufgenommen. Im Rahmen der intensivmedizinischen Behandlung entwickelte die Patientin einen fulminanten septischen Schock mit konsekutiver schwerer Thrombozytopenie. Es erfolgte eine dilatative Tracheotomie. Der Weaning-Progress blieb durch rezidivierende septische Sch\u00fcbe erschwert. Als urs\u00e4chlich f\u00fcr die septischen Sch\u00fcbe konnte eine Nekrose im Bereich des rechten Fu\u00dfes ausgemacht werden. Bei fehlendem alternativen Fokus erfolgte die chirurgische Sanierung mit Teilamputation. Anschlie\u00dfend blieb die Patientin infektfrei und konnte vom Respirator entw\u00f6hnt werden.<\/jats:p>","DOI":"10.1055\/a-1362-4028","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T22:53:55Z","timestamp":1618872835000},"page":"526-530","source":"Crossref","is-referenced-by-count":2,"title":["39-j\u00e4hrige Frau mit schwerer COVID-19-Pneumonie: Erfolgreiches Weaning nach septischem Schock und Vorfu\u00dfamputation wegen mikrovaskul\u00e4rer Komplikationen"],"prefix":"10.1055","volume":"75","author":[{"given":"D.","family":"Pinzon","sequence":"additional","affiliation":[{"name":"Vamed Klinik Hagen-Ambrock, Klinik f\u00fcr Pneumologie, Hagen Ambrock"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Baumgarten","sequence":"additional","affiliation":[{"name":"Vamed Klinik Hagen-Ambrock, Klinik f\u00fcr Pneumologie, Hagen Ambrock"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Galetke","sequence":"additional","affiliation":[{"name":"Vamed Klinik Hagen-Ambrock, Klinik f\u00fcr Pneumologie, Hagen Ambrock"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1016\/s2213-2600(20)30316-7","article-title":"Case characteristics, resource use, and outcomes of 10\u2006021 patients with COVID-19 admitted to 920 German hospitals: an observational study","volume":"8","author":"C Karagiannidis","year":"2020","journal-title":"Lancet Respiratory Medicine"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1016\/S0140-6736(20)31189-2","article-title":"Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study","volume":"395","author":"M J Cummings","year":"2020","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study [published correction appears in Lancet. 2020 Mar 28; 395 (10229): 1038]","volume":"395","author":"F Zhou","year":"2020","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1111\/jth.14817","article-title":"Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy","volume":"18","author":"N Tang","year":"2020","journal-title":"J Thromb Haemost"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s13613-019-0577-9","article-title":"Recruiting the microcirculation in septic shock","volume":"9","author":"M Legrand","year":"2019","journal-title":"Ann Intensive Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1007\/s00134-020-05954-2","article-title":"Novel coronavirus infection during the 2019\u20132020 epidemic: preparing intensive care units\u2013 the experience in Sichuan Province, China","volume":"46","author":"X Liao","year":"2020","journal-title":"Intensive Care Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"E145","DOI":"10.1148\/radiol.2020201343","article-title":"Diagnostic Performance of CT and Reverse Transcriptase Polymerase Chain Reaction for Coronavirus Disease 2019: A Meta-Analysis","volume":"296","author":"H Kim","year":"2020","journal-title":"Radiology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/RLI.0000000000000670","article-title":"Chest CT Findings in Patients With Coronavirus Disease 2019 and Its Relationship With Clinical Features","volume":"55","author":"J Wu","year":"2020","journal-title":"Invest Radiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1007\/s00134-020-06033-2","article-title":"COVID-19 pneumonia: different respiratory treatments for different phenotypes?","volume":"46","author":"L Gattinoni","year":"2020","journal-title":"Intensive Care Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1055\/a-1068-4183","article-title":"Aktuelle ethische Herausforderungen in der Intensivmedizin angesichts der Corona-Pandemie","volume":"145","author":"U Janssens","year":"2020","journal-title":"Dtsch Med Wochenschr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2516","DOI":"10.1097\/01.ccm0000148011.51681.e2","article-title":"Does noninvasive positive pressure ventilation improve outcome in acute hypoxemic respiratory failure? 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