Kinder Notfall–Intensiv by Franz-Josef Kretz and Thomas Beushausen (Eds.)

By Franz-Josef Kretz and Thomas Beushausen (Eds.)

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Die kontinuierliche EKG-Aufzeichnung und Anzeige am Überwachungsmonitor dokumentiert die elektrische Herzaktion. Sie induziert normalerweise eine mechanische Kontraktion der Herzkammern mit nachfolgendem Auswurf des Blutes in die großen Arterien. Die Sequenz „elektrische Erregung – Kontraktion“ wird als elektromechanische Kopplung bezeichnet. Sie kann bei schwerstkranken Kindern gestört sein kann, so dass auf die elektrische Erregung keine ordnungsgemäße mechanische Aktion folgt. Dann wird kein oder ein vermindertes Zum Monitoring der mechanischen Herzaktion ist neben der Palpation des Herzspitzenstoßes, des Pulses und der Auskultation des Herzens die Echokardiographie hervorragend geeignet.

Des 3. Ventrikels) • Doppler- und Farbdopplersonographie (Gefäßspasmus, extremes Hirnödem bzw. Hirntod) • zerebrale Angiographie (Blutung aus einer arteriovenösen Malformation, Hirntoddiagnostik) g) Bildgebende Verfahren bei Erkrankungen des Skelettsystems bzw. a. komplexe Becken- und Wirbelsäulenverletzungen • MRT: entzündliche Erkrankungen von Skelett, Muskel, Gelenken, Weichteilen; Blutungen (einschließlich Ganzkörper-MRT) h) Bildgebende Verfahren bei Erkrankungen der Gefäße: erweiterte Diagnostik Erkrankungen: Venenthrombose (V.

9) Die Charakteristika der wichtigsten Bradykardien auf der Intensivstation sind die folgenden: • Sinusbradykardie – P, PQ, QRS, ST und T normal – Bedeutung: evtl. 3 EKG und Echokardiographie 39 Tab. 18 Detaillierte Angaben zur unteren und oberen Herzfrequenzen bei gesunden Kindern verschiedener Alterstufen (Langzeit-EKG) Herzfrequenzen [1/min] bei gesunden Kindern (Langzeit-EKG) Nagashima [1] Southall [2] Southall [3] Frühgeborene HFmax im Mittel (SD) 195 (16) HFmin im Mittel (SD) 91 (18) Spannweite 36 bis 240 Probanden n = 100 Neugeborene HFmax im Mittel (SD) 189 (15) 173 (19) 189 (20) HFmin im Mittel (SD) 96 (15) 93 (12) 88 (13) Spannweite 70 bis 240 59 bis 220 61 bis 230 Probanden n = 63 n = 134 n = 50 Säuglinge HFmax im Mittel (SD) 191 (20) HFmin im Mittel (SD) 97 (14) Spannweite 70 bis 250 Probanden n = 50 4 bis 6 Jahre HFmax im Mittel (SD) 156 (17) HFmin im Mittel (SD) 67 (9) Spannweite 46 bis 195 Probanden n = 53 9 bis 12 Jahre HFmax im Mittel (SD) 158 (16) HFmin im Mittel (SD) 56 (7) Spannweite 40 bis 196 Probanden n = 97 13 bis 15 Jahre HFmax im Mittel (SD) 159 (18) HFmin im Mittel (SD) 51 (6) Spannweite 40 bis 192 Probanden n = 97 [1] Nagashima, M et al.

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