Bakterielle Translokation beim kritisch kranken Patienten mit aneurysmatischer Subarachnoidalblutung

Bacterial translocation in the critically ill patient with aneurysmal subarachnoid hemorrhage

by Silvia Flachs Nóbrega née Schultze
Doctoral thesis
Date of Examination:2023-02-22
Date of issue:2023-02-16
Advisor:PD Dr. Jörn Schäper
Referee:PD Dr. Jörn Schäper
Referee:Prof. Dr. Dorothee Mielke
Persistent Address: http://dx.doi.org/10.53846/goediss-9731

 

 

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Abstract

English

Sepsis is the most common reason for the death of critically ill patients. The pathogenesis of sepsis is therefore of central importance in order to find therapeutic approaches for this common clinical picture. The strictest possible definition of the patient group to be examined and the point in time at which organ dysfunction or organ failure occurs in the course of intensive care medicine play an important role in order to be able to draw conclusions about the causality of influencing factors. A disrupted epithelial intestinal barrier with consecutive bacterial translocation and endotoxemia is ascribed a central role in the pathogenesis of septic multi-organ failure. Despite a large number of experimental and clinical studies, the data on the causal relationship between epithelial barrier disruption, bacterial translocation and the prognostic value for the survival of a critically ill patient in the literature to date are scarce and inhomogeneous. This study was carried out to reassess the processes in the intestinal epithelium of critically ill patients using modern analysis methods and to examine a translocation, i.e. a transfer of bacteria or their components from the intestinal lumen into the systemic circulation as a predictor for organ failure. For this purpose, a group of patients was selected who had suffered a spontaneous aneurysmal subarachnoid hemorrhage (SAH).
Keywords: sepsis; bacterial translocation; epithelial barrier disruption; spontaneous aneurysmal subarachnoid hemorrhage
 
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