Überwachung labordiagnostischer Parameter bei Intensivpatienten – Teil 1

Zusammenfassung

Kritisch kranke Hunde und Katzen zeigen häufig komplexe Veränderungen mehrerer Organsysteme sowie systemische Entzündungsreaktionen und Infektionen. Eine strukturierte Herangehensweise an die Diagnostik dieser Patienten ist essenziell, um relevante Abweichungen frühzeitig zu erkennen und gezielt therapieren zu können. Ein etabliertes Hilfsmittel hierfür stellt das sogenannte „Rule of 20“-Schema dar, das eine systematische Erfassung zentraler klinischer und labordiagnostischer Parameter ermöglicht. Ziel des vorliegenden Übersichtsartikels ist es, einen praxisorientierten Überblick über die wichtigsten labordiagnostischen Tests sowie deren häufigsten Befunde bei kritisch kranken Hunden und Katzen zu geben.

Teil 1 dieses zweiteiligen Übersichtsartikels befasst sich mit zentralen hämatologischen Parametern bei intensivmedizinisch betreuten Kleintierpatienten. Im Fokus stehen Hämatokrit, Leukozyten- und Thrombozytenzahl sowie häufige Veränderungen wie Anämie, Polyzythämie, Leukozytose und Thrombozytopenie. Zudem werden Störungen der Hämostase im Sinne einer Hypo- oder Hyperkoagulabilität diskutiert. Zur Diagnostik systemischer Entzündungsreaktionen sowie Infektionen werden die Bedeutung von Akute-Phase-Proteinen und mikrobiologischer Untersuchungen dargestellt. Zudem werden myokardiale Marker als Hinweis auf infektiöse Myokardschäden, wie sie bei Sepsis auftreten können besprochen.

Abstract

Critically ill dogs and cats commonly present with a dysfunction of multiple organ systems, systemic inflammatory response, and infection. The “Rule of 20” scheme provides a structured framework to systematically assess these changes, including numerous laboratory diagnostics. This two-part review article summarizes key laboratory tests and their most frequent alterations in critically ill dogs and cats.

Part one focuses on hematologic tests, especially the parameters hematocrit, leukocyte count, and platelet count, with common alterations in critically ill patients including anemia, polycythemia, leukocytosis. In addition, changes in the coagulation system, such as hypo- or hypercoagulability, can frequently occur in critically ill patients, therefore these are also discussed. To support the diagnosis of systemic inflammation and infections, the utility of acute-phase-protein analysis and bacteriological examinations is discussed. In addition, myocardial markers are considered as indicators of myocardial injury, as they may occur in systemic inflammatory response and sepsis.

Schlüsselwörter

Kritisch kranke Hunde und Katzen - rule of 20 - Survival Prediction Index - Anämie - Gerinnungsstörungen - systemisches Entzündungsreaktionssyndrom - myokardiale Marker

Keywords

Critically ill dogs and cats - rule of 20 - Survival Prediction Index - anemia - coagulation disorders - systemic inflammatory response syndrome - myocardial markers

Publikationsverlauf

Eingereicht: 26. Mai 2025

Angenommen: 31. Juli 2025

Artikel online veröffentlicht:
02. September 2025

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