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Flugmedizin · Tropenmedizin · Reisemedizin - FTR 2021; 28(05): 226-231
DOI: 10.1055/a-1545-2799
Raumfahrtmedizin

Evaluation neuer Methoden zur Atemwegssicherung bei Langzeitmissionen im Weltall

Evaluation of new methods for airway secure during long-term space missions
Tobias Warnecke
1   Universitätsklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Oldenburg AöR
,
Steffen Kerkhoff
2   Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR)
3   Space Medicine Group, European Society of Aerospace Medicine (ESAM), Köln
,
Jan Schmitz
2   Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR)
3   Space Medicine Group, European Society of Aerospace Medicine (ESAM), Köln
,
Jochen Hinkelbein
2   Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln (AöR)
3   Space Medicine Group, European Society of Aerospace Medicine (ESAM), Köln
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ZUSAMMENFASSUNG

In den kommenden Jahren rücken Langzeitmissionen mit Errichtung einer Raumstation in der Mondumlaufbahn und bemannte Mars- missionen in erreichbare Nähe. Eine kurzfristige Evakuierung wird nicht möglich sein und die Besatzung muss, ggf. auch ohne ärztliche Unterstützung, autark eine Vielzahl möglicher medizinischer Ereig- nisse versorgen können. Hierzu zählen Notfälle mit Sicherung der Atemwege, wie auch eine notwendige Analgosedierung oder Voll- narkose. Nach Auswertung bisheriger Studien zur Evaluation geeig- neter Devices, empfiehlt sich der Einsatz supraglottischer Atemwegshilfsmittel bei freischwebender Anwendung in Schwerelosigkeit. Im Falle einer notwendigen endotrachealen Intubation muss aufgrund der Einflüsse der Schwerelosigkeit mit Schwellungen der Atemwege gerechnet werden, weshalb ein Videolaryngoskop Teil der Ausstat- tung sein sollte. Wann immer möglich, sollte zumindest der Patient während der Atemwegssicherung auf einem geeigneten Untergrund (z. B. Stretcher) fixiert sein.

Abstract

Long-term missions with the construction of Lunar Orbital Plat- form-Gateway and manned Mars missions will be within reach in the upcoming years. An emergency evacuation will not be feasible, thus the crew must handle a lot of possible medical events, presumably without a physician onboard. Including emergencies with a need for airway secure and general anesthesia, recent data shows, that using supraglottic airway is the method of choice in microgravity. If endo- tracheal intubation is necessary, the usage of videolaryngoscopy is recommended, due to the swelling caused by cardiovascular changes under influence of microgravity. Whenever possible, the patient should be restrained on a stretcher, while securing the airway.

Key words

airway management - space - aerospace - microgravity - weightlessness


Publication History

Article published online:
05 November 2021

© 2021. Thieme. All rights reserved.

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