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Intensivmedizin up2date 2024; 20(01): 25-43
DOI: 10.1055/a-2149-8576
Allgemeine Intensivmedizin

Beatmungsstrategien in der Intensivmedizin

Carolin Jung
,
Peter Markus Spieth
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Beatmung ist eine lebensrettende Maßnahme zur Sicherstellung eines suffizienten pulmonalen Gasaustauschs sowie zur Entlastung des respiratorischen Systems, kann jedoch auch eine Schädigung der Lunge bewirken. Ein fundiertes physiologisches Verständnis sowie Kenntnisse der Beatmungstechnik sind notwendig, um eine differenzierte Lungenunterstützung anwenden zu können. Im Folgenden wird ein Überblick evidenzbasierter Therapieverfahren bei der akuten respiratorischen Insuffizienz gegeben.
Kernaussagen

  • Beatmung ist das wichtigste Organersatzverfahren in der Intensivmedizin.

  • Das Verständnis grundlegender Beatmungskonzepte ist wichtiger als die Anwendung spezifischer Beatmungsmodi.

  • Eine lungenprotektive Beatmung sollte sich an niedrigen Tidalvolumina und niedrigen Atemwegsdrücken orientieren.

  • Die Bauchlagerung ist eine der wenigen Therapien, die mit hohem Evidenzgrad die Letalität bei Patient*innen mit moderatem bis schwerem ARDS (Acute Respiratory Distress Syndrome) reduziert.

  • Die Therapie von Patienten mit therapierefraktären Störungen des Gasaustauschs sollte in spezialisierten ARDS-Zentren erfolgen.

Schlüsselwörter

Beatmung - Intensivmedizin - ARDS - akutes Lungenversagen


Publication History

Article published online:
22 March 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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