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DOI: 10.1055/a-2271-4113
Nicht invasive Beatmung und High-Flow-Therapie: Lebensretter nicht nur bei COPD
Die nicht invasive Beatmung (NIV) und die nasale High-Flow-Therapie (HFNC) sind aus dem Instrumentarium der Intensiv- und Notfallmedizin nicht mehr wegzudenken. Richtig angewendet, können sie dem Patienten mit respiratorischer Insuffizienz eine Intubation ersparen und seine Prognose entscheidend verbessern.
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Um die Vorteile der nicht invasiven Beatmung (NIV) voll ausschöpfen zu können, ist neben der richtigen Indikationsstellung die individuelle Anpassung des Verfahrens an den Patienten und sein Krankheitsbild entscheidend.
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Essenziell sind die Auswahl und Anpassung des Interfaces sowie die differenzierte Einstellung der Beatmungsparameter.
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Die Beatmung mit High-Flow-Nasenkanüle (HFNC) bietet im hypoxisch bedingten Versagen eine wertvolle Alternative zur NIV; im hyperkapnischen Versagen kann sie die NIV oft sinnvoll ergänzen, z. B. in NIV-Pausen.
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Beide Verfahren erfordern eine engmaschige Überprüfung des Therapieerfolgs.
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Bei Therapieversagen ist eine rechtzeitige Intubation indiziert (s. hierzu auch [Abb. 3]).
Publikationsverlauf
Artikel online veröffentlicht:
04. Juni 2024
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