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Intensivmedizin up2date 2014; 10(02): 117-128
DOI: 10.1055/s-0034-1365160
Allgemeine Prinzipien der Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Prävention der beatmungsassoziierten Pneumonie[*]

Karl Lewalter
,
Sebastian Lemmen
,
Simone Scheithauer
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Publication History

Publication Date:
20 March 2014 (online)

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Kernaussagen

  • Die beatmungsassoziierte Pneumonie (VAP) ist die häufigste nosokomiale Infektion auf Intensivstationen und von großer medizinischer und ökonomischer Relevanz.

  • Als wesentlicher Pathomechanismus gilt die Mikroaspiration. Übersedierung, unnötige Beatmung und die Vernachlässigung krankenhaushygienischer Präventionsmaßnahmen sind die wesentlichen Ursachen für die VAP.

  • Zur Vermeidung der VAP stehen viele Interventionsmöglichkeiten mit unterschiedlicher Evidenz zur Verfügung.

  • Besonders bewährt hat sich die Einführung einiger ausgewählter, evidenzbasierter Maßnahmen als Bündel.

  • Bleibt trotz Ausschöpfung aller Basismaßnahmen die VAP-Rate hoch, kann man weitere Maßnahmen erwägen, wie z. B. subglottische Sekretabsaugung oder SOD bzw. SDD.

  • Den Erfolg infektionspräventiver Maßnahmen sollte man durch die Teilnahme an Surveillanceprogrammen überprüfen (z. B. KISS).

* Die Erstpublikation dieses Beitrags erschien in Krankenh hyg up2date 2012; 7 (4): 275–289. DOI: 10.1055/s-0032-1325954


Die Literatur zu diesem Beitrag finden Sie unter http://dx.doi.org/10.1055/s-0034-1365160.

 

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