Abstract
Invasive mechanical ventilation can be terminated by immediate (palliative) extubation
or by gradual reduction of ventilation with the ventilation access left open (terminal
weaning). Both procedures are ethically equivalent and can be performed in everyday
life, so that individual patient factors and the experience of the treatment team
are decisive. However, the primary goal is to ensure that the patient and relatives
do not suffer. This article presents step by step which aspects are relevant: communication,
adjust or stop monitoring, selection and implementation of the appropriate procedure,
preparatory measures, recognition and treatment of distressing symptoms by means of
drug or non-drug therapy options and last but not least accurate documentation.
Eine invasive mechanische Beatmung kann beendet werden durch sofortige (palliative)
Extubation oder durch schrittweise Reduktion der Beatmung mit Belassen des Beatmungszugangs
(terminales Weaning). Beide Verfahren sind ethisch gleichwertig und im Alltag durchführbar,
sodass individuelle Patientenfaktoren und die Erfahrung des Behandlungsteams ausschlaggebend
sind. Im Vordergrund steht immer das Ziel: Patient und Angehörige sollen nicht leiden.
Schlüsselwörter
palliative Extubation - terminales Weaning - Palliative Care - Management am Lebensende
- Intensivmedizin
Key words
palliative extubation - terminal weaning - palliative care - end-of-life management
- intensive care medicine
