Das Leitsymptome „Akute Dyspnoe“ und die ursächlich zugrunde liegenden Erkrankungen weisen ein hohes Risikopotenzial für einen ungünstigen Behandlungsverlauf mit einer hohen Letalität auf. Diese Übersicht über mögliche Ursachen, diagnostisches Vorgehen und leitliniengerechte Therapie soll dazu beitragen, eine zielgerichtete und strukturierte notfallmedizinische Versorgung in der Notaufnahme umzusetzen.
Abstract
Acute dyspnea The leading symptom “acute dyspnea” and the causal underlying diseases have a high risk potential for an unfavorable course of treatment with a high letality. This overview of possible causes, diagnostic procedures and guideline-based therapy is intended to help implement a targeted and structured emergency medical care in the emergency department. The leading symptom “acute dyspnea” is present in 10% of prehospital and 4–7% of patients in the emergency department. The most common conditions in the emergency department with the leading symptom “acute dyspnea” are heart failure in 25%, COPD in 15%, pneumonia in 13%, respiratory disorders in 8%, and pulmonary embolism in 4%. In 18% of cases, the leading symptom “acute dyspnea” is sepsis. The in-hospital letality is high and amounts to 9%. In critically ill patients in the non-traumatologic resuscitation room, respiratory disorders (B-problems) are present in 26–29%. In addition to cardiovascular disease, noncardiovascular disease may underlie “acute dyspnea” and requires differential diagnostic consideration. A structured approach can contribute to a high degree of certainty in the clarification of the leading symptom “acute dyspnea”.
Schlüsselwörter
Akute Luftnot - Dyspnoe - Beatmung - Notaufnahme - Behandlungspfad - Respiratory Care Unit
Keywords
acute dyspnea - ventilation - emergency department - Respiratory Care Unit - treatment pathway - outcome
