Technische Aspekte und Neuerungen in der nicht-invasiven und invasiven Beatmung

Zusammenfassung

Nicht-invasive und invasive Beatmung sind für die Therapie bei akuter und chronischer respiratorischer Insuffizienz unerlässlich geworden. Mehr als ein Drittel der Patienten auf Intensivstationen wird invasiv beatmet, und auch in der außerklinischen Beatmung nimmt die Zahl beatmeter Patienten stetig zu. Während die Normalisierung der Blutgase in vergangenen Jahrzehnten als bedeutsamstes Ziel angesehen wurde und der Gedanke, dass mechanische Beatmung auch Gefahren birgt, kaum eine Rolle spielte, ist der dominierende Gedanke derzeit die Applikation von Beatmung unter möglichst protektiven Gesichtspunkten. Da eine grundlegende Änderung der Gerätetechnik schwierig sein dürfte, wird die Verbesserung protektiver Beatmung und eine Weiterentwicklung des Verständnisses der pathophysiologischen Vorgänge bei akutem und chronischem Lungenversagen auch in der Zukunft eine große Bedeutung haben. Der Artikel fasst unterschiedliche Aspekte der technischen Grundlagen der nicht-invasiven und invasiven Beatmung und deren praktische Umsetzung zusammen.

Abstract

Non-invasive and invasive ventilation have become essential for therapy in acute and chronic respiratory failure. More than one-third of patients in intensive care units receive invasive ventilation, and the number of ventilated patients in out-of-hospital care is also steadily increasing. While normalization of blood gases was considered the most significant goal in past decades, and the idea that mechanical ventilation also poses dangers played little role, the dominant thought at present is the application of ventilation from the most protective point of view possible. Because fundamental change in equipment technology is likely to be difficult, improvement of protective ventilation and further development of understanding of pathophysiologic processes in acute and chronic respiratory failure will continue to be of great importance in the future. This article summarizes different aspects of the technical basis of noninvasive and invasive ventilation and their practical implementation.

Schlüsselwörter

Beatmung - nicht-invasive Beatmung - respiratorische Insuffizienz - invasive Beatmung

Keywords

mechanical ventilation - non-invasive ventilation - respiratory failure - invasive mechanical ventilation

Publikationsverlauf

Eingereicht: 02. September 2023

Angenommen nach Revision: 11. Dezember 2023

Artikel online veröffentlicht:
16. Februar 2024

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