Atemwegsmanagement in der Intensivmedizin – Schritt für Schritt

Der standardisierte Ablauf der Intubation von Intensivpatienten reduziert lebensbedrohliche Komplikationen im Rahmen der Atemwegssicherung – insbesondere beim schwierigen Atemweg. Definierte Abläufe sowie festgelegte und trainierte „Airway Tools“ geben dem durchführenden Team Sicherheit und führen zu Routine und Patientensicherheit.

Schlüsselwörter

Atemwegsmanagement - Beatmungstherapie - Intubation - schwieriger Atemweg - Laryngoskopie - Videolaryngoskopie

Publication History

Article published online:
19 February 2021

• Literatur

• 1 Higgs A, McGrath BA, Goddard C. et al. Guidelines for the management of tracheal intubation in critically ill adults. Brit J Anaesth 2018; 120: 323-352 doi:10.1016/j.bja.2017.10.021
• 2 Jaber S, Amraoui J, Lefrant J-Y. et al. Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Crit Care Med 2006; 34: 2355-2361 doi:10.1097/01.CCM.0000233879.58720.87
• 3 Nolan JP, Kelly FE. Airway challenges in critical care. Anaesthesia 2011; 66 (Suppl. 02) 81-92 doi:10.1111/j.1365-2044.2011.06937.x
• 4 Sherren PB, Tricklebank S, Glover G. Development of a standard operating procedure and checklist for rapid sequence induction in the critically ill. Scand J Trauma Resusc Emerg Med 2014; 22: 41 doi:10.1186/s13049-014-0041-7
• 5 Jaber S, Jung B, Corne P. et al. An intervention to decrease complications related to endotracheal intubation in the intensive care unit: a prospective, multiple-center study. Intensive Care Med 2010; 36: 248-255 doi:10.1007/s00134-009-1717-8
• 6 Buis ML, Maissan IM. Hoeks. et al. Defining the learning curve for endotracheal intubation using direct laryngoscopy: A systematic review. Ireland. Resuscitation 2016; 99: 63-71 doi:10.1016/j.resuscitation.2015.11.005
• 7 Piepho T, Cavus E, Noppens R. et al. S1-Leitlinie Atemwegsmanagement. Anaesthesist 2015; 64: 859-873 doi:10.1007/s00101-015-0087-6
• 8 Timmermann A, Böttiger BW, Byhahn C. et al. S1-Leitlinie: Prähospitales Atemwegsmanagement. Anästh Intensivmed 2019; 60: 316-336 doi:10.19224/ai2019.316
• 9 Jiang J, Ma D-X, Li B. et al. Videolaryngoscopy versus fiberoptic bronchoscope for awake intubation – a systematic review and meta-analysis of randomized controlled trials. Ther Clin Risk Manag 2018; 14: 1955-1963 doi:10.2147/TCRM.S172783
• 10 Benumof JL, Dagg R, Benumof R. Critical hemoglobin desaturation will occur before return to an unparalyzed state following 1 mg/kg intravenous succinylcholine. Anesthesiology 1997; 87: 979-982 doi:10.1097/00000542-199710000-00034
• 11 Lewis SR, Butler AR, Parker J. et al. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev 2016; (11) CD011136 DOI: 10.1002/14651858.CD011136.pub2.
• 12 Heuer JF, Crozier TA, Barwing J. et al. Incidence of Difficult Intubation in Intensive Care Patients. Analysis of Contributing Factors. Anaesth Intensive Care 2019; 40: 120-127 doi:10.1177/0310057X1204000113
• 13 Roth D, Pace NL, Lee A. et al. Bedside tests for predicting difficult airways. An abridged Cochrane diagnostic test accuracy systematic review. Anaesthesia 2019; 74: 915-928 doi:10.1111/anae.14608
• 14 Reddy RM, Adke M, Patil P. et al. Comparison of glottic views and intubation times in the supine and 25 degree back-up positions. BMC Anesthesiol 2016; 16: 836 doi:10.1186/s12871-016-0280-4
• 15 Collins JS, Lemmens HJ, Brodsky JB. et al. Laryngoscopy and morbid obesity. A comparison of the “sniff” and “ramped” positions. Obes Surg 2004; 14: 1171-1175 doi:10.1381/0960892042386869
• 16 Guitton C, Ehrmann S, Volteau C. et al. Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient: a randomized clinical trial. Intensive Care Med 2019; 45: 447-458 doi:10.1007/s00134-019-05529-w
• 17 Perbet S, Jong A de Delmas J. et al. Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: A multicenter observational study. Crit Care 2015; 19: 257 doi:10.1186/s13054-015-0975-9
• 18 Tran DTT, Newton EK, Mount VAH. et al. Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database Syst Rev 2015; (08) 376 doi:10.1002/14651858.CD002788.pub3
• 19 Takahata O, Kubota M, Mamiya K. et al. The Efficacy of the “BURP” maneuver during a difficult laryngoscopy. Anesthes Analg 1997; 84: 419-421 doi:10.1097/00000539-199702000-00033
• 20 Langeron O, Masso E, Huraux C. et al. Prediction of difficult mask ventilation. Anesthesiology 2000; 92: 1229-1236 doi:10.1097/00000542-200005000-00009
• 21 Warters RD, Szabo TA, Spinale FG. et al. The effect of neuromuscular blockade on mask ventilation. Anaesthesia 2011; 66: 163-167 doi:10.1111/j.1365-2044.2010.06601.x
• 22 Lotz G. Atemwegsmanagement – Vergleich verschiedener Leitlinien zum Management des schwierigen Atemwegs. Anasthesiol Intensivmed Notfallmed Schmerzther 2016; 51: 244-252 doi:10.1055/s-0041-103155
• 23 Miller RL, Cole RP. Association between reduced cuff leak volume and postextubation stridor. Chest 1996; 110: 1035-1040 doi:10.1378/chest.110.4.1035