Transition von langzeitbeatmeten Kindern in die Erwachsenenmedizin

Zusammenfassung

Durch die Fortschritte in der Langzeitbeatmung erreichen heutzutage viele Kinder mit chronisch respiratorischer Insuffizienz das Erwachsenenalter. Die medizinische Betreuung dieser Kinder muss deshalb von den Kinderärzten:innen zu den Erwachsenenärzten:innen übergehen. Dieser Prozess heißt „Transition“. Die Transition in die Erwachsenenmedizin dient v.a. der Förderung der Autonomie der heranwachsenden Jugendlichen und trägt den mit zunehmendem Alter eintretenden Änderung der Krankheitsbilder und der auftretenden Koerkrankungen Rechnung. Transition schafft aber auch Verunsicherung bei den Patienten und deren Eltern. Sie birgt die Gefahr des Verlustes des „Medical Home“ und sogar den Verlust der vollständigen medizinischen Versorgung. Gute strukturelle Voraussetzungen zur Bewältigung sind notwendig, genauso wie professionelle Vorbereitung der Patienten auf die Transition, durch Coaching der Patienten während der Umsetzung der Transition sowie eine formalisierte strukturierte Übergabe zwischen den Behandler:innen. Dieser Artikel zeigt auf, wie gute Transition funktionieren kann mit dem Fokus auf langzeitbeatmete Kinder.

Abstract

Through advances in long-term ventilation, the number of children with chronic respiratory insufficiency reaching adult age has increased tremendously. Therefore, transition of children from pediatric to adult care has become inevitable. Transition is necessary for medicolegal reasons, to increase autonomy of the young patients and because of change in the disease as a result of increasing age. Transition bears the risks of uncertainty of patients and parents, loss of the medical home or even loss of complete medical care. Good structural conditions, professional preparation of patient and parents, a comprehensive formalized transfer and patient coaching are prerequisites for a successful professional transition. This article discusses issues of transition with focus on long-term ventilated children.

Schlüsselwörter

Langzeitbeatmung - außerklinische Beatmung - Kinder - Transition - neuromuskuläre Erkrankungen

Keywords

long term ventilation - home mechanical ventilation - children - transition - neuromuscular diseases

Publication History

Received: 26 January 2023

Accepted after revision: 03 April 2023

Article published online:
09 June 2023

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