Invasive Beatmung

Zusammenfassung

Auf dem Gebiet der Beatmungsmedizin hat sich den letzten Jahren eine Paradigmenwechsel vollzogen. Insbesondere die wissenschaftlichen und klinischen Erkenntnisse, dass aggressive Beatmung per se eine weitere Schädigung der Lunge bewirken kann, haben zu dem Konzept der protektiven Beatmung geführt. Alle dazugehörigen Maßnahmen sind darauf ausgerichtet, eine möglichst schonende Beatmung durchzuführen. Diese Techniken wie die Anwendung von kleinen Atemzugvolumina oder die Applikation eines höheren positiven endexspiratorischen Drucks (PEEP) sowie frühzeitige Spontanatmung sind inzwischen hinreichend wissenschaftlich überprüft und klinisch etabliert. Die Beatmung von Patienten mit einer akuten Schädigung der Lunge ist eine notwendige, aber invasive therapeutische Maßnahme, die für jeden Patienten ein strukturiertes und klares Beatmungskonzept erfordert.

Summary

In the field of artificial ventilation a paradigm shift occurred within the last years. In particular the scientific and clinical cognitions that aggressive ventilation itself may cause a progressive lung damage yielded the concept of protective-ventilation. Protective-ventilation includes a variety of strategies aiming for limitation of ventilator associated lung damage. These strategies such as the application of small tidal volumes, use of higher PEEP as well as early switch to the spontaneous ventilation mode are meanwhile scientifically proven and clinically established. Artificial ventilation of patients with acute respiratory distress is a mandatory, but invasive therapy that requires for each individual patient a structured and definite ventilation strategy.

Schlüsselwörter

invasive Beatmung - ARDS - protektive Beatmung - Hoch-Frequenz-Oszillations-Ventilation

Key words

invasive ventilation - ARDS - protective ventilation - high-frequency-oscillation-ventilation

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