Aerosoltherapie auf Intensivstation

Zusammenfassung

Die Inhalationstherapie stellt v. a. bei pneumologischen Grund- oder Begleiterkrankungen sowohl bei invasiver als auch nichtinvasiver Beatmung häufig einen Eckpfeiler der Therapie dar, überwiegend in Form einer antiobstruktiven Therapie bei Asthma und COPD. Daneben wird im pädiatrischen Bereich beim respiratorischen Versagen infolge Frühgeburtlichkeit häufig Surfactant vernebelt. Weitere Medikamente sind inhalativ verabreichte Antibiotika, Sekretolytika sowie Substanzen zur Senkung des Pulmonalisdrucks. Der vorliegende Artikel fokussiert auf die Erwachsenen-Medizin und gibt Empfehlungen für eine korrekte Durchführung der Inhalationstherapie sowohl bei invasiver als auch nichtinvasiver Beatmung auf der Intensivstation. Ebenso werden Aspekte der Sicherheit von Patient und Personal während der Inhalationsphasen im Zusammenhang mit der aktuellen Corona-Epidemie besprochen.

Abstract

Inhalation therapy is a cornerstone especially in pulmonary diseases or comorbidities, either in invasive or noninvasive mechanical ventilation. In pediatric patients, mainly in respiratory failure of the premature born child inhalation of surfactant is crucial in the therapy. Additional drugs given by inhalation are antibiotics, mucoactive substances and drugs that treat pulmonary hypertension. This article describes main deposition mechanisms of inhalation therapies and presents recommendations for correct performance of inhalation therapy in invasively as well as noninvasively ventilated patients in ICU. Also safety aspects for patients and medical staff during aerosol therapy in the Corona pandemic era are discussed.

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