PaCO2 als Parameter zur Steuerung der Beatmung

DIETER KÖHLER; DOMINIC DELLWEG

doi:10.1055/s-0038-1626176

Schlaf, Table of Contents

Schlaf 2017; 06(03): 152-156
DOI: 10.1055/s-0038-1626176

Review

Schattauer GmbH

PaCO₂ als Parameter zur Steuerung der Beatmung

Primäre oder sekundäre Größe?

Authors

DIETER KÖHLER

¹ehem. ärztlicher Direktor Krankenhaus Kloster Grafschaft Winkhausen Auf dem Kamp 11 57392 Schmallenberg, Email: hdieter.koehler@t-online.de
DOMINIC DELLWEG

²Fachkrankenhaus Kloster Grafschaft GmbH Annostr. 1 57392 Schmallenberg, Email: d.dellweg@fkkg.de

Abstract

Eine Hyperkapnie wird praktisch immer durch eine Minderbeatmung (Hypoventilation) im Vergleich zum Bedarf verursacht. Ursache ist zu über 95 % eine über den physiologischen Grenzwert hinaus belastete Atempumpe. Dabei ist in fast allen Fällen diese Hypoventilation ein sinnvoller Mechanismus, um ein lebensbedrohliches Versagen der Atempumpe zu verhindern. Die primäre Zielgröße zur klinischen Bewertung der Hyperkapnie ist der Sauerstoffverbrauch der Atemmuskulatur (oxygen cost of breathing, OCB). Anhand der Langzeitsauerstofftherapie (LTOT) und der nicht invasiven Beatmung (NIV) wird gezeigt, dass jeweils die OCB reduziert wird wobei sich bei der LTOT die Hyperkapnie erhöht und bei der NIV vermindert.

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References

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