High-Flow-Sauerstofftherapie in der Intensivmedizin

Ließ sich bei der Therapie der respiratorischen Insuffizienz durch Nasenbrillen oder Mund-Nasen-Masken keine ausreichende Oxygenierung erzielen, waren über lange Zeit als Eskalation nur die nicht-invasive und die invasive Beatmung verfügbar. Das Repertoire ist nun ergänzt durch die speziellen Systeme der High-Flow-Sauerstofftherapie – high-flow nasal cannula (HFNC) oder nasaler High-Flow (NHF) –, die zunehmend, insbesondere auf Intensivstationen, eingesetzt werden.

Kernaussagen

• Die physiologischen Effekte der High-Flow-Sauerstofftherapie (HFNC) gehen über die alleinige Erhöhung der inspiratorischen Sauerstofffraktion hinaus.

• Die Anwendung der HFNC bei Patienten mit respiratorischer Insuffizienz führt zu einer Verbesserung von Oxygenierung und klinischen Parametern und kann helfen, die Intubation zu vermeiden.

• Die Anwendung der HFNC im Rahmen der Intubation erlaubt die Fortsetzung der Sauerstoffgabe auch während des eigentlichen Intubationsvorgangs in Apnoe und kann damit zur Verbesserung der Oxygenierung während der Intubation beitragen.

• Die HFNC kann in der Phase nach der Extubation bei respiratorischen Komplikationen und zu deren Prävention angewendet werden.

Schlüsselwörter

Beatmung - Dyspnoe - respiratorische Insuffizienz - Hypoxämie

• Literatur

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