ARDS – Ein Update – Teil 2: Therapie und Outcome

Rolf Dembinski; Frank Mielck

doi:10.1055/s-0043-122136

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Inhaltsverzeichnis

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53(02): 112-125
DOI: 10.1055/s-0043-122136

Topthema

CME-Fortbildung

Georg Thieme Verlag KG Stuttgart · New York

ARDS – Ein Update – Teil 2: Therapie und Outcome

ARDS – An Update – Part 2: Therapy and Outcome

Rolf Dembinski

,

Frank Mielck

Abstract

Zusammenfassung

Das Acute respiratory Distress Syndrome (ARDS) ist nunmehr seit über 50 Jahren als gravierende Komplikation verschiedener Grunderkrankungen bekannt [1]. Trotz intensiver Forschung in all dieser Zeit gibt es hinsichtlich der bestmöglichen Therapie des ARDS auch heute noch viele offene Fragen – insbesondere zur maschinellen Beatmung. Der zweite Teil des Update ARDS gibt einen aktualisierten Überblick zu Therapie und Outcome des ARDS.

Abstract

The Acute Respiratory Distress Syndrome (ARDS) is defined by hypoxemic respiratory failure due to inflammatory response within the lung usually requiring invasive mechanical ventilation. Despite more than 50 years of scientific research numerous issues especially regarding mechanical ventilation as the most important treatment option remain unclear. Most important, adjustment of mechanical ventilation is challenging due to desirable beneficial effects on pulmonary gas exchange on the one hand and deleterious effects in terms of ventilator-associated lung injury on the other. Specifically, optimal settings of positive end-expiratory pressure and the role of spontaneous breathing activity are still controversial. Because no specific pharmacological therapy revealed beneficial effects until today, adjunctive treatment is actually limited to prone positioning and restrictive fluid balance. Long-term outcome of ARDS survivors is often affected by anxiety and mental health disorders.

Schlüsselwörter

akute respiratorische Insuffizienz - maschinelle Beatmung - beatmungsinduzierte Lungenschädigung - Langzeit-Outcome

Key words

acute respiratory failure - mechanical ventilation - ventilator-induced lung injury - long-term outcome

Volltext

Referenzen

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