Zusammenfassung
Die Sauerstoffreserven bei kleinen Kindern sind klein, da einem hohen Sauerstoffverbrauch
eine geringe Transportkapazität gegenübersteht. Respiratorische Komplikationen sind
bei sonst gesunden Kindern die häufigste anästhesieassoziierte Ursache für Komplikationen.
Während der vergangenen Jahre hat das Wissen über die Auswirkungen verschiedener künstlicher
Atemwege auf die Atemwege von Kindern stark zugenommen. Moderne Anästhesiekonzepte
inkludieren neben der Spontanatmung auch den Gebrauch von Tuben mit Cuff.
Abstract
The oxygen reserves of infants are low because of high oxygen demand in combination
with low transport capacity. Respiratory adverse events are one of the major causes
of morbidity and mortality during paediatric anaesthesia. During the last years our
knowledge has grown substantially about the influence of artificial airways on the
airway of paediatric patients. Modern anaesthetic concepts in infants and children
include the use of cuffed tubes as well as a spontaneous breathing child.
Schlüsselwörter:
Kinderanästhesie - Beatmung - Luftwegsmanagement
Keywords:
paediatric anaesthesia - ventilation - airway management
Kernaussagen
-
Viele anatomische und physiologische Parameter hängen nicht vom Alter ab.
-
Das Risiko von Komplikationen wird unter anderem durch die Erfahrung des Anästhesisten
und die Art des operativen Eingriffs bestimmt.
-
Die Sauerstoffreserven von Kindern sind klein.
-
Für Kinder stehen inzwischen alle gängigen künstlichen Atemwege in passender Größe
zur Verfügung - sie alle können sinnvoll genutzt werden.
-
Der Microcuff®-Tubus ist eine gute Alternative zu herkömmlichen Tuben mit Cuff.
-
Moderne Anästhesiekonzepte erlauben differenzierte Beatmungsmodi inklusive Spontanatmungsverfahren.
-
Die Überwachung der respiratorischen Funktion bei Spontanatmung während Narkosen ist
non-invasiv möglich.
-
Das Tracheobronchialsystem ist bei Kindern sehr reagibel.
-
Mit dem Auftreten respiratorischer Komplikationen ist besonders während des Exzitationsstadiums
zu rechnen.
-
Für die Therapie respiratorischer Komplikationen sind vorausschauende Konzepte, z.B.
in Form fester Therapieschemata, sinnvoll.
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Dr. med. Alexander Reich
Email: reich@anit.uni-muenster.de
