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Neonatologie Scan 2018; 07(03): 195-208
DOI: 10.1055/a-0596-6313
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© Georg Thieme Verlag KG Stuttgart · New York

Nicht-invasive Hochfrequenzbeatmung – physikalische Wirkungsweise und klinische Studien

Dimitra Stavropoulou
,
Roland Hentschel
Subject Editor: Wissenschaftlich verantwortlich gemäß Zertifizierungsbestimmungen für diesen Beitrag ist Dr. med. Dimitra Stavropoulou, Freiburg.
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Publication History

Publication Date:
28 August 2018 (online)

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Das „Respiratory distress syndrome“ (RDS) führt trotz hoher Rate an pränataler Lungenreifung und nicht-invasiver Surfactant-Gabe auch heute oft noch zur Notwendigkeit einer Beatmung. Eine neue Form der nicht-invasiven Beatmung, die zunehmend an Bedeutung gewinnt, ist die nicht-invasive Hochfrequenzoszillation (NHFOV). Ihr wird eine effektivere CO2-Elimination zugeschrieben, sodass sie unter Umständen helfen kann, eine invasive Beatmung zu vermeiden.
Kernaussagen

  • Die nicht-invasive Hochfrequenzoszillationsbeatmung (NHFOV) scheint in Einzelfällen eine sinnvolle zusätzliche Alternative zu den aktuellen nicht-invasiven Beatmungsmethoden zu sein.

  • Eine effektive und oftmals sogar verbesserte CO2-Elimination – im Vergleich zu NCPAP – kann mittels NHFOV erreicht werden.

  • Ob die Oxygenierung durch NHFOV gleichermaßen positiv beeinflusst wird, ist noch unklar.

  • Eventuell kann die Notwendigkeit einer invasiven Beatmung durch NHFOV verringert werden.

  • Es ist unklar, ob eine Re-Intubation bei Frühgeborenen mit chronischen Lungenerkrankungen durch NHFOV vermieden werden kann.

  • Die Sicherheit und Effektivität dieser Beatmungsform muss jedoch noch im Rahmen von multizentrischen, randomisierten Studien genauer untersucht werden, sowohl hinsichtlich des Kurzzeit- als auch des Langzeitoutcomes.

  • Bisher gibt es zu wenige Daten zu Einstellvariablen der Beatmung und unterschiedlichen Interfaces, jeweils in Abhängigkeit von unterschiedlichen Patientengruppen und Erkrankungen.

Schlüsselwörter

nicht-invasive Hochfrequenzoszillationsbeatmung - NHFOV - Atemnotsyndrom - RDS - nicht-invasive Beatmung
 

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