Steuerung der Intensivtherapie bei Neugeborenen mit schwerer Asphyxie

Die Beherrschung der Asphyxie von Neugeborenen erfordert einen kritischen Einsatz komplexer intensivmedizinischer Strategien. Eine kontrollierte milde Hypothermie-Behandlung kann bei diesen Patienten die Chance für ein Überleben verbessern und das Risiko neurologischer Schäden reduzieren. Die Hypothermie-Behandlung bei Neugeborenen wird in den Leitlinien der AWMF und des ERC empfohlen [1] [2].

Kernaussagen

• Die Anwendung der milden Hypothermie (33,0–34,0°C) verbessert bei asphyktischen Neugeborenen mit Enzephalopathie die Überlebenswahrscheinlichkeit und die Chance des schadensfreien Überlebens.

• Die Hypothermie-Behandlung wird bei Neugeborenen anhand von Leitlinien der AWMF und des ERC empfohlen.

• Die Indikation zur therapeutischen Hypothermie ergibt sich durch das Vorliegen einer Enzephalopathie.

• Das Deutsche Hypothermie-Register hat sich zum Ziel gesetzt, die Therapie deutschlandweit zu standardisieren. Dabei decken sich die dort genannten Einschlusskriterien mit der aktuellen AWMF-Empfehlung.

• Der Behandlungserfolg hängt neben einer klaren Indikationsstellung und raschen Einleitung der Kühlung auch von der Steuerung der neonatologischen Intensivtherapie ab, welche auf die Stabilisierung der Herz-Kreislauf-Regulation und die Kompensation von Organfehlfunktionen abzielt.

• Eine adäquate Schmerztherapie ist unverzichtbar.

• Fehlfunktionen einzelner Organsysteme können als Folge der Asphyxie, aber teilweise auch als Nebenwirkung der Kühlung entstehen.

Schlüsselwörter

Asphyxie - Neugeborene - Beatmung - Schmerztherapie - therapeutische Hypothermie - Kühltherapie - Krampfanfälle - Nierenversagen

Publikationsverlauf

Artikel online veröffentlicht:
02. Dezember 2025

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