Weaning - Mehr als nur Beatmung beenden

Zusammenfassung

Maschinelle Beatmung ist ein essentieller Bestandteil der modernen Intensivtherapie. Sie kommt bei Patienten mit akuter respiratorischer Insuffizienz zum Einsatz und hat – je nach Art des respiratorischen Versagens – unterschiedliche Einsatzformen. Vor allem die invasive maschinelle Beatmung sollte so rasch wie möglich beendet werden, um dessen Risiken zu vermeiden.

Der überwiegende Anteil beatmeter Patienten kann nach kurzfristiger Behandlungsdauer unproblematisch von der Beatmung entwöhnt werden. Bei etwa 20% aller beatmeten Patienten kann jedoch ein äußerst protrahierter und komplexer Entwöhnungsprozess beobachtet werden, auch wenn die zur Beatmung geführte Ursache längst behoben ist. Neben dem einzelnen Vorgang des Trennens vom Beatmungsgerät werden in diesem Artikel insbesondere die pathophysiologischen Vorgänge, die zum prolongierten Weaning führen, adressiert.

Abstract

Mechanical ventilation is an essential part of modern intensive care. It is used in patients with acute respiratory failure and, depending on the type of respiratory failure, different modes of application. In particular, invasive mechanical ventilation should be terminated as raidly as possible to avoid the associated risks.

The major proportion of ventilated patients can be weaned from mechanical ventilation without problems after a short treatment period. In about 20% of ventilated patients, however, an extremely protracted and complex weaning process can be observed, even though the cause necessitating ventilation has long since been eliminated. In addition to the stages in the process of weaning from the ventilator, in particular the pathophysiological processes that lead to prolonged weaning are addressed in this article.

Schlüsselwörter:

Weaning - maschinelle Beatmung - Intensivtherapie - akute respiratorische Insuffizienz

Keywords:

mechanical ventilation - weaning - modern intensive care - acute respiratory failure

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