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Künstliche Beatmung

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Neugeborenenintensivmedizin

Zusammenfassung

Die Physiologie der perinatalen respiratorischen Adaptation ist in ◘ Tab. 1.6 (s. S. 11) dargestellt. Auch jenseits der postnatalen Umstellung unterscheidet sich die Atmung des Neugeborenen erheblich von der des Erwachsenen. So können Neugeborene zwar meist durch den Mund atmen, geraten aber bei Obstruktionen der Nase (z. B. Choanalatresie)häufig in schwere Ateminsuffizienz oder obstruktive Apnoen.

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Literatur

  1. Balaguer A, Escribano J, Roque M (2003) Infant position in neonates receiving mechanical ventilation. Cochrane Database Syst Rev:CD003668

    Google Scholar 

  2. Balaguer A, Escribano J, Roque M (2006) Infant position in neonates receiving mechanical ventilation. Cochrane Database Syst Rev:CD003668

    Google Scholar 

  3. Bancalari E (1986) Inadvertent positive end-expiratory pressure during mechanical ventilation. J Pediatr 108:567–9

    Article  PubMed  CAS  Google Scholar 

  4. Bernstein G, Mannino FL, Heldt GP, Callahan JD, Bull DH, Sola A, Ariagno RL, Hoffman GL, Frantz ID 3rd, Troche BI, Roberts JL, Dela Cruz TV, Costa E (1996) Randomized multicenter trial comparing synchronized and conventional intermittent mandatory ventilation in neonates. J Pediatr 128:453–63

    Article  PubMed  CAS  Google Scholar 

  5. Bhuta T, Henderson-Smart DJ (2000) Rescue high frequency oscillatory ventilation versus conventional ventilation for pulmonary dysfunction in preterm infants. Cochrane Database Syst Rev:CD000438

    Google Scholar 

  6. Carbajal R, Eble B, Anand KJ (2007) Premedication for tracheal intubation in neonates: confusion or controversy? Semin Perinatol 31:309–17

    Article  PubMed  Google Scholar 

  7. Chan V, Greenough A (1993) Randomised controlled trial of weaning by patient triggered ventilation or conventional ventilation. Eur J Pediatr 152:51–4

    Article  PubMed  CAS  Google Scholar 

  8. Choong K, AlFaleh K, Doucette J, Gray S, Rich B, Verhey L, Paes B (2010) Remifentanil for endotracheal intubation in neonates: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 95:F80–4

    Article  PubMed  CAS  Google Scholar 

  9. Cignacco E, Hamers JP, van Lingen RA, Zimmermann LJ, Muller R, Gessler P, Nelle M (2008) Pain relief in ventilated preterms during endotracheal suctioning: a randomized controlled trial. Swiss Med Wkly 138:635–45

    PubMed  Google Scholar 

  10. Claure N, D’Ugard C, Bancalari E (2003) Elimination of ventilator dead space during synchronized ventilation in premature infants. J Pediatr 143:315–20

    Article  PubMed  Google Scholar 

  11. Collins MP, Lorenz JM, Jetton JR, Paneth N (2001) Hypocapnia and other ventilation-related risk factors for cerebral palsy in low birth weight infants. Pediatr Res 50:712–9

    Article  PubMed  CAS  Google Scholar 

  12. Cools F, Askie LM, Offringa M, Asselin JM, Calvert SA, Courtney SE, Dani C, Durand DJ, Gerstmann DR, Henderson-Smart DJ, Marlow N, Peacock JL, Pillow JJ, Soll RF, Thome UH, Truffert P, Schreiber MD, Van Reempts P, Vendettuoli V, Vento G (2010) Elective high-frequency oscillatory versus conventional ventilation in preterm infants: a systematic review and meta-analysis of individual patients’ data. Lancet 375:2082–91

    Article  PubMed  Google Scholar 

  13. Cools F, Henderson-Smart DJ, Offringa M, Askie LM (2009) Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants. Cochrane Database Syst Rev:CD000104

    Google Scholar 

  14. Davies MW, Davis PG (2002) Nebulized racemic epinephrine for extubation of newborn infants. Cochrane Database Syst Rev:CD000506

    Google Scholar 

  15. Davis PG, Henderson-Smart DJ (2000) Intravenous dexamethasone for extubation of newborn infants. Cochrane Database Syst Rev:CD000308

    Google Scholar 

  16. Davis PG, Henderson-Smart DJ (2003) Nasal continuous positive airways pressure immediately after extubation for preventing morbidity in preterm infants. Cochrane Database Syst Rev:CD000143

    Google Scholar 

  17. Davis PG, Lemyre B, de Paoli AG (2001) Nasal intermittent positive pressure ventilation (NIPV) versus nasal continuous positive airway pressure (NCPAP ) for preterm neonates after extubation. Cochrane Database Syst Rev:CD003212

    Google Scholar 

  18. Dempsey EM, Al Hazzani F, Faucher D, Barrington KJ (2006) Facilitation of neonatal endotracheal intubation with mivacurium and fentanyl in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed 91:F279–82

    Article  PubMed  CAS  Google Scholar 

  19. De Paoli AG, Davis PG, Faber B, Morley CJ (2008) Devices and pressure sources for administration of nasal continuous positive airway pressure (NCPAP ) in preterm neonates. Cochrane Database Syst Rev:CD002977

    Google Scholar 

  20. De Winter JP, de Vries MA, Zimmermann LJ (2010) Clinical practice: noninvasive respiratory support in newborns. Eur J Pediatr 169:777–82

    Article  PubMed  Google Scholar 

  21. Figueras J, Rodriguez-Miguelez JM, Botet F, Thio M, Jimenez R (1997) Changes in TcPCO2 regarding pulmonary mechanics due to pneumotachometer dead space in ventilated newborns. J Perinat Med 25:333–9

    Article  PubMed  CAS  Google Scholar 

  22. Finer NN, Carlo WA, Walsh MC, Rich W, Gantz MG, Laptook AR, Yoder BA, Faix RG, Das A, Poole WK, Donovan EF, Newman NS, Ambalavanan N, Frantz ID 3rd, Buchter S, Sanchez PJ, Kennedy KA, Laroia N, Poindexter BB, Cotten CM, Van Meurs KP, Duara S, Narendran V, Sood BG, O’Shea TM, Bell EF, Bhandari V, Watterberg KL, Higgins RD (2010) Early CPAP versus surfactant in extremely preterm infants. N Engl J Med 362:1970–9

    Article  PubMed  CAS  Google Scholar 

  23. Flenady VJ, Gray PH (2002) Chest physiotherapy for preventing morbidity in babies being extubated from mechanical ventilation. Cochrane Database Syst Rev:CD000283

    Google Scholar 

  24. Gemeinsamer Bundesausschuss (2005) Vereinbarung über Maßnahmen zur Qualitätssicherung der Versorgung von Früh- und Neugeborenen. Dtsch Arztebl 11:519–21

    Google Scholar 

  25. Gerstmann DR, Minton SD, Stoddard RA, Meredith KS, Monaco F, Bertrand JM, Battisti O, Langhendries JP, Francois A, Clark RH (1996) The Provo multicenter early high-frequency oscillatory ventilation trial: improved pulmonary and clinical outcome in respiratory distress syndrome. Pediatrics 98:1044–57

    PubMed  CAS  Google Scholar 

  26. Gittermann MK, Fusch C, Gittermann AR, Regazzoni BM, Moessinger AC (1997) Early nasal continuous positive airway pressure treatment reduces the need for intubation in very low birth weight infants. Eur J Pediatr 156:384–8

    Article  PubMed  CAS  Google Scholar 

  27. Greenough A, Sharma A (2005) Optimal strategies for newborn ventilation – a synthesis of the evidence. Early Hum Dev 81:957–64

    Article  PubMed  Google Scholar 

  28. Greenough A, Dimitriou G, Prendergast M, Milner AD (2008) Synchronized mechanical ventilation for respiratory support in newborn infants. Cochrane Database Syst Rev:CD000456

    Google Scholar 

  29. Grein AJ, Weiner GM (2005) Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation. Cochrane Database Syst Rev:CD003314

    Google Scholar 

  30. Gupta S, Sinha SK, Donn SM (2009) The effect of two levels of pressure support ventilation on tidal volume delivery and minute ventilation in preterm infants. Arch Dis Child Fetal Neonatal Ed 94: F80–3

    Article  PubMed  CAS  Google Scholar 

  31. Gupta S, Sinha SK, Tin W, Donn SM (2009) A randomized controlled trial of postextubation bubble continuous positive airway pressure versus Infant Flow Driver continuous positive airway pressure in preterm infants with respiratory distress syndrome. J Pediatr 154:645–50

    Article  PubMed  Google Scholar 

  32. Harding JE, Miles FK, Becroft DM, Allen BC, Knight DB (1998) Chest physiotherapy may be associated with brain damage in extremely premature infants. J Pediatr 132:440–4

    Article  PubMed  CAS  Google Scholar 

  33. Henderson-Smart DJ, Davis PG (2000) Prophylactic doxapram for the prevention of morbidity and mortality in preterm infants undergoing endotracheal extubation. Cochrane Database Syst Rev:CD001966

    Google Scholar 

  34. Henderson-Smart DJ, Davis PG (2003) Prophylactic methylxanthines for extubation in preterm infants. Cochrane Database Syst Rev:CD000139

    Google Scholar 

  35. Henderson-Smart DJ, De Paoli AG, Clark RH, Bhuta T (2009) High frequency oscillatory ventilation versus conventional ventilation for infants with severe pulmonary dysfunction born at or near term. Cochrane Database Syst Rev:CD002974

    Google Scholar 

  36. Henderson-Smart DJ, Subramaniam P, Davis PG (2001) Continuous positive airway pressure versus theophylline for apnea in preterm infants. Cochrane Database Syst Rev:CD001072

    Google Scholar 

  37. Henderson-Smart DJ, Wilkinson A, Raynes-Greenow CH (2002) Mechanical ventilation for newborn infants with respiratory failure due to pulmonary disease. Cochrane Database Syst Rev:CD002770

    Google Scholar 

  38. HIFI (1989) High-frequency oscillatory ventilation compared with conventional mechanical ventilation in the treatment of respiratory failure in preterm infants. The HIFI Study Group. N Engl J Med 320:88–93

    Article  Google Scholar 

  39. HiFO (1993) Randomized study of high-frequency oscillatory ventilation in infants with severe respiratory distress syndrome. HiFO Study Group. J Pediatr 122:609–19

    Article  Google Scholar 

  40. Ho JJ, Henderson-Smart DJ, Davis PG (2002) Early versus delayed initiation of continuous distending pressure for respiratory distress syndrome in preterm infants. Cochrane Database Syst Rev:CD002975

    Google Scholar 

  41. Ho JJ, Subramaniam P, Henderson-Smart DJ, Davis PG (2002) Continuous distending pressure for respiratory distress syndrome in preterm infants. Cochrane Database Syst Rev:CD002271

    Google Scholar 

  42. Hoellering AB, Copnell B, Dargaville PA, Mills JF, Morley CJ, Tingay DG (2008) Lung volume and cardiorespiratory changes during open and closed endotracheal suction in ventilated newborn infants. Arch Dis Child Fetal Neonatal Ed 93:F436–41

    Article  PubMed  CAS  Google Scholar 

  43. Hough JL, Flenady V, Johnston L, Woodgate PG (2008) Chest physiotherapy for reducing respiratory morbidity in infants requiring ventilatory support. Cochrane Database Syst Rev:CD006445

    Google Scholar 

  44. Johnson AH, Peacock JL, Greenough A, Marlow N, Limb ES, Marston L, Calvert SA (2002) High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity. N Engl J Med 347:633–42

    Article  PubMed  Google Scholar 

  45. Joshi VH, Bhuta T (2006) Rescue high frequency jet ventilation versus conventional ventilation for severe pulmonary dysfunction in preterm infants. Cochrane Database Syst Rev:CD000437

    Google Scholar 

  46. Kamlin CO, Davis PG (2004) Long versus short inspiratory times in neonates receiving mechanical ventilation. Cochrane Database Syst Rev:CD004503

    Google Scholar 

  47. Lemyre B, Cheng R, Gaboury I (2009) Atropine, fentanyl and succinylcholine for non-urgent intubations in newborns. Arch Dis Child Fetal Neonatal Ed 94:F439–42

    Article  PubMed  CAS  Google Scholar 

  48. Lista G, Castoldi F, Bianchi S, Battaglioli M, Cavigioli F, Bosoni MA (2008) Volume guarantee versus high-frequency ventilation: lung inflammation in preterm infants. Arch Dis Child Fetal Neonatal Ed 93:F252–6

    Article  PubMed  CAS  Google Scholar 

  49. Long T, Soderstrom E (1996) A critical appraisal of positioning infants in the neonatal intensive care unit. Phys Occup Ther Pediatr 15:17–32

    Google Scholar 

  50. Mariani G, Cifuentes J, Carlo WA (1999) Randomized trial of permissive hypercapnia in preterm infants. Pediatrics 104:1082–8

    Article  PubMed  CAS  Google Scholar 

  51. McCallion N, Davis PG, Morley CJ (2005) Volume-targeted versus pressure-limited ventilation in the neonate. Cochrane Database Syst Rev:CD003666

    Google Scholar 

  52. Mizuno K, Aizawa M (1999) Effects of body position on blood gases and lung mechanics of infants with chronic lung disease during tube feeding. Pediatr Int 41:609–14

    Article  PubMed  CAS  Google Scholar 

  53. Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB (2008) Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 358:700–8

    Article  PubMed  CAS  Google Scholar 

  54. Morley CJ, Lau R, De Paoli A, Davis PG (2005) Nasal continuous positive airway pressure: does bubbling improve gas exchange? Arch Dis Child Fetal Neonatal Ed 90:F343–4

    Article  PubMed  CAS  Google Scholar 

  55. Muramatsu K, Yukitake K, Oda T (1992) Variability of respiratory system compliance in mechanically ventilated infants. Pediatr Pulmonol 12:140–5

    Article  PubMed  CAS  Google Scholar 

  56. Nolte S (1992) Totraum und Beatmung bei Neugeborenen. Klin Paediatr 204:368–372

    Article  CAS  Google Scholar 

  57. OCTA VE (1991) Multicentre randomised controlled trial of high against low frequency positive pressure ventilation. Oxford Region Controlled Trial of Artificial Ventilation OCTA VE Study Group. Arch Dis Child 66:770–5

    Article  Google Scholar 

  58. Patel DS, Rafferty GF, Lee S, Hannam S, Greenough A (2009) Work of breathing during SIMV with and without pressure support. Arch Dis Child 94:434–6

    Article  PubMed  Google Scholar 

  59. Perrotta C, Ortiz Z, Roque M (2005) Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane Database Syst Rev:CD004873

    Google Scholar 

  60. Pohlandt F, Saule H, Schroder H, Leonhardt A, Hornchen H, Wolff C, Bernsau U, Oppermann HC, Obladen M, Feilen KD (1992) Decreased incidence of extraalveolar air leakage or death prior to air leakage in high versus low rate positive pressure ventilation: results of a randomised seven-centre trial in preterm infants. Eur J Pediatr 151:904–9

    Article  PubMed  CAS  Google Scholar 

  61. Pritchard M, Flenady V, Woodgate P (2001) Preoxygenation for tracheal suctioning in intubated, ventilated newborn infants. Cochrane Database Syst Rev:CD000427

    Google Scholar 

  62. Raval D, Yeh TF, Mora A, Cuevas D, Pyati S, Pildes RS (1987) Chest physiotherapy in preterm infants with RDS in the first 24 hours of life. J Perinatol 7:301–4

    PubMed  CAS  Google Scholar 

  63. Roberts KD, Leone TA, Edwards WH, Rich WD, Finer NN (2006) Premedication for nonemergent neonatal intubations: a randomized, controlled trial comparing atropine and fentanyl to atropine, fentanyl, and mivacurium. Pediatrics 118:1583–91

    Article  PubMed  Google Scholar 

  64. Simbruner G (1986) Inadvertent positive end-expiratory pressure in mechanically ventilated newborn infants: detection and effect on lung mechanics and gas exchange. J Pediatr 108:589–95

    Article  PubMed  CAS  Google Scholar 

  65. Skov L, Ryding J, Pryds O, Greisen G (1992) Changes in cerebral oxygenation and cerebral blood volume during endotracheal suctioning in ventilated neonates. Acta Paediatr 81:389–93

    Article  PubMed  CAS  Google Scholar 

  66. So BH, Tamura M, Mishina J, Watanabe T, Kamoshita S (1995) Application of nasal continuous positive airway pressure to early extubation in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 72:F191–3

    Article  PubMed  CAS  Google Scholar 

  67. Spence K, Barr P (2000) Nasal versus oral intubation for mechanical ventilation of newborn infants. Cochrane Database Syst Rev:CD000948

    Google Scholar 

  68. Spence K, Gillies D, Waterworth L (2003) Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants. Cochrane Database Syst Rev:CD003309

    Google Scholar 

  69. Steer P, Flenady V, Shearman A, Charles B, Gray PH, Henderson-Smart D, Bury G, Fraser S, Hegarty J, Rogers Y, Reid S, Horton L, Charlton M, Jacklin R, Walsh A (2004) High dose caffeine citrate for extubation of preterm infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 89:F499–503

    Article  PubMed  CAS  Google Scholar 

  70. Subramaniam P, Henderson-Smart DJ, Davis PG (2005) Prophylactic nasal continuous positive airways pressure for preventing morbidity and mortality in very preterm infants. Cochrane Database Syst Rev:CD001243

    Google Scholar 

  71. Tapia JL, Bancalari A, Gonzalez A, Mercado ME (1995) Does continuous positive airway pressure (CPAP ) during weaning from intermittent mandatory ventilation in very low birth weight infants have risks or benefits? A controlled trial. Pediatr Pulmonol 19:269–74

    Article  PubMed  CAS  Google Scholar 

  72. Tarnow-Mordi WO, Wilkie RA, Reid E (1994) Static respiratory compliance in the newborn. I: A clinical and prognostic index for mechanically ventilated infants. Arch Dis Child Fetal Neonatal Ed 70:F11–5

    Article  PubMed  CAS  Google Scholar 

  73. Thomas MR, Rafferty GF, Limb ES, Peacock JL, Calvert SA, Marlow N, Milner AD, Greenough A (2004) Pulmonary function at follow-up of very preterm infants from the United Kingdom oscillation study. Am J Respir Crit Care Med 169:868–72

    Article  PubMed  Google Scholar 

  74. Tooley J, Dyke M (2003) Randomized study of nasal continuous positive airway pressure in the preterm infant with respiratory distress syndrome. Acta Paediatr 92:1170–4

    Article  PubMed  CAS  Google Scholar 

  75. Tracy M, Downe L, Holberton J (2004) How safe is intermittent positive pressure ventilation in preterm babies ventilated from delivery to newborn intensive care unit? Arch Dis Child Fetal Neonatal Ed 89:F84–7

    Article  PubMed  CAS  Google Scholar 

  76. Upton CJ, Milner AD, Stokes GM (1990) The effect of changes in inspiratory time on neonatal triggered ventilation. Eur J Pediatr 149:648–50

    Article  PubMed  CAS  Google Scholar 

  77. VanLooy JW, Schumacher RE, Bhatt-Mehta V (2008) Efficacy of a premedication algorithm for nonemergent intubation in a neonatal intensive care unit. Ann Pharmacother 42:947–55

    Article  Google Scholar 

  78. Verder H, Albertsen P, Ebbesen F, Greisen G, Robertson B, Bertelsen A, Agertoft L, Djernes B, Nathan E, Reinholdt J (1999) Nasal continuous positive airway pressure and early surfactant therapy for respiratory distress syndrome in newborns of less than 30 weeks’ gestation. Pediatrics 103:E24

    Article  PubMed  CAS  Google Scholar 

  79. Welzing L, Kribs A, Eifinger F, Huenseler C, Oberthuer A, Roth B (2010) Propofol as an induction agent for endotracheal intubation can cause significant arterial hypotension in preterm neonates. Paediatr Anaesth 20:605–11

    Article  PubMed  Google Scholar 

  80. Woodgate PG, Davies MW (2001) Permissive hypercapnia for the prevention of morbidity and mortality in mechanically ventilated newborn infants. Cochrane Database Syst Rev:CD002061

    Google Scholar 

  81. Woodgate PG, Flenady V (2001) Tracheal suctioning without disconnection in intubated ventilated neonates. Cochrane Database Syst Rev:CD003065

    Google Scholar 

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Maier, R.F. (2011). Künstliche Beatmung. In: Maier, R.F., Obladen, M. (eds) Neugeborenenintensivmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01069-9_4

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