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Update Tracheotomie

Update on tracheotomy

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Zusammenfassung

Die Tracheotomie beim Intensivpatienten mit absehbarer Langzeitbeatmung ist fester Bestandteil der intensivmedizinischen Routinepraxis. Ziel ist die Erleichterung des respiratorischen Weanings und eine Verbesserung des klinischen Outcomes durch Verminderung beatmungs- und sedierungsassoziierter Nebenwirkungen. Gleichzeitig muss das Risiko von Komplikationen durch die Tracheotomie so weit wie möglich minimiert werden. Bei der Entscheidung zur Tracheotomie sind Indikation, Methode und Zeitpunkt individuell für jeden Patienten zu berücksichtigen. Wesentliche Parameter für den Entscheidungsprozess, den Erfolg und die Sicherheit sind der zu erwartende klinische Nutzen, das patientenseitige Risikoprofil für Komplikationen und anwenderbezogene bzw. logistische Aspekte. Der Beitrag fasst den aktuellen Forschungstand zu diesem Thema zusammen.

Abstract

Tracheotomy in mechanically ventilated critically ill patients is a procedure commonly performed in the intensive care unit. The aim is to facilitate respiratory weaning and improve clinical outcome by reducing side effects of prolonged invasive mechanical ventilation and sedation. At the same time, the risk of tracheotomy associated complications must be minimized. Indications, method and timing must be individualized for each patient. Main determinants for decision-making, success and safety are the expected individual clinical benefits, the patient risk factors for complications and aspects of local experience and logistics. This review summarizes current concepts and evidence.

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Interessenkonflikt

Der korrespondierende Autor gibt für sich und seinen Koautor an: Bei SB besteht kein Interessenkonflikt. SK hat finanzielle Unterstützung für ein Forschungsprojekt von der Firma COOK erhalten.

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Authors and Affiliations

  1. Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    S. Braune MPH & S. Kluge

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  1. S. Braune MPH
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  2. S. Kluge
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Correspondence to S. Braune MPH.

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Braune, S., Kluge, S. Update Tracheotomie. Med Klin Intensivmed Notfmed 107, 543–547 (2012). https://doi.org/10.1007/s00063-012-0089-y

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