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Medizinische Notfallteams

Stand und Perspektiven präventiver innerklinischer Intensivmedizin

Medical emergency teams

Current situation and perspectives of preventive in-hospital intensive care medicine

  • Notfallmedizin
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Zusammenfassung

Bei bis zu 10% aller hospitalisierten Normalstationpatienten treten während ihres Krankenhausaufenthalts schwerwiegende medizinische Zwischenfälle auf. Diese Zwischenfälle gehen mit einer innerklinischen Letalität von 5–8% einher. Wie im präklinischen Bereich auch, können bei der Mehrzahl dieser Patienten Vorzeichen eines lebensbedrohlichen Ereignisses frühzeitig erkannt werden. Studien legen nahe, dass die Einführung eines innerklinischen, medizinischen Notfallteams („medical emergency team“, MET), das bei mehr oder minder objektivierbaren Abweichungen physiologischer Parameter aktiviert wird, die Inzidenz von innerklinischen Kreislaufstillständen sowie unerwarteten bzw. erneuten Aufnahmen auf die Intensivstation wirkungsvoll reduzieren kann. Diesem Konzept entsprechend sollen MET gefährdete Patienten außerhalb von Intensivpflegestationen frühzeitig evaluieren und behandeln, bevor es zu einer ggf. fatalen Progredienz der Symptomatik kommt. Der vorliegende Artikel gibt einen Überblick über die aktuelle Datenlage zur präventiven innerklinischen Intensivmedizin und reflektiert die Rahmenbedingungen für die Etablierung eines MET-Konzeptes im deutschsprachigen Raum.

Abstract

Severe clinical incidents occur in up to 10% of all non-intensive care unit (ICU) patients, which have an estimated mortality of 5–8%. As in the prehospital setting, early clinical warning signs can be identified in the majority of cases. Studies suggest that introduction of an in-hospital medical emergency team (MET) which responds to objective criteria of physiological deterioration, may effectively reduce the incidence of in-hospital cardiac arrests as well as unanticipated or readmissions to the ICU. According to this concept, METs would evaluate and treat non-ICU patients at risk at an early stage before a potentially fatal deterioration of cardiorespiratory parameters occurs. This article reviews available data on preventive in-hospital intensive care medicine and reflects on the circumstances for an implementation of METs in Germany, Austria and Switzerland.

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Danksagung

Unser Dank gilt Frau Birgit Weh, DGKS, Operative Intensivstation 1, Abteilung für Anästhesiologie und operative Intensivmedizin, AKH Linz, Österreich, für die Bereitstellung umfangreichen Informationsmaterials.

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  1. Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland

    S.G. Russo DEAA, C. Eich, M. Roessler, B.M. Graf, M. Quintel & A. Timmermann

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  1. S.G. Russo DEAA
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  2. C. Eich
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Correspondence to S.G. Russo DEAA.

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Russo, S., Eich, C., Roessler, M. et al. Medizinische Notfallteams. Anaesthesist 57, 70–80 (2008). https://doi.org/10.1007/s00101-007-1271-0

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