Zusammenfassung
Mit zunehmender Technisierung und Invasivität der Intensivmedizin, aber auch steigender Komorbidität und höherem Alter der Patienten wächst die Anzahl der Patienten, die nur schwierig vom Respirator entwöhnbar sind bzw. eine Langzeitbeatmung (LZB) benötigen. Die Erschöpfung der Atmungsmuskulatur ist die wesentliche Ursache für die erfolglose Entwöhnung vom Respirator (Weaning). In spezialisierten Entwöhnungseinheiten gelingt die Respiratorentwöhnung mithilfe einer therapeutischen Gesamtstrategie relativ häufig. Es ist wichtig, bereits zum Zeitpunkt der Intubation und in der frühen Beatmungsphase wichtige Prinzipien der Respiratorentwöhnung zu beachten, um spätere Komplikationen und eine LZB möglichst zu verhindern. Schließlich bleiben Weaning in der Terminalphase und Sterben am Respirator eine große Herausforderung für alle Beteiligten.
Abstract
The prevalence of difficult weaning or prolonged mechanical ventilation is increasing due to a growing number of multi-morbid, elderly and pulmonary-deficient patients being mechanically ventilated. Respiratory failure is frequently caused by overloaded respiratory muscles and/or reduced capacity of the respiratory muscles. In specialized facilities, complex weaning strategies are often successful. These strategies must be considered as soon as possible in order to avoid late complications and prolonged mechanical ventilation. Terminal weaning and end-of-life issues continue to pose a challenge to everyone involved.
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Für seine kritischen Anmerkungen zum Manuskript danke ich Herrn Christian Berndt
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Schönhofer, B. Weaning vom Respirator beginnt mit der Intubation. Pneumologe 5, 150–162 (2008). https://doi.org/10.1007/s10405-008-0224-x
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DOI: https://doi.org/10.1007/s10405-008-0224-x