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Erschienen in: Notfall +  Rettungsmedizin 8/2017

02.10.2017 | Leitthema

Nichtinvasive Beatmung bei Kindern mit akuter respiratorischer Insuffizienz

verfasst von: PD Dr. H. Fuchs, D. Klotz, T. Nicolai

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 8/2017

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Zusammenfassung

Akutes Atemversagen kann auch im Kindesalter mit nichtinvasiver Beatmung (NIV) behandelt werden. In den letzten Jahren wurden die technischen Voraussetzungen der NIV-Beatmungsgeräte für das Kindesalter verbessert, zudem steht heutzutage eine größere Auswahl an konfektionierten nasalen und Full-face-Masken für Kinder ab dem Säuglingsalter als Interface zur Verfügung. Vor allem Kinder mit hyperkapnischem Atemversagen profitieren von der NIV. Evidenz für Vorteile der NIV besteht für die Bronchiolitis, Asthma sowie für das „Acute-on-chronic“-Atemversagen, d. h. ein Atemversagen bedingt durch eine akute Infektion bei einer zugrunde liegenden neuromuskulären Erkrankung, Zerebralparese oder einer chronischen Lungenerkrankung wie der zystischen Fibrose. Nichtinvasive Beatmung ist bei prolongiertem Weaning von invasiver Beatmung und bei Fehlbildungen des oberen Atemwegs hilfreich. Alveoläre Erkrankungen mit vorwiegend hypoxämischem Atemversagen wie ambulant erworbene Pneumonien oder das „acute respiratory distress syndrome“ (ARDS) stellen keine Indikationen für die NIV dar. Aufgrund relevanter möglicher Nebenwirkungen und der Möglichkeit der schnellen Verschlechterung des Gasaustauschs bei NIV-Versagen sollte die NIV auf der pädiatrischen Intensivstation mit der Möglichkeit zu einem raschen Wechsel auf einen invasiven Beatmungszugang stattfinden.
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Metadaten
Titel
Nichtinvasive Beatmung bei Kindern mit akuter respiratorischer Insuffizienz
verfasst von
PD Dr. H. Fuchs
D. Klotz
T. Nicolai
Publikationsdatum
02.10.2017
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 8/2017
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-017-0368-5

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