Subkutane Flüssigkeitssubstitution bei betagten Patienten während Hitzewellen

 

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Zusammenfassung

Zunehmend werden geriatrische Patienten in Krankenhäusern wegen Exsikkose behandelt, was eine steigende Belastung für das Gesundheitssystem darstellt. Bei Hitzeperioden sind ältere Menschen anfälliger für Dehydratationszustände, insbesondere bei febrilen Begleiterkrankungen und einer Polypharmazie. Sowohl im häuslichen Umfeld wie in Pflegeeinrichtungen werden Strategien notwendig sein, um Krankenhauseinweisungen aufgrund eines transienten Flüssigkeitsmangels zu vermeiden. Dadurch können vielfach höhere Kosten und ein zusätzlicher Ressourcenverbrauch im stationären Gesundheitssektor eingegrenzt werden. Es müssen ambulante Versorgungsstrukturen gesichert werden, um eine orale Flüssigkeitsaufnahme zu gewährleisten, auch wenn dies einen zusätzlichen Betreuungs- bzw. Pflegeaufwand bedeutet. Parallel dazu muss die Möglichkeit der zeitlich begrenzten parenteralen Flüssigkeitsgabe wie die subkutane Infusion (Hypodermoclysis) im ambulanten Gesundheitssektor flächendeckend eingesetzt werden. Seit August 2013 kann durch einen Beschluss des Gemeinsamen Bundesausschlusses (G-BA) die subkutane Infusion im Rahmen der häuslichen Krankenpflege verordnet werden.

Abstract

Geriatric patients were more often treated in hospitals for Dehydration in the last years resembling a rising burden for Health systems. Elderly people are more vulnerable for Dehydration during Heat Waves especially when there are complicating factors like febrile episodes or multiple medications. In private care situations as in homes for elderly Strategies have to be implemented in Germany to prevent hospital admissions in the case of transient Dehydration. By this a rise of costs and a waste of ressources should be diminished. Prehospital stuctures have to be implemented to maintain oral Rehydration aware of a more intensive care. At the same time there is the need to use the parenteral method of subcutaneous infusion (Hypodermoclysis) for a defined time

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