Skip to main content

Intensivmedizinische Behandlung Brandverletzter/Respiratorisches Management

  • Chapter
Verbrennungen

Zusammenfassung

Die intensivmedizinische Behandlung Brandverletzter setzt eine sehr hohe Spezialisierung sowohl von chirurgischer als auch von intensivmedizinischer Seite voraus. Aus diesem Grund werden in den Guidelines der European Burns Association (EBA) unter anderem die Behandlung von mindestens 75 Brandverletzten pro Jahr und Zentrum gefordert. Im Folgenden sollen die Besonderheiten in der Behandlung Brandverletzter zusammengefasst werden, wobei jede einzelne Besonderheit für sich wahrscheinlich keinen großen Unterschied für den Behandlungserfolg ausmacht, aber in Summe, wie kleine Mosaiksteine, den Unterschied zwischen einer auf die Behandlung Brandverletzter spezialisierten und einer allgemeinen Intensivstation ausmacht und somit das Outcome mit beeinflusst. Da einigen Maßnahmen ein eigenes Kapitel gewidmet ist, werden diese nur summatorisch erwähnt, auf andere, wie insbesondere das respiratorische Management, wird genauer eingegangen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Weiterführende Literatur

  • Amato MBP, Barbas CSV, Medeiros DM, et al (1998) Effect of a protective ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 338: 347–354

    Article  CAS  PubMed  Google Scholar 

  • Benzer H, Bergmann H, Mutz N (1988) Die künstliche Beatmung auf Intensivstationen. In. Beiträge zur Anaesthesiologie und Intensivmedizin, Bd 25. Maudrich, Wien

    Google Scholar 

  • Cancio LC, Galvez E, Jr., Turner CE, Kypreos NG, Parker A, Holcomb JB (2006) Base deficit and alveolar-arterial gradient during resuscitation contribute independently but modestly to the prediction of mortality after burn injury. J Burn Care Res 27: 289–296; discussion 96–97

    Article  PubMed  Google Scholar 

  • Cianci P, Williams C, Lueders H, et al (1990) Adjunctive hyperbaric oxygen in the treatment of thermal burns. An economic analysis. J Burn Care Rehabil 11: 140–143

    Article  CAS  PubMed  Google Scholar 

  • Cioffi WG, Jr., Rue LW, 3rd, Graves TA, McManus WF, Mason AD, Jr., Pruitt BA, Jr. (1991) Prophylactic use of high-frequency percussive ventilation in patients with inhalation injury. Ann Surg 213: 575–580; discussion 80–82

    Article  PubMed  Google Scholar 

  • Cioffi WG, Graves TA, McManus WF, Pruitt BA, Jr. (1989) High-frequency percussive ventilation in patients with inhalation injury. J Trauma 29: 350–354

    Article  CAS  PubMed  Google Scholar 

  • Cortiella J, Mlcak R, Herndon D (1999) High frequency percussive ventilation in pediatric patients with inhalation injury. J Burn Care Rehabil 20: 232–235

    Article  CAS  PubMed  Google Scholar 

  • Fitzpatrick JC, Cioffi WG, Jr. (1997) Ventilatory support following burns and smoke-inhalation injury. Respir Care Clin North Am 3: 21–49

    CAS  Google Scholar 

  • Fodor L, Ramon Y, Meilik B, Carmi N, Shoshani O, Ullmann Y (2006) Effect of hyperbaric oxygen on survival of composite grafts in rats. Scand J Plast Reconstr Surg Hand Surg 40: 257–260

    Article  PubMed  Google Scholar 

  • Kilian J, Benzer H, Ahnefeld FW (1991) Grundzüge der Beatmung. Klinische Anästhesiologie und Intensivtherapie, Bd 39. Springer, Wien New York

    Google Scholar 

  • Köhler D, Vastag E (1991) Bronchiale Clearance. Pneumologie 45: 314–332

    PubMed  Google Scholar 

  • Konrad F (1996) Die mukoziliäre Klärfunktion und ihre medikamentöse Beeinflussung. Anästhesiol Intensivmed Notfallmed Schmerzther 31: 404–408

    Article  CAS  PubMed  Google Scholar 

  • Lachmann B (1992) Open up the lung and keep the lung open. Intensive Care Med 18: 319–321

    Article  CAS  PubMed  Google Scholar 

  • Lentz CW, Peterson HD (1997) Smoke inhalation is a multilevel insult to the pulmonary system. Curr Opin Pulm Med 3: 221–226

    Article  CAS  PubMed  Google Scholar 

  • Marik P, Krikorian J (1997) Pressure-controlled ventilation in ARDS: a practical approach. Chest 112:1102–1106 Ogura H, Sumi Y, Matsushima A, et al (2005) [Smoke inhalation injury: diagnosis and respiratory management]. Nippon Geka Gakkai Zasshi 106: 740–744

    Article  CAS  PubMed  Google Scholar 

  • Matthys H (1988) Clearancemechanismen der Bronchial-schleimhaut. Atemw-Lungenkrkh 6: 280–284

    Google Scholar 

  • Mlcak R, Cortiella J, Desai M, Herndon D (1997) Lung compliance, airway resistance, and work of breathing in children after inhalation injury. J Burn Care Rehabil 18: 531–534

    Article  CAS  PubMed  Google Scholar 

  • Niezgoda JA, Cianci P, Folden BW, Ortega RL, Slade JB, Storrow AB (1997) The effect of hyperbaric oxygen therapy on a burn wound model in human volunteers. Plast Reconstr Surg 99: 1620–1625

    Article  CAS  PubMed  Google Scholar 

  • Oczenski W, Andel H, Werba A (2006) Atem—Atemhilfen, 7. Aufl. Thieme, Stuttgart

    Google Scholar 

  • Paulsen SM, Killyon GW, Barillo DJ (2002) High-frequency percussive ventilation as a salvage modality in adult respiratory distress syndrome: a preliminary study. Am Surg 68: 852–856; discussion 6

    PubMed  Google Scholar 

  • Putensen Ch, Mutz NJ, Putensen-Himmer G, Zinserling J (1999) Spontaneous breathing during ventilatory support improves ventilation-perfusion distributions in patients with adult respiratory distress syndrome Am J Respir Crit Care Med 159: 1241–1248

    CAS  PubMed  Google Scholar 

  • Ranieri VM, Tortorella C, Grasso S (1998) Pressure — volume relationship in the injured lung. In: Marini JJ, Evans TW (Eds) Update in intensive care and emergency medicine, Vol 30. Acute lung injury. pp 215–235

    Google Scholar 

  • Reper P, Van Bos R, Van Loey K, Van Laeke P, Vanderkelen A (2003) High frequency percussive ventilation in burn patients: hemodynamics and gas exchange Burns 29: 603–608

    Article  CAS  PubMed  Google Scholar 

  • Reper P, Wibaux O, Van Laeke P, Vandeenen D, Duinslaeger L, Vanderkelen A (2002) High frequency percussive ventilation and conventional ventilation after smoke inhalation: a randomised study. Burns 28: 503–508

    Article  CAS  PubMed  Google Scholar 

  • Reper P, Dankaert R, van Hille F, van Laeke P, Duinslaeger L, Vanderkelen A (1998) The usefulness of combined high-frequency percussive ventilation during acute respiratory failure after smoke inhalation. Burns 24: 34–38

    Article  CAS  PubMed  Google Scholar 

  • Rodeberg DA, Maschinot NE, Housinger TA, Warden GD (1992) Decreased pulmonary barotrauma with the use of volumetric diffusive respiration in pediatric patients with burns: the 1992 Moyer Award. J Burn Care Rehabil 13: 506–511

    Article  CAS  PubMed  Google Scholar 

  • Shapiro B (1985) PEEP therapy in acute lung injury. ASA Refresher Course. 12–16.10. Am Soc Anesth 173:1–6

    Google Scholar 

  • Shimazu T, Ogura H, Sugimoto H (1998) [Clinical and pathophysiologic problems associated with smoke inhalation injury]. Nippon Geka Gakkai Zasshi 99: 46–51

    CAS  PubMed  Google Scholar 

  • Wang D, Zwischenberger JB, Savage C, et al (2006) High-frequency percussive ventilation with systemic heparin improves short-term survival in a LD100 sheep model of acute respiratory distress syndrome. J Burn Care Res 27: 463–471

    Article  PubMed  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag/Wien

About this chapter

Cite this chapter

Andel, H.L., Chiari, A. (2009). Intensivmedizinische Behandlung Brandverletzter/Respiratorisches Management. In: Kamolz, LP., Herndon, D.N., Jeschke, M.G. (eds) Verbrennungen. Springer, Vienna. https://doi.org/10.1007/978-3-211-79896-6_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-79896-6_15

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-79895-9

  • Online ISBN: 978-3-211-79896-6

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics