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Strategien in der Respiratorentwöhnung

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Weaning

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Zusammenfassung

Nicht selten resultieren aus einer komplexen, intensivmedizinischen Behandlung mit Beatmung immer älter werdender Patienten eine Langzeitabhängigkeit von Beatmungsmedizin. Nur etwa die Hälfte langzeitbeatmeter Patienten (>14 Tage) ist vor Entlassung aus dem Krankenhaus vom Respirator entwöhnt. Und nur etwa 41 % der Patienten nach Langzeitbeatmung leben noch ein Jahr nach Entlassung aus dem Krankenhaus. Die Ursachen für eine Langzeitbeatmung und ein Scheitern der Respiratorentwöhnung sind vielfältig und reichen von iatrogenen Verursachungen, wie z. B. Übersedierung, Fehlen eines protokollbasierten Managements zur Erfassung des Weaningpotentials, einer unzureichenden Adaption der Beatmungsunterstützung an die klinische Situation des Patienten, über Folgezustände einer protrahierten Intensivtherapie mit Entwicklung z. B. eines Delirs oder Ausbildung eines schwerwiegenden neuromuskulären Organversagens, bis hin zu Problemen, die durch die respiratorische Grunderkrankung begründet sind.

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Author information

Authors and Affiliations

  1. KRH Klinikum Siloah, Klinik für Pneumologie, Intensiv- und Schlafmedizin, Stadionbrücke 4, 30459, Hannover, Deutschland

    Bernd Schönhofer

  2. Charité-Universitätsmedizin Berlin, Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    Steffen Weber-Carstens

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  1. Bernd Schönhofer
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Editor information

Editors and Affiliations

  1. Klinik für Operative Intensivmedizin und Intermediate Care, Universitätsklinikum RWTH Aachen, Aachen, Germany

    Johannes Bickenbach

  2. Klinik für Operative Intensivmedizin und Intermediate Care, Universitätsklinikum RWTH Aachen, Aachen, Germany

    Gernot Marx

  3. Klinik für Kardiologie, Pneumologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum RWTH Aachen, Aachen, Germany

    Michael Dreher

  4. Klinik für Pneumologie, Intensiv- und Schlafmedizin, KRH Klinikum Siloah, Hannover, Germany

    Bernd Schönhofer

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Schönhofer, B., Weber-Carstens, S. (2018). Strategien in der Respiratorentwöhnung. In: Bickenbach, J., Marx, G., Dreher, M., Schönhofer, B. (eds) Weaning. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49795-1_3

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