Zusammenfassung
Die maschinelle Beatmung ist ein wesentlicher Teil der intensivmedizinischen Therapie, da insbesondere bei Patienten mit zerebralen Schädigungen fast regelhaft auch eine Störung der Atemfunktion vorliegt. Die Entwicklung moderner Intensivventilatoren wurde durch die Polioepidemien in Europa in den 1950er Jahren getriggert. Inzwischen stehen hochkomplexe, computergesteuerte Geräte zur Verfügung, die zur Ausnutzung ihrer Potenziale vom Anwender grundlegende Kenntnisse der Atemphysiologie und spezifi sche Kenntnisse der Atemregulation erfordern. Die Vielfalt verfügbarer Beatmungsmodi macht es möglich, für jeden Patienten die Beatmungstherapie individuell anzupassen. Das ist insofern wichtig, als die maschinelle Beatmung zwar eine akut lebensrettende Maßnahme darstellt, bei unsachgemäßer Durchführung aber eine Schädigung der Lunge verursachen kann.
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Literatur
Afshari A, Brok J, Moller AM, Wetterslev J. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults. Cochrane Database Syst Rev 2010;CD002787
Antonelli M, Pennisi MA, Pelosi P, et al. Noninvasive positive pressure ventilation using a helmet in patients with acute exacerbation of chronic obstructive pulmonary disease: a feasibility study. Anesthesiology 2004;100:16–24
Bein T, Weber F, Philipp A, et al. A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia. Crit Care Med 2006;34:1372–1377
Bernard GR, Artigas A, Brigham KL, et al. Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. The Consensus Committee. Intensive Care Med 1994;20:225–232
Blackwood B, Alderdice F, Burns KE, et al. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev 2010;CD006904
Bosma K, Ferreyra G, Ambrogio C, et al. Patient-ventilator interaction and sleep in mechanically ventilated patients: Pressure support versus proportional assist ventilation. Critical Care Medicine 2007;35:1048–1054
Bosma KJ, Taneja R, Lewis JF. Pharmacotherapy for prevention and treatment of acute respiratory distress syndrome: current and experimental approaches. Drugs 2010;70:1255–1282
Brander L, Leong-Poi H, Beck J, et al. Titration and implementation of neurally adjusted ventilatory assist in critically ill patients. Chest 2009;135:695–703
Briel M, Meade M, Mercat A, et al. Higher vs lower positive endexpiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and metaanalysis. JAMA 2010;303:865–873
Brochard L, Rauss A, Benito S, et al. Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med 1994;150:896–903
Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008;358:125–139
Burns KE, Adhikari NK, Keenan SP, Meade M. Use of non-invasive ventilation to wean critically ill adults offinvasive ventilation: meta-analysis and systematic review. BMJ 2009;338:b1574
Davies A, Jones D, Bailey M, et al. Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA 2009;302:1888–1895
Dembinski R, Max M, Bensberg R, et al. Pressure Support Compared with Controlled Mechanical Ventilation in Experimental Lung Injury. Anesth Analg 2002;94:1570–1576
Determann RM, Royakkers A, Wolthuis EK, et al. Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care 2010;14:R1
Deutsche Gesellschaft fuer Pneumologie und Beatmungsmedizin. S3 Leitlinie Nichtinvasive Beatmung als Therapie der akuten Respiratorischen Insuffizienz. www.leitlinien.net . 2010
Diaz JV, Brower R, Calfee CS, Matthay MA. Therapeutic strategies for severe acute lung injury. Crit Care Med 2010;38:1644–1650
Eichacker PQ, Gerstenberger EP, Banks SM, et al. Meta-analysis of acute lung injury and acute respiratory distress syndrome trials testing low tidal volumes. Am J Respir Crit Care Med 2002;166:1510–14
Esteban A, Alia I, Tobin MJ, et al. Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 1999;159:512–518
Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 2002;287:345–355
Esteban A, Frutos-Vivar F, Ferguson ND, et al. Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med 2004;350:2452–2460
Fabry B, Guttmann J, WolffG. Automatic compensation of endotracheal tube resitance in spontaneously breathing patients. Technol Health Care 1994;1:281–291
Finfer S, Norton R, Bellomo R, et al. The SAFE study: saline vs. albumin for fluid resuscitation in the critically ill. Vox Sang 2004;87 Suppl 2:123–131
Gama de AM, Spieth PM, Pelosi P, et al. Noisy pressure support ventilation: a pilot study on a new assisted ventilation mode in experimental lung injury. Crit Care Med 2008;36:818–27
Gattinoni L, Caironi P, Pelosi P, Goodman LR. What has computed tomography taught us about the acute respiratory distress syndrome? Am J Respir Crit Care Med 2001;164:1701–1711
Girard TD, Kress JP, Fuchs BD, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 2008;371:126–134
Gonzalez M, Arroliga AC, Frutos-Vivar F, et al. Airway pressure release ventilation versus assist-control ventilation: a comparative propensity score and international cohort study. Intensive Care Med 2010;36:817–827
Graham MR, Haberman CJ, Brewster JF, et al. Mathematical modelling to centre low tidal volumes following acute lung injury: a study with biologically variable ventilation. Respir Res 2005;6:64
Hedenstierna G, Tokics L, Lundquist H, et al. Phrenic nerve stimulation during halothane anesthesia. Effects of atelectasis. Anesthesiology 1994;80:751–760
Hering R, Peters D, Zinserling J, et al. Effects of spontaneous breathing during airway pressure release ventilation on renal perfusion and function in patients with acute lung injury. Intensive Care Med 2002;28:1426–1433
Hormann C, Baum M, Putensen C, et al. Effects of spontaneous breathing with BIPAP on pulmonary gas exchange in patients with ARDS. Acta Anaesthesiol Scand Suppl 1997;111:152–155
Keenan SP, Sinuff T, Burns KE, et al. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ 2011 online first
Kleinman BS, Frey K, VanDrunen M, et al. Motion of the diaphragm in patients with chronic obstructive pulmonary disease while spontaneously breathing versus during positive pressure breathing after anesthesia and neuromuscular blockade. Anesthesiology 2002;97:298–305
Kopp R, Henzler D, Dembinski R, Kuhlen R. [Extracorporeal membrane oxygenation by acute respiratory distress syndrome]. Anaesthesist 2004;53:168–174
Meade M, Guyatt G, Cook D, et al. Predicting success in weaning from mechanical ventilation. Chest 2001;120:400S-424S
Meade MO, Cook DJ, Guyatt GH, et al. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 2008;299:637–645
Metnitz PG, Krenn CG, Steltzer H, et al. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med 2002;30:2051–2058
Namen AM, Ely EW, Tatter SB, Case LD, Lucia MA, Smith A, Landry S, Wilson JA, Glazier SS, Branch CL, Kelly DL, Bowton DL, Haponik EF. Predictors of successful extubation in neurosurgical patients. Am J Respir Crit Care Med 2001;163(3 Pt 1):658–664
Papazian L, Forel JM, Gacouin A, et al. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 2010;363:1107–1116
Peek GJ, Mugford M, Tiruvoipati R, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009;374:1351–1363
Putensen C, Zech S, Wrigge H, et al. Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury. Am J Respir Crit Care Med 2001;164:43–49
Ranieri VM, Suter PM, Tortorella C, et al. Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA 1999;282:54–61
Rossaint R, Werner C, Zwissler B (2008) Die Anästhesiologie, 2. Aufl. Springer, Berlin Heidelberg New York
S2e-Leitlinie der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI). Lagerungstherapie zur Prophylaxe oder Therapie von pulmonalen Funktionsstörungen. Anästhesie Intensivmed 2008;49:S1-S24
Slutsky AS, Tremblay LN. Multiple system organ failure. Is mechanical ventilation a contributing factor? Am J Respir Crit Care Med 1998;157:1721–1725
Sud S, Friedrich JO, Taccone P, et al. Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 2010;36:585–599
Terragni PP, Del SL, Mascia L, et al. Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology 2009;111:826–835
The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000;342:1301–1308
West JB. Respiratory Physiology - The Essentials. 6. 2000. Baltimore, Lippincott Williams & Wilkins
Wiedemann HP, Wheeler AP, Bernard GR, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006;354:2564–2575
Xirouchaki N, Kondili E, Vaporidi K, et al. Proportional assist ventilation with load-adjustable gain factors in critically ill patients: comparison with pressure support. Intensive Care Med 2008;34:2026–2034
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Henzler, D., Rossaint, R. (2012). Beatmung, Atemregulation und Weaning, ARDS. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16911-3_9
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