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Nichtinvasive Beatmung zur Therapie der akuten respiratorischen Insuffizienz

Die Intensivmedizin

Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Das respiratorische System besteht aus 2 weitgehend unabhängig voneinander arbeitenden Anteilen: dem Lungenparenchym für den Gasaustausch und der Atmungspumpe für die Ventilation. Schwerwiegende Erkrankungen führen zu unterschiedlichen Formen der akuten respiratorischen Insuffizienz (ARI): im Lungenparenchym kommt es zur hypoxämischen ARI, bei der Atmungspumpe zur hyperkapnischen ARI. Maschinelle Beatmung bessert den gestörten Gasaustausch und entlastet die Atemmuskulatur. Durch NIV lassen sich Komplikationen der invasiven Beatmung häufig vermeiden.

Wenn möglich, sollte die NIV bei Erkrankungen, die zur hyperkapnischen ARI führen, angewendet werden, da sie hier die Intubations- und Mortalitätsrate deutlich senkt (besonders für pH 7,2–7,35).

Der Stellenwert der NIV bei hypoxämischer ARI ist deutlich geringer. Für das kardial bedingte Lungenödem ist der Effekt von CPAP bzw. NIV in Kombination mit der medikamentösen Standardtherapie belegt. Hingegen kann die NIV bei der nichtkardialen hypoxämischen ARI nicht grundsätzlich als Therapie empfohlen werden.

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Literatur

  • Adda M, Coquet I, Darmon M et al (2008) Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure. Crit Care Med 36:2766–2772

    Article  PubMed  Google Scholar 

  • Antonelli M, Conti G, Bufi M et al (2000) Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial. JAMA 283:235–241

    Article  CAS  PubMed  Google Scholar 

  • Antonelli M, Conti G, Pelosi P et al (2002) New treatment of acute hypoxemic respiratory failure: noninvasive pressure support ventilation delivered by helmeta pilot controlled trial. Crit Care Med 30:602–608

    Article  PubMed  Google Scholar 

  • Antonelli M, Pennisi MA, Pelosi P et al (2004) Noninvasive positive pressure ventilation using a helmet in patients with acute exacerbation of chronic obstructive pulmonary disease: a feasibility study. Anesthesiology 100:16–24

    Article  PubMed  Google Scholar 

  • Boque MC, Gualis B, Sandiumenge A et al (2004) Endotracheal tube intraluminal diameter narrowing after mechanical ventilation: use of acoustic reflectometry. Intensive Care Med 30:2204–2209

    Article  CAS  PubMed  Google Scholar 

  • Bott J, Baudouin SV, Moxham J (1991) Nasal intermittent positive pressure ventilation in the treatment of respiratory failure in obstructive sleep apnoea. Thorax 46:457–458

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Bott J, Carroll MP, Conway JH et al (1993) Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease. Lancet 341:1555–1557

    Article  CAS  PubMed  Google Scholar 

  • Brochard L, Mancebo J, Wysocki M et al (1995) Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 333:817–822

    Article  CAS  PubMed  Google Scholar 

  • Bunburaphong T, Imanaka H, Nishimura M et al (1997) Performance characteristics of bilevel pressure ventilators: a lung model study. Chest 111:1050–1060

    Article  CAS  PubMed  Google Scholar 

  • Carlucci A, Delmastro M, Rubini F et al (2003) Changes in the practice of non-invasive ventilation in treating COPD patients over 8 years. Intensive Care Med 29:419–425

    PubMed  Google Scholar 

  • Confalonieri M, Potena A, Carbone G et al (1999) Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med 160:1585–1591

    Article  CAS  PubMed  Google Scholar 

  • Craven DE, Duncan RA (2006) Preventing ventilator-associated pneumonia: tiptoeing through a minefield. Am J Respir Crit Care Med 173:1297–1298

    Article  PubMed  Google Scholar 

  • Delclaux C, L´Her E, Alberti C et al (2000) Treatment of acute hypoxemic nonhypercapnic respiratory insufficiency with continuous positive airway pressure delivered by a face mask: a randomized controlled trial. JAMA 284:2352–2360

    Article  CAS  PubMed  Google Scholar 

  • Depuydt PO, Benoit DD, Roosens CD et al (2010) The impact of the initial ventilatory strategy on survival in hematological patients with acute hypoxemic respiratory failure. J Crit Care 25:30–36

    Article  PubMed  Google Scholar 

  • Esteban A, Frutos-Vivar F, Ferguson ND et al (2004) Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med 350:2452–2460

    Article  CAS  PubMed  Google Scholar 

  • Fagon JY, Chastre J, Hance AJ et al (1993) Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Am J Med 94:281–288

    Article  CAS  PubMed  Google Scholar 

  • Gorini M, Ginanni R, Villella G et al (2004) Non-invasive negative and positive pressure ventilation in the treatment of acute on chronic respiratory failure. Intensive Care Med 30:875–881

    Article  PubMed  Google Scholar 

  • Gray A, Goodacre S, Newby DE et al (2008) Noninvasive ventilation in acute cardiogenic pulmonary edema. N Engl J Med 359:142–151

    Article  CAS  PubMed  Google Scholar 

  • Hilbert G, Gruson D, Vargas F et al (2001) Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 344:443

    Article  Google Scholar 

  • International Consensus Conferences in Intensive Care Medicine (2001) Noninvasive positive pressure ventilation in acute Respiratory failure. Am J Respir Crit Care Med 163:283–291

    Article  Google Scholar 

  • Keenan SP, Powers C, McCormack DG et al (2002) Noninvasive positive-pressure ventilation for postextubation respiratory distress: a randomized controlled trial. JAMA 287:3238–3244

    Article  PubMed  Google Scholar 

  • Kollef MH (2004) Prevention of hospital-associated pneumonia and ventilator-associated pneumonia. Crit Care Med 32:1396–1405

    Article  PubMed  Google Scholar 

  • Kramer N, Meyer TJ, Meharg J et al (1995) Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med 151:1799–1806

    Article  CAS  PubMed  Google Scholar 

  • Kwok H, McCormack J, Cece R et al (2003) Controlled trial of oronasal versus nasal mask ventilation in the treatment of acute respiratory failure. Crit Care Med 31:468–473

    Article  PubMed  Google Scholar 

  • Lassen HCA (1953) A preliminary report on the 1952 epidemic of poliomyelitis in Copenhagen with special reference to the treatment of acute respiratory insufficiency. Lancet 1:37–40

    Article  CAS  PubMed  Google Scholar 

  • Lightowler JV, Wedzicha JA, Elliott MW et al (2003) Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: cochrane systematic review and meta-analysis. BMJ 326:185

    Article  PubMed Central  PubMed  Google Scholar 

  • Mehta S, Hill NS (2001) Noninvasive ventilation. Am J Respir Crit Care Med 163:540–577

    Article  CAS  PubMed  Google Scholar 

  • Mehta S, McCool FD, Hill NS (2001) Leak compensation in positive pressure ventilators: a lung model study. Eur Respir J 17:259–267

    Article  CAS  PubMed  Google Scholar 

  • Moerer O, Fischer S, Hartelt M et al (2006) Influence of two different interfaces for noninvasive ventilation compared to invasive ventilation on the mechanical properties and performance of a respiratory system: a lung model study. Chest 129:1424–1431

    Article  PubMed  Google Scholar 

  • Nava S, Evangelisti I, Rampulla C et al (1997) Human and financial costs of noninvasive mechanical ventilation in patients affected by COPD and acute respiratory failure. Chest 111:1631–1638

    Article  CAS  PubMed  Google Scholar 

  • Patroniti N, Foti G, Manfio A et al (2003) Head helmet versus face mask for non-invasive continuous positive airway pressure: a physiological study. Intensive Care Med 29:1680–1687

    Article  PubMed  Google Scholar 

  • Pepin JL, Leger P, Veale D et al (1995) Side effects of nasal continuous positive airway pressure in sleep apnea syndrome. Study of 193 patients in two French sleep centers. Chest 107:375–381

    Article  CAS  PubMed  Google Scholar 

  • Plant PK, Owen JL, Elliott MW (2000) Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet 355:1931–1935

    Article  CAS  PubMed  Google Scholar 

  • Plotz FB, Slutsky AS, van Vught AJ et al (2004) Ventilator-induced lung injury and multiple system organ failure: a critical review of facts and hypotheses. Intensive Care Med 30:1865–1872

    Article  PubMed  Google Scholar 

  • Rasanen J, Heikkila J, Downs J et al (1985) Continuous positive airway pressure by face mask in acute cardiogenic pulmonary edema. Am J Cardiol 55:296–300

    Article  CAS  PubMed  Google Scholar 

  • Schönhofer B, Köhler D (1994) Ventilatorische Insuffizienz und hyperkapnische Kompensation infolge chronisch belasteter „Atempumpe“. Dtsch Med Wochenschr 119:1209–1214

    Article  PubMed  Google Scholar 

  • Schönhofer B, Sortor-Leger S (2002) Equipment needs for noninvasive mechanical ventilation. Eur Respir J 20:1029–1036

    Article  PubMed  Google Scholar 

  • Schönhofer B, Euteneuer S, Nava S et al (2002) Survival of mechanically ventilated patients admitted to a specialised weaning centre. Intensive Care Med 28:908–916

    Article  PubMed  Google Scholar 

  • Schönhofer B, Kuhlen R, Neumann P, Westhoff M, Berndt C, Sitter H (2008) Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz. Pneumologie 62:449–479

    Article  PubMed  Google Scholar 

  • Shapiro M, Wilson RK, Casar G et al (1986) Work of breathing through different sized endotracheal tubes. Crit Care Med 14:1028–1031

    Article  CAS  PubMed  Google Scholar 

  • Squadrone V, Coha M, Cerutti E et al (2005) Continuous positive airway pressure for treatment of postoperative hypoxemia: a randomized controlled trial. JAMA 293:589–595

    Article  CAS  PubMed  Google Scholar 

  • Tobin MJ (2001) Advances in mechanical ventilation. N Engl J Med 344:1986–1996

    Article  CAS  PubMed  Google Scholar 

  • Vitacca M, Clini E, Pagani M et al (2000) Physiologic effects of early administered mask proportional assist ventilation in patients with chronic obstructive pulmonary disease and acute respiratory failure. Crit Care Med 28:1791–1797

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Abt. für Pneumologie u. Internist. Intensivmedizin, Klinikum Region Hannover Krankenhaus Oststadt-Heidehaus, Podbielskistr. 380, 30659, Hannover, Deutschland

    B. Schönhofer

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  1. B. Schönhofer
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Correspondence to B. Schönhofer .

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Editors and Affiliations

  1. Klinik für Anästhesiologie, RWTH Aachen Universitätsklinikum Aachen, Aachen, Germany

    Gernot Marx

  2. Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lübeck, Germany

    Elke Muhl

  3. Dir. der Klinik fuer Anaesthesie Intensivmed. und Schmerzther., Frankfurt, Hessen, Germany

    Kai Zacharowski

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Schönhofer, B. (2015). Nichtinvasive Beatmung zur Therapie der akuten respiratorischen Insuffizienz. In: Marx, G., Muhl, E., Zacharowski, K. (eds) Die Intensivmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54675-4_31-1

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  • DOI: https://doi.org/10.1007/978-3-642-54675-4_31-1

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  • Online ISBN: 978-3-642-54675-4

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Chapter history

  1. Latest

    Nichtinvasive Beatmung zur Therapie der akuten respiratorischen Insuffizienz
    Published:
    04 April 2023

    DOI: https://doi.org/10.1007/978-3-642-54675-4_31-2

  2. Original

    Nichtinvasive Beatmung zur Therapie der akuten respiratorischen Insuffizienz
    Published:
    18 June 2015

    DOI: https://doi.org/10.1007/978-3-642-54675-4_31-1

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