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Extrakorporale Verfahren zur Lungenunterstützung

  • S. Braune
  • A. Sieweke
  • D. Jarczak
  • S. KlugeEmail author
Leitthema

Zusammenfassung

Verfahren zur extrakorporalen Lungenunterstützung haben in den letzten Jahren eine rapide technologische Weiterentwicklung mit Verbesserung von Effektivität und Sicherheit erfahren. Trotz der derzeit noch sehr begrenzten wissenschaftlichen Evidenz kommen diese Systeme in der Intensivmedizin zunehmend zur Therapie unterschiedlicher Arten akuter respiratorischer Insuffizienzen zum Einsatz. Die Systeme lassen sich in Verfahren zur extrakorporalen Kohlendioxid (CO2-)Eliminierung (ECCO2R) bei ventilatorischer Insuffizienz und Verfahren zur extrakorporalen Membranoxygenierung (ECMO) bei schwerer hypoxämischer Insuffizienz unterteilen. Trotz der technologischen Fortentwicklung bleiben extrakorporale Lungenunterstützungsverfahren invasive und potenziell komplikationsträchtige Therapieformen mit Blutungen und Gefäßverletzungen als die beiden Hauptkomplikationen. Daher sollten Indikation und Kontraindikationen stets kritisch abgewogen werden und ihr Einsatz nur in Zentren mit entsprechender Erfahrung und Expertise erfolgen.

Schlüsselwörter

Respiratorisches Versagen Hyperkapnie Extrakorporale Membranoxygenierung Beatmung Weaning 

Extracorporeal lung support

Abstract

Systems for extracorporeal lung support have recently undergone significant technological improvements leading to more effective and safe treatment. Despite limited scientific evidence these systems are increasingly used in the intensive care unit for treatment of different types of acute respiratory failure. In general two types of systems can be differentiated: devices for extracorporeal carbon dioxide removal (ECCO2R) for ventilatory insufficiency and devices for extracorporeal membrane oxygenation (ECMO) for severe hypoxemic failure. Despite of all technological developments extracorporeal lung support remains an invasive and a potentially dangerous form of treatment with bleeding and vascular injury being the two main complications. For this reason indications and contraindications should always be critically considered and extracorporeal lung support should only be carried out in centers with appropriate experience and expertise.

Keywords

Respiratory failure Hypercapnia Extracorporeal membrane oxygenation  Ventilation Weaning  

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

S. Braune hat Vortragshonorare von der Novalung GmbH erhalten. S. Kluge ist Mitglied im Advisory Board der Novalung GmbH und der Firma Gambro, er hat zudem Vortragshonorare von der Novalung GmbH und der Firma Gambro erhalten. A. Sieweke und D. Jarczak geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Klinik für IntensivmedizinUniversitätsklinikum Hamburg-EppendorfHamburgDeutschland
  2. 2.IV. Medizinische Klinik, Internistische Intensivmedizin und NotaufnahmeSt. Franziskus-HospitalMünsterDeutschland

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