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Nichtinvasive Beatmung in der präklinischen Notfallmedizin

Noninvasive ventilation in out-of-hospital emergency medicine

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Medizinische Klinik - Intensivmedizin und Notfallmedizin Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Bei nichtinvasiver Beatmung handelt es sich um eine maschinelle Unterstützung der Atmung ohne Einsatz eines künstlichen Atemwegs. Es ist also kein Tubus und damit auch keine Analgosedierung notwendig. Sie bietet gegenüber invasiven Formen der Beatmung einige Vorteile.

Fragestellung

Viele Patienten werden präklinisch wegen akuter Atemnot behandelt. Für diese Patienten ist nichtinvasive Beatmung eine mögliche Therapieoption. Einige präklinische Intubationen können dadurch vermieden werden, dass irgendeine Art von nichtinvasiver präklinischer Beatmung zur Verfügung steht.

Schlussfolgerung

Damit die nichtinvasive Beatmung allen Patienten mit respiratorischer Insuffizienz angeboten werden kann, muss sie auch präklinisch verfügbar sein. Die modernen, im Rettungsdienst eingesetzten Beatmungsgeräte sind zur Durchführung von nichtinvasiver Beatmung geeignet.

Abstract

Background

Noninvasive ventilation is mechanical respiratory support without the use of an artificial airway. There is no need for a tube or analgosedation. There are some advantages in comparison to invasive forms of ventilation.

Objectives

Many patients are treated out of hospital because of acute dyspnea. For these patients, noninvasive ventilation is a therapeutic option. Some prehospital intubations can be avoided, if some kind of noninvasive ventilation is available.

Conclusions

In order to offer noninvasive ventilation to all patients, it also has to be available in the prehospital setting. Modern mechanical ventilators, which are used in emergency medical service, are eligible to provide noninvasive ventilation.

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Abbreviations

ARDS:

„Acute respiratory distress syndrome“ – schwere entzündliche Reaktion der Lunge, hervorgerufen durch Infektion, Sepsis oder direkte Lungenschädigung

CPAP:

„Continuous positive airway pressure“ – Spontanatmung kombiniert mit kontinuierlichem Überdruck (PEEP)

PEEP:

„Positive end-expiratory pressure“ – positiver endexspiratorischer Druck bei maschineller Beatmung

NIV:

„Noninvasive ventilation“ – Beatmung über eine Maske oder einen Helm ohne gleichzeitige Atemwegssicherung mittels Intubation

PSV:

„Pressure support ventilation“ – Druckunterstützung spontaner Atemanstrengungen

COPD:

„Chronic obstructive pulmonary disease“ – Lungenerkrankungen, bei denen v. a. die Ausatmung behindert ist.

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Interessenkonflikt. R. Doppler gibt an, dass kein Interessenkonflikt besteht.

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  1. Medizinische Abteilung, LKH-Bruck, Tragösserstr. 1, 8600, Bruck an der Mur, Österreich

    R. Doppler

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Doppler, R. Nichtinvasive Beatmung in der präklinischen Notfallmedizin. Med Klin Intensivmed Notfmed 109, 109–114 (2014). https://doi.org/10.1007/s00063-013-0305-4

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