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Erworbene Atemstörungen beim reifen Neugeborenen: Diagnostik und Therapie einschließlich extrakorporaler Membranoxygenierung

Acquired respiratory failure in full-term newborns: diagnostics and therapy including extracorporeal membrane oxygenation

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Intensivmedizin und Notfallmedizin

Abstract

Newborns who require mechanical ventilation represent a high-risk population who have significant morbidity and mortality. Experienced handling of conventional therapies including high frequency oscillation ventilation and initiation of newer treatment options, such as surfactants and nitric oxide, has led to some improvements. Nevertheless extracorporeal membrane oxygenation (ECMO) is a life-saving technology in newborns with respiratory failure refractory to maximal medical therapy. This article demonstrates clinical management and selection criteria for ECMO in newborns contributing to the incidence and clinical signs of acquired diseases which may lead to so called neonatal acute respiratory distress syndrome (neonatal ARDS).

Zusammenfassung

Neugeborene, die künstlich beatmet werden müssen, stellen eine Risikogruppe mit hoher Morbidität und Mortalität dar. Schonendere konventionelle Beatmung sowie die Hochfrequenzoszillations-Ventilation und die Einführung neuerer Behandlungsverfahren wie die Therapie mit Surfactant oder Stickstoffmonoxid hat einige Verbesserungen erbracht. Dennoch ist die Extrakorporale Membranoxygenierung (ECMO) eine lebensrettende Technologie für diejenigen Neugeborenen mit Lungenversagen, bei denen die maximale klinische Therapie nicht greift. Dieser Artikel zeigt das therapeutische Management und die Auswahlkriterien für ECMO beim Neugeborenen ausgehend von den klinischen Zeichen der erworbenen Krankheiten, die zu einem so genannten akuten Atemnotsyndrom (neonatales ARDS) führen können.

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Authors and Affiliations

  1. Kinderklinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim, Germany

    Thomas Schaible

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  1. Thomas Schaible
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Correspondence to Thomas Schaible.

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Serie: Respiratorisches Versagen im Früh- und Neugeborenenalter Herausgegeben von L. Gortner (Homburg/Saar)

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Schaible, T. Erworbene Atemstörungen beim reifen Neugeborenen: Diagnostik und Therapie einschließlich extrakorporaler Membranoxygenierung. Intensivmed 45, 111–120 (2008). https://doi.org/10.1007/s00390-008-0867-1

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  • DOI: https://doi.org/10.1007/s00390-008-0867-1

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