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Einsatz von gecufften Endotrachealtuben bei Kindern in der Notfall- und Rettungsmedizin

Cuffed pediatric tracheal tubes in emergency medicine

  • Pädiatrische Notfälle
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Notfall + Rettungsmedizin Aims and scope Submit manuscript

Zusammenfassung

Moderne Pädiatrietuben mit Cuff kommen in der Kinderanästhesie und Kinderintensivmedizin vermehrt zur Anwendung. Hohe Treffsicherheit bei der Tubusgrößenwahl sowie die zuverlässige Abdichtung des Atemwegssystems ohne den Einsatz übergroßer Tuben sind entscheidende Vorteile gecuffter Tuben auch bei Säuglingen und kleinen Kindern in der Notfall- und Rettungsmedizin. Für einen sicheren Einsatz gecuffter Tuben in dieser Altersgruppe ist die Auswahl eines Pädiatrietubus mit korrekt platziertem Hochvolumen-Niederdruck-Cuff und Intubationstiefenmarkierung sowie eine geprüfte Tubusgrößenauswahlliste die Vorraussetzung. Die Überprüfung des Tubus auf eine Luftleckage nach der Intubation bei noch entleertem Cuff, das Füllen des Cuffs unter Cuffdruckkontrolle sowie die Cuffdruckbegrenzung auf maximal 20 cmH2O erlauben den sicheren Einsatz von gecufften Tuben bei Säuglingen und Kindern. Fehlen gute Kindertuben mit Cuff, Altersgrößenauswahlliste und Cuffmanometer, so dürfen gecuffte Tuben bei Säuglingen und Kindern in der Rettungs- und Notfallmedizin nicht eingesetzt werden. Dann sollten weiterhin ungecuffte Tuben zum Einsatz gelangen.

Abstract

Cuffed pediatric tracheal tubes are increasingly used in pediatric anesthesia and pediatric intensive care for infants and small children. High chance to select a correct-fitting tube and reliable sealing of the trachea without the use of an oversized uncuffed tube are the most import advantages of using cuffed tubes for infants and small children in emergency situations. If cuffed tubes in pediatric emergency are used a well-designed tube with a correctly placed high volume-low pressure and an adequate intubation depth mark and the presence of a printed chart with recommendations for age-related tube size selection should be available. Confirmation of an air leak around the tracheal tube after intubation with the cuff not inflated, cuff inflation by cuff pressure monitoring and limitation of cuff pressure at 20 cmH2O allows the safe use of cuffed tracheal tubes in infants and children. In case of lack of good pediatric cuffed tubes, lack of a chart with recommendations for age-related tube size selection and lack of a cuff pressure manometer, cuffed pediatric tubes should not be used in infants and children in the emergency setting.

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Interessenkonflikt

PD Dr. M. Weiss entwickelt in Zusammenarbeit mit Microcuff GmbH (Weinheim, Deutschland) und TYCO Health Care, Respiratory Group (Athlone, Irland) kindergerechte Beatmungstuben mit Cuff. Aus diesen Kooperationen sind weder Patentrechte, Verträge noch finanzielle Abgeltungen für PD Dr. Weiss hervorgegangen.

Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Authors and Affiliations

  1. Intensivstation des Dr. von Haunerschen Kinderspitals, Klinikum der Universität München

    T. Nicolai

  2. Anästhesieabteilung, Universitäts-Kinderkliniken, Steinwiesstraße 75, 8043, Zürich, Schweiz

    M. Weiss

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  1. M. Weiss
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  2. T. Nicolai
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Correspondence to M. Weiss.

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Weiss, M., Nicolai, T. Einsatz von gecufften Endotrachealtuben bei Kindern in der Notfall- und Rettungsmedizin. Notfall Rettungsmed 9, 186–189 (2006). https://doi.org/10.1007/s10049-006-0805-3

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  • DOI: https://doi.org/10.1007/s10049-006-0805-3

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