Zusammenfassung
Die akute Exazerbation einer interstitiellen Lungenerkrankung ist gekennzeichnet durch eine kritische Verschlechterung des Gasaustauschs und der Ventilation. Neben der Exazerbation der Grunderkrankung sind in erster Linie akute, schwere Infektionen, akute Lungenembolie oder das Auftreten eines Pneumothorax Ursachen für die klinische Verschlechterung. Das klinische Bild wird dominiert durch eine zunehmende respiratorische Insuffizienz, die eine mechanische Atmungsunterstützung (nichtinvasiv oder invasiv) erfordert. Die Mortalität von beatmungspflichtigen Patienten mit akuter Verschlechterung einer interstitiellen Lungenerkrankung ist sehr hoch und liegt zwischen 80 und 100 %, so dass die Indikation für eine mechanische Beatmungsunterstützung kritisch gesehen werden muss. Die Einstellung und Durchführung der mechanischen Beatmung richtet sich sehr nach der individuellen pathophysiologischen Situation und stellt eine große Herausforderung an den Intensivmediziner dar.
Abstract
Acute exacerbation of interstitial pulmonary disease is characterized by a critical deterioration of gas exchange and respiration. In addition to exacerbation of the underlying disease, the causes of the clinical deterioration are primarily acute severe infections, acute pulmonary embolism and the occurrence of pneumothorax. The clinical picture is characterized by increasing respiratory insufficiency which necessitates mechanical respiratory support (non-invasive or invasive). The mortality of ventilated patients with acute deterioration of interstitial pulmonary disease is very high and ranges between 80 and 100 % so that the indications for mechanical respiratory support must be viewed critically. The conditions and performance of mechanical ventilation depend very much on the individual pathophysiological situation and represent a great challenge for intensive care physicians.
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Pfeifer, M. Chronisch interstitielle Lungenerkrankungen. Pneumologe 10, 253–257 (2013). https://doi.org/10.1007/s10405-012-0619-6
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DOI: https://doi.org/10.1007/s10405-012-0619-6