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Weaningstation – was ist anders als auf der ICU?

Weaning ward—different from the ICU?

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Zusammenfassung

Die Beatmungsentwöhnung von Patienten ist auf vielen Intensivstationen oftmals ein nachrangiges Problem, verglichen mit den akut lebensbedrohlich Erkrankten. Patienten, deren akutes grundliegendes Problem weitgehend behandelt wurde, sei es neurologisch, operativ oder internistisch, benötigen aber im Gegensatz eine effektive Strategie, um die Beatmungsdauer zu verkürzen, eine Dekanülierung zu erreichen und eine Rekonvaleszenz ad Integrum einzuleiten.

Weaningstationen fokussieren diese oftmals komplexen Maßnahmen, um insbesondere bei Patienten im prolongierten Weaning die Entwöhnung von der maschinellen Beatmung zu ermöglichen. Diese Aufgabe gelingt nur im Team von Ärzten, Pflegern, Atem-/Physiotherapeuten, Logopäden und Psychologen. Grundvoraussetzungen sind von Fachgesellschaften im Rahmen von Zertifizierungsmaßnahmen festgelegt worden, um einheitliche Versorgungsstandards herzustellen. Bei Aufnahme eines Entwöhnungspatienten muss der aktuelle Status seiner Erkrankungen inklusive der respiratorischen muskulären Funktion eruiert werden, um das dem Weaningversagen zugrunde liegende pathophysiologische Problem behandeln zu können. Ein weiterer Schwerpunkt einer Weaningstation liegt auf der Überleitung der Patienten in die weitere stationäre Versorgung, Rehabilitationsklinik oder auch in die Heimbeatmung.

Abstract

Weaning from mechanical ventilation is generally not the most urgent topic on many ICUs, because acutely endangered patients are usually the staff’s main focus. Nevertheless, even these patients whose underlying problem has been mostly solved—whether it was neurologic, internal or surgical—are in need of a structured weaning strategy. The aim of this weaning “road map” is ventilator independence, decannulation and regaining of muscular strength. Achieving of these aims needs a well-educated team of physicians, nurses, respiratory/physical therapists, logopedists and pychologists. Assessment of patient health status, including respiratory muscle function must be part of the overtaking procedure to be able to focus on the main problem that may be causative for the inability to wean so far. Every weaning unit must be able to organize the future treatment of patients (different ward inside the hospital, rehabilitation) or the transfer into a (ventilated) home care situation.

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  1. Klinik für Operative Intensivmedizin und Intermediate Care, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland

    C. S. Bruells, J. Bickenbach & G. Marx

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  1. C. S. Bruells
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  2. J. Bickenbach
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  3. G. Marx
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Correspondence to C. S. Bruells.

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C. S. Bruells, J. Bickenbach und G. Marx geben an, dass kein Interessenkonflikt besteht.

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

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Bruells, C.S., Bickenbach, J. & Marx, G. Weaningstation – was ist anders als auf der ICU?. Med Klin Intensivmed Notfmed 113, 94–100 (2018). https://doi.org/10.1007/s00063-016-0192-6

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  • DOI: https://doi.org/10.1007/s00063-016-0192-6

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