intensiv 2009; 17(6): 284-291
DOI: 10.1055/s-0029-1243272
Schwerpunkt: Der atmungsbeeinträchtigte Patient

© Georg Thieme Verlag KG Stuttgart · New York

Herkömmliche und moderne Spontanatmungsverfahren in der Respiratortherapie

Oliver Rothaug, Norbert Schwabbauer, Christian Karagiannidis, Thomas Bretschneider, Arnold Kaltwasser, Rolf Dubb
Further Information

Publication History

Publication Date:
02 December 2009 (online)

Zusammenfassung

In der Vergangenheit wurde bei der Entwicklung von Intensivrespiratoren vermehrt Rücksicht darauf genommen, die Mess- und Regeltechnik so sensibel und exakt wie irgend möglich zugunsten einer besseren Interaktion zwischen Respirator und Atemmuster des Patienten zu gestalten. Derzeit bieten die zur Verfügung stehenden Respiratoren eine Vielzahl verschiedener Beatmungsverfahren an, welche die Spontanatmung des Patienten in unterschiedlichen Maßen zulassen bzw. unterstützen.

Literatur

  • 1 Tassaux D, Dalmas E, Gratadour P. et al. . Patient-ventilator interactions during partial ventilatory support: a preliminary study comparing the effects of adaptive support ventilation with synchronized intermittent mandatory ventilation plus inspiratory pressure support.  Crit Care Med. 2002;  30 801-807
  • 2 Moerer O, Beck J, Brander L, Quintel M, Slutsky A S, Brunet F, Sinderby C. Subjectventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation.  Intensive Care Med. 2008;  34 1615-1623
  • 3 Kondili E, Xirouchaki N, Georgopoulos D. Modulation and treatment of patient-ventilator dyssynchrony.  Curr Opin Crit Care. 2007;  13 84-89
  • 4 Ranieri V M, Giunta F, Suter P M. et al. . Mechanical Ventilation as a Mediator of Multisystem Organ Failure in Acute Respiratory Distress Syndrome.  JAMA. 2000;  284 43-f.
  • 5 Levine S, Nguyen T, Taylor N, Friscia M E, Budak M T, Rothenberg P, Zhu J, Sachdeva R, Sonnad S, Kaiser L R, Rubinstein N A, Powers S K, Shrager J B. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans.  N Engl J Med. 2008;  358 1327-1335
  • 6 Vassilakopoulos T. Ventilator-induced diaphragm dysfunction: the clinical relevance of animal models.  Intensiv Care Med. 2008;  34 7-16
  • 7 Putensen C, Rasanen J, Lopez F A, Downs J B. Ventilation-perfusion distributions during mechanical ventilation with superimposed spontaneous breathing in canine lung injury.  Am J Respir Crit Care Med. 1994;  150 101-108
  • 8 Stüber F, Spiegel T von, Mutz N. Long-Term Effects of Spontaneous Breathing During Ventilatory Support in Patients with Acute Lung Injury.  AJRCCM. 2001;  164 43-49
  • 9 Sinderby C, Navalesi P, Beck J, Skrobic J, Comtois N, Friberg S, Gottfried S B, Lindström L. Neural control of mechanical ventilation.  Nature Med. 1999;  5 1433-1436
  • 10 Sinderby C. Ventilatory assist driven by patient demand.  Am J Respir Crit Care Med. 2003;  168 729-730
  • 11 Tassaux D, Gainnier M, Battisti A, Jolliet P. Impact of Expiratory Trigger Setting on Delayed Cycling and Inspiratory Muscle Workload.  Am J Respir Crit Care Med. 2005;  172 1283-1289
  • 12 Thille A W, Rodiquez P, Cabello B, Lellouche F, Brochard L. Patient-ventilator asynchrony during assisted mechanical ventilation.  Intensive Care Med. 2006;  32 1515-1522
  • 13 Laurence V, Didier T, Philippe J. Performance of noninvasive ventilation modes on ICU ventilators during pressure support : a bench model study.  Intensive Care Medicine. 2007;  33 1444-1451
  • 14 Esteban A, Anzueto A, Alia I. et al. . How is mechanical ventilation employed in the intensive care unit? An international utilization review.  Am J Respir Crit Care Med. 2000;  161 1450-1458
  • 15 Ferreira I C, Chipman D W, Kacmarek R M. et al. . Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study.  Intensive Care Med. 2008;  34 1669-1675
  • 16 Imanaka H, Nishimura M, Takeuchi M. et al. . Autotriggering caused by cardiogenic oscillation during flow-triggered mechanical ventilation.  Crit Care Med. 2000;  28 402-407
  • 17 Putensen C, Zech S, Wrigge H, Zinserling Wrigge H, Varelmann D, Zinserling J, Hering R, Kuhlen R. „Proportional assist ventilation” kombiniert mit„automatic tube compensation”. Ein viel versprechendes Konzept der augmentierten Spontanatmung?.  Anästhesist. 2003;  52 341-348
  • 18 Moerer O, Barwing J, Quintel M. Neurally adjusted ventilatory assist (NAVA).  Anaesthesist. 2008;  57 998-1005
  • 19 Oczenski W. Atmen – Atemhilfen. 8., überarb. Aufl. Thieme, Stuttgart 2008
  • 20 Calderoni E, Confalonieri M, Puccio P G. et al. . Patient-ventilatior asynchrony during noninvasive ventilation: the role of expiratory trigger. ; : – .  Intensive Care Med. 1999;  25 662-667
  • 21 Beck J, Campoccia F, Allo J C, Brander L, Brunet F, Slutsky A S, Sinderby C. Improved synchrony and respiratory unloading by Neurally Adjusted Ventilatory Assist (NAVA) in lung-injured rabbits.  Pediatr Res. 2007;  61 289-294
  • 22 Ellett M L, Beckstrand J, Flueckinger J. et al. . Predicting the insertion distance for placing gastric tubes.  Clin Nurs Res. 2005;  14 11-27
  • 23 Colombo D, Cammarota G, Bergamaschi V, De Lucia M, Corte F D, Navalesi P. Physiologic response to varying levels of pressure support and neurally adjusted ventilatory assist in patients with acute respiratory failure.  Intensive Care Med. 2008;  34 2010-2018

Oliver Rothaug

Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin

Anaesthesiologie II – Operative Intensivstation 0118

Universitätsmedizin Göttingen

Robert-Koch-Straße 40

37075 Göttingen

Email: o.rothaug@gmx.de

    >