Akutes Lungenversagen (ARDS) – Standardisierte Therapie auf der Intensivstation

Das akute Lungenversagen (ARDS) ist trotz umfangreicher, jahrzehntelanger Bemühungen weiterhin mit einer hohen Mortalität verbunden und stellt höchste Ansprüche an die intensivmedizinische Therapie. In den letzten Jahren konnten Fortschritte in der ARDS-Therapie verzeichnet und erstmals ein messbarer Rückgang der Mortalität erzielt werden. Grundlage einer effektiven Therapie ist die zeitnahe Erkennung eines drohenden Lungenversagens, eine frühe und sachgerechte Behandlung der Grunderkrankung sowie eine adäquate Beatmungstherapie zur Vermeidung weiterer beatmungsassoziierter Lungenschäden. Die neue ARDS-Definition sowie die Kernelemente der Therapie werden hier zusammengefasst.

Despite of enormous efforts acute respiratory distress syndrome (ARDS) still is associated with high mortality among patients and constitutes a major challenge for the intensive care physician. In recent years it could be demonstrated that early diagnosis and standardized therapy algorithms led to decreased mortality. The key element of an effective therapy of ARDS is the early identification and diagnosis of the lung injury, early treatment of the underlying disease and a ventilator therapy which minimizes iatrogenic ventilator-induced lung injury. The current definition of ARDS and the key elements of standardized ARDS therapy are summarized here.

Key words

Acute respiratory distress syndrome (ARDS) - mechanical ventilation - PEEP

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