Ort der maschinellen Beatmung im Beatmungszentrum - Intensivstation, Intermediate care oder spezialisierte Normalstation

Zusammenfassung

Oft sind die beiden Begriffe „Beatmung” und „Intensivstation” auch heute noch fest miteinander verknüpft. Die kontinuierlich steigende Anzahl von Beatmungsfällen, der wachsende Kostendruck und die eingeschränkten Ressourcen sind wesentliche Argumente für einen flexiblen Umgang bei der Wahl des Bereiches, in dem beatmet wird. Das pneumologische Beatmungszentrum, in dem sich die Intensivstation für die Maximalversorgung, respiratorische Intermediärstationen und schließlich spezialisierte Normalstationen komplementär ergänzen, hat gute Zukunftsperspektiven. In diesem Konzept kommt der respiratorischen Intermediärstation (respiratory intermediate care unit, RICU) eine Schlüsselrolle zu, da sie einen wichtigen Anteil der bisherigen Aufgaben der Intensivstation effektiv und kostengünstig übernehmen kann. Wichtige Schwerpunkte der RICU sind die schwierige Respiratorentwöhnung und die nicht-invasive Beatmung bei akuter und chronischer Atmungsinsuffizienz. Voraussetzungen für den Therapieerfolg im Bereich der RICU sind das erfahrene Behandlungsteam, adäquate Räumlichkeiten und gute technische Ausstattung.

Abstract

Until recently “mechanical ventilation” meant “intensive care unit (ICU)”. Important arguments for more flexibility concerning the locality where patients are mechanically ventilated are the increase in number of patients, costs and reduced resources. The pulmonary centre for mechanical ventilation, where ICU, respiratory intermediate care unit (RICU) and the specialized normal ward are complementary, is an attractive option for the future. The RICU is the key player in this concept, since as a step down unit it represents a cost-effective approach to the care of substantial numbers of selected patients requiring specialized respiratory care, e. g. intensive respiratory monitoring and therapy, particularly those requiring prolonged mechanical ventilation and non-invasive mechanical ventilation. Success of the RICU requires an experienced team, adequate location and high quality of technical equipment, experienced team, adequate location and high quality of technical equipment.

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