Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
[Weaning from mechanical ventilation: Which strategies are useful?].
During acute respiratory failure, intubation and invasive mechanical ventilation may be life saving procedures. However, with increasing time on the ventilator, the rate of complications increases and prolonged mechanical ventilation is associated with increased morbidity, mortality and high ICU cost. ⋯ These include an early screening of weaning readiness based on established criteria, the choice of the concept of ventilation and ventilator modes, the use of weaning protocols, "closed loop" automated ventilation and weaning. This article describes the relevance of the different ventilator strategies that are applied during weaning from mechanical ventilation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Review[Current concepts of weaning children from invasive ventilation].
Timely weaning from invasive ventilation is of major importance to limit time of invasive ventilation and improve outcomes. However, in pediatrics only limited knowledge on the optimal weaning approach is available. ⋯ Standardized daily evaluation of weaning readiness, daily interruption of sedation, use of pediatric sedation protocols, application of noninvasive ventilation and prophylactic treatment with steroids of patients with high risk for post-extubation upper airway obstruction have been shown to decrease duration of invasive ventilation or to decrease the risk of extubation failure. However, due to the heterogeneous patient population in pediatric intensive care units, an individual approach might be necessary for certain subgroups of pediatric patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
[Weaning - Definition and clinical context from the anesthetic point of view].
Independent from the mode of mechanical ventilation, particularly a quick termination of mechanical ventilation is essential for the weaning progress. Respirator-associated complications need to be early detected and treated. Thus it is important to know correspondent pathomechanisms as they have a crucial influence on the weaning process. To facilitate a holistic treatment approach for patients in prolonged weaning, a tight junction of intensive care within specialized units seems mandatory.