S3-Leitlinie: Nichtinvasive Beatmung als Therapie der chronischen respiratorischen Insuffizienz

Zusammenfassung

Die S3-Leitlinie zur nichtinvasiven Beatmung als Therapie der chronischen respiratorischen Insuffizienz wurde im Juli 2024 auf der Internetseite der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF) veröffentlicht und bietet umfassende Empfehlungen zur Behandlung der chronisch respiratorischen Insuffizienz bei unterschiedlichen Grunderkrankungen wie z.B. COPD, thorako-restriktiven Erkrankungen, Obesitas-Hypoventilationssyndrom und neuromuskulären Erkrankungen. Eine wichtige Neuerung ist die Aufteilung der vorherigen S2k Leitlinie aus dem Jahr 2017, welche zuvor sowohl die Therapie mittels invasiver Beatmung als auch nicht-invasiver Beatmung beinhaltete. Durch eine vermehrte wissenschaftliche Evidenz und eine deutlich gestiegene Anzahl an Betroffenen, werden diese sehr unterschiedlichen Therapieformen nun in zwei getrennten Leitlinien behandelt. Ziel der Leitlinie ist, die Behandlung von Patienten mit chronischer respiratorischer Insuffizienz durch die nichtinvasive Beatmung zu verbessern und die Indikationsstellung und Therapieempfehlungen den an der Therapie beteiligten Akteuren zugänglich zu machen. Sie basiert auf der neuesten wissenschaftlichen Evidenz und ersetzt die frühere Leitlinie. Zu diesem Zweck werden detaillierte Empfehlungen zur Durchführung der nichtinvasiven Beatmung gegeben, der Einstellung der Beatmungsparameter und der anschließenden Überwachung der Therapie.

Als wichtige Neuerungen der S3 Leitlinie sind neben der aktualisierten Evidenz auch die neuen Empfehlungen zur Versorgungsform der Patienten sowie zahlreiche detaillierte Behandlungspfade zu nennen, welche die Anwenderfreundlichkeit der Leitlinie erhöhen. Zusätzlich widmet sich ein gänzlich überarbeitetes Kapitel ethischen Fragen und bietet Empfehlungen für eine Begleitung am Lebensende. Diese Leitlinie ist ein wichtiges Instrument für Ärzte und andere Gesundheitsfachkräfte, um die Versorgung von Patienten mit chronischer respiratorischer Insuffizienz zu optimieren. Diese Leitlinienfassung hat eine Gültigkeit von drei Jahren, bis Juli 2027.

Abstract

The S3 guideline on non-invasive ventilation as a treatment for chronic respiratory failure was published on the website of the Association of the Scientific Medical Societies in Germany (AWMF) in July 2024. It offers comprehensive recommendations for the treatment of chronic respiratory failure in various underlying conditions, such as COPD, thoraco-restrictive diseases, obesity-hypoventilation syndrome, and neuromuscular diseases. An important innovation is the separation of the previous S2k guideline dating back to 2017, which included both invasive and non-invasive ventilation therapy. Due to increased scientific evidence and a significant rise in the number of affected patients, these distinct forms of therapy are now addressed separately in two different guidelines.

The aim of the guideline is to improve the treatment of patients with chronic respiratory insufficiency using non-invasive ventilation and to make the indications and therapy recommendations accessible to all involved in the treatment process. It is based on the latest scientific evidence and replaces the previous guideline. This revised guideline provides detailed recommendations on the application of non-invasive ventilation, ventilation settings, and the subsequent follow-up of treatment.

In addition to the updated evidence, important new features of this S3 guideline include new recommendations on patient care and numerous detailed treatment pathways that make the guideline more user-friendly. Furthermore, a completely revised section is dedicated to ethical issues and offers recommendations for end-of-life care. This guideline is an important tool for physicians and other healthcare professionals to optimize the care of patients with chronic respiratory failure. This version of the guideline is valid for three years, until July 2027.

Publication History

Article published online:
28 October 2024

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