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Pneumologie 2009; 63(5): 282-287
DOI: 10.1055/s-0029-1214508
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Perioperatives Management bei Patienten mit schlafbezogenen Atmungsstörungen

Perioperative Management of Patients Suffering from Sleep-Related Breathing DisordersF.  Dette1 , M.  Zoremba1 , J.  Heitmann2 , S.  Canisius2 , H.  Wulf1 , U.  Koehler2
  • 1Klinik für Anästhesie und Intensivtherapie (Direktor: Prof. Dr. H. Wulf )
  • 2Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
Further Information

Publication History

eingereicht 3. 12. 2008

akzeptiert nach Revision 25. 2. 2009

Publication Date:
15 April 2009 (online)

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Zusammenfassung

Patienten mit schlafbezogenen Atmungsstörungen (SBAS) stellen innerhalb des operativen Gesamtkollektivs eine besondere Risikogruppe dar und sind während der perioperativen Phase in zwei von einander unabhängigen Perioden vital gefährdet. Während sich in der postoperativen Frühphase noch Überhänge von Narkosesubstanzen negativ auf die Atemarbeit auswirken, wird die postoperative Spätphase besonders durch Veränderungen des REM-Schlafanteils in der Nacht und damit assoziierten Herz-Kreislaufdysregulationen charakterisiert. Um ein sicheres perioperatives Management von Patienten mit SBAS gewährleisten zu können, müssen lückenloses Monitoring (O2-Sättigung und pCO2) sowie die Möglichkeit der postoperativen nicht-invasiven Beatmung garantiert werden.

Abstract

Sleep-related breathing disorders have been associated with increased perioperative morbidity and mortality. The respective patients are at risk during two independent periods. Besides an early period, characterised by the influence of anaesthetics, patients are at risk also during a late period, which is characterised by nocturnal desaturation and disturbances of the cardiovascular system, caused by interference with the sleep architecture, especially of the REM sleep. To assure a safe perioperative management, a close monitoring (O2 saturation and pCO2) and the option for non-invasive ventilation have to be guaranteed.

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Dr. med. Frank Dette

Klinik für Anästhesie und Intensivtherapie
Universitätsklinikum Gießen und Marburg GmbH
Standort Marburg

Baldingerstraße 1
35033 Marburg

Email: Frank.Dette@web.de

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