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Intensivmedizin up2date 2024; 20(02): 141-160
DOI: 10.1055/a-2271-4113
Allgemeine Intensivmedizin

Nicht invasive Beatmung und High-Flow-Therapie: Lebensretter nicht nur bei COPD

Felix Bronisch
,
Thomas Gude
,
F. Joachim Meyer
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Die nicht invasive Beatmung (NIV) und die nasale High-Flow-Therapie (HFNC) sind aus dem Instrumentarium der Intensiv- und Notfallmedizin nicht mehr wegzudenken. Richtig angewendet, können sie dem Patienten mit respiratorischer Insuffizienz eine Intubation ersparen und seine Prognose entscheidend verbessern.
Kernaussagen

  • Um die Vorteile der nicht invasiven Beatmung (NIV) voll ausschöpfen zu können, ist neben der richtigen Indikationsstellung die individuelle Anpassung des Verfahrens an den Patienten und sein Krankheitsbild entscheidend.

  • Essenziell sind die Auswahl und Anpassung des Interfaces sowie die differenzierte Einstellung der Beatmungsparameter.

  • Die Beatmung mit High-Flow-Nasenkanüle (HFNC) bietet im hypoxisch bedingten Versagen eine wertvolle Alternative zur NIV; im hyperkapnischen Versagen kann sie die NIV oft sinnvoll ergänzen, z. B. in NIV-Pausen.

  • Beide Verfahren erfordern eine engmaschige Überprüfung des Therapieerfolgs.

  • Bei Therapieversagen ist eine rechtzeitige Intubation indiziert (s. hierzu auch [Abb. 3]).

Schlüsselwörter

nicht-invasive Beatmung - NIV - High-Flow-Therapie - HFNC - exazerbierte COPD


Publication History

Article published online:
04 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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