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2023 | Atemwegsmanagement | OriginalPaper | Buchkapitel

23. Intra- und postoperative Beatmung

verfasst von : Reinhard Larsen, Alexander Mathes

Erschienen in: Beatmung

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die intraoperative Beatmung erfolgt mit speziellen Narkosegeräten im Kreissystem unter Verwendung von CO2-Absorbern. Am häufigsten werden die volumenkontrollierte (VC-CMV) und die druckkontrollierte (PC-CMV) angewandt. Hierbei sollten die Prinzipien der lungenprotektiven Beatmung berücksichtigt werden. Postoperative Störungen der Lungenfunktion sind v. a. bei Oberbauch- und bei intrathorakalen Eingriffen zu erwarten, meist hervorgerufen durch Störungen der Atemmechanik und der Ventilation mit Abnahme der Lungenvolumina und der FRC. Bei den meisten Patienten kann die postoperative respiratorische Insuffizienz ohne maschinelle Atemunterstützung behandelt werden. Bei akuter hypoxämischer respiratorischer Insuffizienz ist Masken-CPAP bzw. PSV häufig ausreichend wirksam. Bei postoperativem Lungenparenchymversagen oder Versagen der Atempumpe muss die Atmung dagegen frühzeitig maschinell unterstützt werden, um eine schwerwiegende respiratorische Dekompensation zu verhindern.
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Metadaten
Titel
Intra- und postoperative Beatmung
verfasst von
Reinhard Larsen
Alexander Mathes
Copyright-Jahr
2023
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-64536-9_23

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