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2015 | Hypoxämie | OriginalPaper | Buchkapitel

9. Beatmung, Atemregulation und Weaning, ARDS

verfasst von : Dietrich Henzler, Dr., Rolf Rossaint, Prof. Dr.

Erschienen in: NeuroIntensiv

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die maschinelle Beatmung ist ein wesentlicher Teil der intensivmedizinischen Therapie, da insbesondere bei Patienten mit zerebralen Schädigungen fast regelhaft auch eine Störung der Atemfunktion vorliegt. Die Entwicklung moderner Intensivventilatoren wurde durch die Polioepidemien in Europa in den 1950er Jahren getriggert. Inzwischen stehen hochkomplexe, computergesteuerte Geräte zur Verfügung, die zur Ausnutzung ihrer Potenziale vom Anwender grundlegende Kenntnisse der Atemphysiologie und spezifische Kenntnisse der Atemregulation erfordern. Die Vielfalt verfügbarer Beatmungsmodi macht es möglich, für jeden Patienten die Beatmungstherapie individuell anzupassen. Das ist insofern wichtig, als die maschinelle Beatmung zwar eine akut lebensrettende Maßnahme darstellt, bei unsachgemäßer Durchführung aber eine Schädigung der Lunge verursachen kann. Dieses Kapitel befasst sich mit den Grundlagen der Atemphysiologie und der Technik der maschinellen Beatmung. Es soll den Anwender in die Lage versetzen, die Beatmungseinstellung möglichst optimal an den individuellen Patienten anzupassen.
Literatur
1.
Zurück zum Zitat Afshari A, Brok J, Moller AM, Wetterslev J (2010) Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults. Cochrane Database Syst Rev CD002787 Afshari A, Brok J, Moller AM, Wetterslev J (2010) Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults. Cochrane Database Syst Rev CD002787
2.
Zurück zum Zitat Antonelli M, Pennisi MA, Pelosi P et al (2004) Noninvasive positive pressure ventilation using a helmet in patients with acute exacerbation of chronic obstructive pulmonary disease: a feasibility study. Anesthesiology 100:16–24CrossRefPubMed Antonelli M, Pennisi MA, Pelosi P et al (2004) Noninvasive positive pressure ventilation using a helmet in patients with acute exacerbation of chronic obstructive pulmonary disease: a feasibility study. Anesthesiology 100:16–24CrossRefPubMed
3.
Zurück zum Zitat Bein T, Weber F, Philipp A et al (2006) A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia. Crit Care Med 34:1372–1377CrossRefPubMed Bein T, Weber F, Philipp A et al (2006) A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia. Crit Care Med 34:1372–1377CrossRefPubMed
4.
Zurück zum Zitat Bernard GR, Artigas A, Brigham KL et al (1994) Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. The Consensus Committee. Intensive Care Med 20:225–232CrossRefPubMed Bernard GR, Artigas A, Brigham KL et al (1994) Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. The Consensus Committee. Intensive Care Med 20:225–232CrossRefPubMed
5.
Zurück zum Zitat Blackwood B, Alderdice F, Burns KE et al (2010) Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev CD006904 Blackwood B, Alderdice F, Burns KE et al (2010) Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev CD006904
6.
Zurück zum Zitat Bosma K, Ferreyra G, Ambrogio C et al (2007) Patient-ventilator interaction and sleep in mechanically ventilated patients: Pressure support versus proportional assist ventilation. Critical Care Medicine 35:1048–1054CrossRefPubMed Bosma K, Ferreyra G, Ambrogio C et al (2007) Patient-ventilator interaction and sleep in mechanically ventilated patients: Pressure support versus proportional assist ventilation. Critical Care Medicine 35:1048–1054CrossRefPubMed
7.
Zurück zum Zitat Bosma KJ, Taneja R, Lewis JF (2010) Pharmacotherapy for prevention and treatment of acute respiratory distress syndrome: current and experimental approaches. Drugs 70:1255–1282CrossRefPubMed Bosma KJ, Taneja R, Lewis JF (2010) Pharmacotherapy for prevention and treatment of acute respiratory distress syndrome: current and experimental approaches. Drugs 70:1255–1282CrossRefPubMed
8.
Zurück zum Zitat Brander L, Leong-Poi H, Beck J et al (2009) Titration and implementation of neurally adjusted ventilatory assist in critically ill patients. Chest 135:695–703CrossRefPubMed Brander L, Leong-Poi H, Beck J et al (2009) Titration and implementation of neurally adjusted ventilatory assist in critically ill patients. Chest 135:695–703CrossRefPubMed
9.
Zurück zum Zitat Braun JP, Kumpf O, Deja M, Brinkmann A, Marx G, Bloos F, Kaltwasser A, Dubb R, Muhl E, Greim C, Bause H, Weiler N, Chop I, Waydhas C, Spies C (2013) Intensivmedizinische Qualitätsindikatoren für Deutschland 2013 – 2. Aufl. GMS. Ger Med Sci 2013 (Doc09):11 doi:10.3205/000177 Braun JP, Kumpf O, Deja M, Brinkmann A, Marx G, Bloos F, Kaltwasser A, Dubb R, Muhl E, Greim C, Bause H, Weiler N, Chop I, Waydhas C, Spies C (2013) Intensivmedizinische Qualitätsindikatoren für Deutschland 2013 – 2. Aufl. GMS. Ger Med Sci 2013 (Doc09):11 doi:10.3205/000177
10.
Zurück zum Zitat Briel M, Meade M, Mercat A et al (2010) Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 303:865–873CrossRefPubMed Briel M, Meade M, Mercat A et al (2010) Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 303:865–873CrossRefPubMed
11.
Zurück zum Zitat Brochard L, Rauss A, Benito S et al (1994) Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med 150:896–903CrossRefPubMed Brochard L, Rauss A, Benito S et al (1994) Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med 150:896–903CrossRefPubMed
12.
Zurück zum Zitat Brunkhorst FM, Engel C, Bloos F et al (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 358:125–139CrossRefPubMed Brunkhorst FM, Engel C, Bloos F et al (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 358:125–139CrossRefPubMed
13.
Zurück zum Zitat Burns KE, Adhikari NK, Keenan SP, Meade M (2009) Use of non-invasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review. BMJ 338:b1574CrossRefPubMedPubMedCentral Burns KE, Adhikari NK, Keenan SP, Meade M (2009) Use of non-invasive ventilation to wean critically ill adults off invasive ventilation: meta-analysis and systematic review. BMJ 338:b1574CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Davies A, Jones D, Bailey M et al (2009) Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA 302:1888–1895CrossRefPubMed Davies A, Jones D, Bailey M et al (2009) Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA 302:1888–1895CrossRefPubMed
15.
Zurück zum Zitat Dembinski R, Max M, Bensberg R et al (2002) Pressure Support Compared with Controlled Mechanical Ventilation in Experimental Lung Injury. Anesth Analg 94:1570–1576PubMed Dembinski R, Max M, Bensberg R et al (2002) Pressure Support Compared with Controlled Mechanical Ventilation in Experimental Lung Injury. Anesth Analg 94:1570–1576PubMed
16.
Zurück zum Zitat Determann RM, Royakkers A, Wolthuis EK et al (2010) Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care 14:R1CrossRefPubMedPubMedCentral Determann RM, Royakkers A, Wolthuis EK et al (2010) Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care 14:R1CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Deutsche Gesellschaft fuer Pneumologie und Beatmungsmedizin (2010) S3 Leitlinie Nichtinvasive Beatmung als Therapie der akuten Respiratorischen Insuffizienz. www.leitlinien.net Deutsche Gesellschaft fuer Pneumologie und Beatmungsmedizin (2010) S3 Leitlinie Nichtinvasive Beatmung als Therapie der akuten Respiratorischen Insuffizienz. www.​leitlinien.​net
19.
Zurück zum Zitat Eichacker PQ, Gerstenberger EP, Banks SM et al (2002) Meta-analysis of acute lung injury and acute respiratory distress syndrome trials testing low tidal volumes. Am J Respir Crit Care Med 166:1510–1514CrossRefPubMed Eichacker PQ, Gerstenberger EP, Banks SM et al (2002) Meta-analysis of acute lung injury and acute respiratory distress syndrome trials testing low tidal volumes. Am J Respir Crit Care Med 166:1510–1514CrossRefPubMed
20.
Zurück zum Zitat Esteban A, Alia I, Tobin MJ et al (1999) Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 159:512–518CrossRefPubMed Esteban A, Alia I, Tobin MJ et al (1999) Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 159:512–518CrossRefPubMed
21.
Zurück zum Zitat Esteban A, Anzueto A, Frutos F et al (2002) Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 287:345–355CrossRefPubMed Esteban A, Anzueto A, Frutos F et al (2002) Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 287:345–355CrossRefPubMed
22.
Zurück zum Zitat Esteban A, Frutos-Vivar F, Ferguson ND et al (2004) Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med 350:2452–2460CrossRefPubMed Esteban A, Frutos-Vivar F, Ferguson ND et al (2004) Noninvasive positive-pressure ventilation for respiratory failure after extubation. N Engl J Med 350:2452–2460CrossRefPubMed
23.
Zurück zum Zitat Fabry B, Guttmann J, Wolff G (1994) Automatic compensation of endotracheal tube resitance in spontaneously breathing patients. Technol Health Care 1:281–291PubMed Fabry B, Guttmann J, Wolff G (1994) Automatic compensation of endotracheal tube resitance in spontaneously breathing patients. Technol Health Care 1:281–291PubMed
24.
Zurück zum Zitat Finfer S, Norton R, Bellomo R et al (2004) The SAFE study: saline vs. albumin for fluid resuscitation in the critically ill. Vox Sang 87(Suppl 2):123–131CrossRefPubMed Finfer S, Norton R, Bellomo R et al (2004) The SAFE study: saline vs. albumin for fluid resuscitation in the critically ill. Vox Sang 87(Suppl 2):123–131CrossRefPubMed
25.
Zurück zum Zitat de Gama AM, Spieth PM, Pelosi P et al (2008) Noisy pressure support ventilation: a pilot study on a new assisted ventilation mode in experimental lung injury. Crit Care Med 36:818–27CrossRef de Gama AM, Spieth PM, Pelosi P et al (2008) Noisy pressure support ventilation: a pilot study on a new assisted ventilation mode in experimental lung injury. Crit Care Med 36:818–27CrossRef
26.
Zurück zum Zitat Gattinoni L, Caironi P, Pelosi P, Goodman LR (2001) What has computed tomography taught us about the acute respiratory distress syndrome? Am J Respir Crit Care Med 164:1701–1711CrossRefPubMed Gattinoni L, Caironi P, Pelosi P, Goodman LR (2001) What has computed tomography taught us about the acute respiratory distress syndrome? Am J Respir Crit Care Med 164:1701–1711CrossRefPubMed
27.
Zurück zum Zitat Girard TD, Kress JP, Fuchs BD et al (2008) Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 371:126–134CrossRefPubMed Girard TD, Kress JP, Fuchs BD et al (2008) Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 371:126–134CrossRefPubMed
28.
Zurück zum Zitat Gonzalez M, Arroliga AC, Frutos-Vivar F et al (2010) Airway pressure release ventilation versus assist-control ventilation: a comparative propensity score and international cohort study. Intensive Care Med 36:817–827CrossRefPubMed Gonzalez M, Arroliga AC, Frutos-Vivar F et al (2010) Airway pressure release ventilation versus assist-control ventilation: a comparative propensity score and international cohort study. Intensive Care Med 36:817–827CrossRefPubMed
29.
Zurück zum Zitat Graham MR, Haberman CJ, Brewster JF et al (2005) Mathematical modelling to centre low tidal volumes following acute lung injury: a study with biologically variable ventilation. Respir Res 6:64CrossRefPubMedPubMedCentral Graham MR, Haberman CJ, Brewster JF et al (2005) Mathematical modelling to centre low tidal volumes following acute lung injury: a study with biologically variable ventilation. Respir Res 6:64CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Hedenstierna G, Tokics L, Lundquist H et al (1994) Phrenic nerve stimulation during halothane anesthesia. Effects of atelectasis. Anesthesiology 80:751–760CrossRefPubMed Hedenstierna G, Tokics L, Lundquist H et al (1994) Phrenic nerve stimulation during halothane anesthesia. Effects of atelectasis. Anesthesiology 80:751–760CrossRefPubMed
31.
Zurück zum Zitat Hering R, Peters D, Zinserling J et al (2002) Effects of spontaneous breathing during airway pressure release ventilation on renal perfusion and function in patients with acute lung injury. Intensive Care Med 28:1426–1433CrossRefPubMed Hering R, Peters D, Zinserling J et al (2002) Effects of spontaneous breathing during airway pressure release ventilation on renal perfusion and function in patients with acute lung injury. Intensive Care Med 28:1426–1433CrossRefPubMed
32.
Zurück zum Zitat Hormann C, Baum M, Putensen C et al (1997) Effects of spontaneous breathing with BIPAP on pulmonary gas exchange in patients with ARDS. Acta Anaesthesiol Scand Suppl 111:152–155PubMed Hormann C, Baum M, Putensen C et al (1997) Effects of spontaneous breathing with BIPAP on pulmonary gas exchange in patients with ARDS. Acta Anaesthesiol Scand Suppl 111:152–155PubMed
33.
Zurück zum Zitat Keenan SP, Sinuff T, Burns KE et al (2011) Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ (online first) Keenan SP, Sinuff T, Burns KE et al (2011) Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ (online first)
34.
Zurück zum Zitat Kleinman BS, Frey K, VanDrunen M et al (2002) Motion of the diaphragm in patients with chronic obstructive pulmonary disease while spontaneously breathing versus during positive pressure breathing after anesthesia and neuromuscular blockade. Anesthesiology 97:298–305CrossRefPubMed Kleinman BS, Frey K, VanDrunen M et al (2002) Motion of the diaphragm in patients with chronic obstructive pulmonary disease while spontaneously breathing versus during positive pressure breathing after anesthesia and neuromuscular blockade. Anesthesiology 97:298–305CrossRefPubMed
35.
Zurück zum Zitat Kopp R, Henzler D, Dembinski R, Kuhlen R (2004) Extracorporeal membrane oxygenation by acute respiratory distress syndrome. Anaesthesist 53:168–174CrossRefPubMed Kopp R, Henzler D, Dembinski R, Kuhlen R (2004) Extracorporeal membrane oxygenation by acute respiratory distress syndrome. Anaesthesist 53:168–174CrossRefPubMed
36.
Zurück zum Zitat Meade M, Guyatt G, Cook D et al (2001) Predicting success in weaning from mechanical ventilation. Chest 120:400S–424SCrossRefPubMed Meade M, Guyatt G, Cook D et al (2001) Predicting success in weaning from mechanical ventilation. Chest 120:400S–424SCrossRefPubMed
37.
Zurück zum Zitat Meade MO, Cook DJ, Guyatt GH et al (2008) Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299:637–645CrossRefPubMed Meade MO, Cook DJ, Guyatt GH et al (2008) Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA 299:637–645CrossRefPubMed
38.
Zurück zum Zitat Metnitz PG, Krenn CG, Steltzer H et al (2002) Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med 30:2051–2058CrossRefPubMed Metnitz PG, Krenn CG, Steltzer H et al (2002) Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med 30:2051–2058CrossRefPubMed
39.
Zurück zum Zitat Namen AM, Ely EW, Tatter SB, Case LD, Lucia MA, Smith A, Landry S, Wilson JA, Glazier SS, Branch CL, Kelly DL, Bowton DL, Haponik EF (2001) Predictors of successful extubation in neurosurgical patients. Am J Respir Crit Care Med 163(3 Pt 1):658–664CrossRefPubMed Namen AM, Ely EW, Tatter SB, Case LD, Lucia MA, Smith A, Landry S, Wilson JA, Glazier SS, Branch CL, Kelly DL, Bowton DL, Haponik EF (2001) Predictors of successful extubation in neurosurgical patients. Am J Respir Crit Care Med 163(3 Pt 1):658–664CrossRefPubMed
40.
Zurück zum Zitat Papazian L, Forel JM, Gacouin A et al (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363:1107–1116CrossRefPubMed Papazian L, Forel JM, Gacouin A et al (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363:1107–1116CrossRefPubMed
41.
Zurück zum Zitat Peek GJ, Mugford M, Tiruvoipati R et al (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374:1351–1363CrossRefPubMed Peek GJ, Mugford M, Tiruvoipati R et al (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 374:1351–1363CrossRefPubMed
42.
Zurück zum Zitat Putensen C, Zech S, Wrigge H et al (2001) Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury. Am J Respir Crit Care Med 164:43–49CrossRefPubMed Putensen C, Zech S, Wrigge H et al (2001) Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury. Am J Respir Crit Care Med 164:43–49CrossRefPubMed
43.
Zurück zum Zitat Ranieri VM, Suter PM, Tortorella C et al (1999) Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA 282:54–61CrossRefPubMed Ranieri VM, Suter PM, Tortorella C et al (1999) Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA 282:54–61CrossRefPubMed
44.
Zurück zum Zitat Rossaint R, Werner C, Zwissler B (2008) Die Anästhesiologie, 2. Aufl. Springer, Berlin Heidelberg New YorkCrossRef Rossaint R, Werner C, Zwissler B (2008) Die Anästhesiologie, 2. Aufl. Springer, Berlin Heidelberg New YorkCrossRef
45.
Zurück zum Zitat S2e-Leitlinie der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) (2008) Lagerungstherapie zur Prophylaxe oder Therapie von pulmonalen Funktionsstörungen. Anästhesie Intensivmed 49:1–24 S2e-Leitlinie der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) (2008) Lagerungstherapie zur Prophylaxe oder Therapie von pulmonalen Funktionsstörungen. Anästhesie Intensivmed 49:1–24
47.
Zurück zum Zitat Sessler CN, Gosnell M, Grap MJ, Brophy GT, O’Neal PV, Keane KA et al (2002) The Richmond Agitation- Sedation Scale: validity and reliability in adult intensive care patients. Am J Respir Crit Care Med 166:1338–1344CrossRefPubMed Sessler CN, Gosnell M, Grap MJ, Brophy GT, O’Neal PV, Keane KA et al (2002) The Richmond Agitation- Sedation Scale: validity and reliability in adult intensive care patients. Am J Respir Crit Care Med 166:1338–1344CrossRefPubMed
48.
Zurück zum Zitat Slutsky AS, Tremblay LN (1998) Multiple system organ failure. Is mechanical ventilation a contributing factor? Am J Respir Crit Care Med 157:1721–1725CrossRefPubMed Slutsky AS, Tremblay LN (1998) Multiple system organ failure. Is mechanical ventilation a contributing factor? Am J Respir Crit Care Med 157:1721–1725CrossRefPubMed
49.
Zurück zum Zitat Sud S, Friedrich JO, Taccone P et al (2010) Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 36:585–599CrossRefPubMed Sud S, Friedrich JO, Taccone P et al (2010) Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 36:585–599CrossRefPubMed
50.
Zurück zum Zitat Terragni PP, Del SL, Mascia L et al (2009) Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology 111:826–835CrossRefPubMed Terragni PP, Del SL, Mascia L et al (2009) Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology 111:826–835CrossRefPubMed
51.
Zurück zum Zitat The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308CrossRef The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308CrossRef
52.
Zurück zum Zitat West JB (2000) Respiratory Physiology – The Essentials, 6. Aufl. Lippincott Williams & Wilkins, Baltimore West JB (2000) Respiratory Physiology – The Essentials, 6. Aufl. Lippincott Williams & Wilkins, Baltimore
53.
Zurück zum Zitat Wiedemann HP, Wheeler AP, Bernard GR et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575CrossRefPubMed Wiedemann HP, Wheeler AP, Bernard GR et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575CrossRefPubMed
54.
Zurück zum Zitat Xirouchaki N, Kondili E, Vaporidi K et al (2008) Proportional assist ventilation with load-adjustable gain factors in critically ill patients: comparison with pressure support. Intensive Care Med 34:2026–2034CrossRefPubMed Xirouchaki N, Kondili E, Vaporidi K et al (2008) Proportional assist ventilation with load-adjustable gain factors in critically ill patients: comparison with pressure support. Intensive Care Med 34:2026–2034CrossRefPubMed
Metadaten
Titel
Beatmung, Atemregulation und Weaning, ARDS
verfasst von
Dietrich Henzler, Dr.
Rolf Rossaint, Prof. Dr.
Copyright-Jahr
2015
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-46500-4_9

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