Skip to main content

16.04.2024 | ECMO | CME

Beatmungskonzepte unter extrakorporaler Membranoxygenierung bei akutem Lungenversagen

verfasst von: Thomas Bluth, Andreas Güldner, Prof. Dr. med. Peter M. Spieth, MSc

Erschienen in: Die Anaesthesiologie

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die extrakorporale Membranoxygenierung (ECMO) stellt häufig die letzte Möglichkeit zur Therapieeskalation bei Patient*innen im schweren akuten Lungenversagen (ARDS) dar. Die Erfolgsaussichten werden dabei v. a. durch patientenindividuelle Faktoren wie Alter, Vorerkrankungen, Dauer und Invasivität der vorbestehenden Beatmungstherapie sowie die Expertise des behandelnden ECMO-Zentrums bestimmt. Insbesondere die Einstellung der Beatmung unter laufender ECMO-Therapie wird noch immer kontrovers diskutiert. Eine Reduktion der Beatmungsinvasivität erscheint aus physiologischen Überlegungen zwar grundsätzlich sinnvoll, jedoch konnten bisher für die Anwendung ultraprotektiver Beatmungsregime keine Outcome-relevanten Vorteile nachgewiesen werden.
Literatur
1.
Zurück zum Zitat Munshi L, Walkey A, Goligher E, Pham T, Uleryk EM, Fan E (2019) Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis. Lancet Respir Med 7(2):163–172PubMedCrossRef Munshi L, Walkey A, Goligher E, Pham T, Uleryk EM, Fan E (2019) Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis. Lancet Respir Med 7(2):163–172PubMedCrossRef
2.
Zurück zum Zitat Barbaro RP, MacLaren G, Boonstra PS, Iwashyna TJ, Slutsky AS, Fan E et al (2020) Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. Lancet 396(10257):1071–1078PubMedPubMedCentralCrossRef Barbaro RP, MacLaren G, Boonstra PS, Iwashyna TJ, Slutsky AS, Fan E et al (2020) Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. Lancet 396(10257):1071–1078PubMedPubMedCentralCrossRef
3.
Zurück zum Zitat Combes A, Schmidt M, Hodgson CL, Fan E, Ferguson ND, Fraser JF et al (2020) Extracorporeal life support for adults with acute respiratory distress syndrome. Intensive Care Med 46(12):2464–2476PubMedPubMedCentralCrossRef Combes A, Schmidt M, Hodgson CL, Fan E, Ferguson ND, Fraser JF et al (2020) Extracorporeal life support for adults with acute respiratory distress syndrome. Intensive Care Med 46(12):2464–2476PubMedPubMedCentralCrossRef
4.
Zurück zum Zitat Combes A, Hajage D, Capellier G, Demoule A, Lavoué S, Guervilly C et al (2018) Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med 378(21):1965–1975PubMedCrossRef Combes A, Hajage D, Capellier G, Demoule A, Lavoué S, Guervilly C et al (2018) Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. N Engl J Med 378(21):1965–1975PubMedCrossRef
5.
Zurück zum Zitat Brodie D, Bacchetta M (2011) Extracorporeal membrane oxygenation for ARDS in adults. N Engl J Med 365(20):1905–1914PubMedCrossRef Brodie D, Bacchetta M (2011) Extracorporeal membrane oxygenation for ARDS in adults. N Engl J Med 365(20):1905–1914PubMedCrossRef
6.
Zurück zum Zitat The ARDS Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 342(18):1301–1308CrossRef The ARDS Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 342(18):1301–1308CrossRef
7.
Zurück zum Zitat Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T et al (2013) Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 368(23):2159–2168PubMedCrossRef Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T et al (2013) Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 368(23):2159–2168PubMedCrossRef
8.
Zurück zum Zitat Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa ELV, Schoenfeld DA et al (2015) Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 372(8):747–755PubMedCrossRef Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa ELV, Schoenfeld DA et al (2015) Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 372(8):747–755PubMedCrossRef
9.
Zurück zum Zitat Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) Investigators, Cavalcanti AB, Suzumura ÉA, Laranjeira LN, de Paisani Damiani DMLP et al (2017) Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 318(14):1335–1345CrossRef Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) Investigators, Cavalcanti AB, Suzumura ÉA, Laranjeira LN, de Paisani Damiani DMLP et al (2017) Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 318(14):1335–1345CrossRef
10.
Zurück zum Zitat Beitler JR, Sarge T, Banner-Goodspeed VM, Gong MN, Cook D, Novack V et al (2019) Effect of titrating positive end-expiratory pressure (PEEP) with an esophageal pressure-guided strategy vs an empirical high PEEP-Fio2 strategy on death and days free from mechanical ventilation among patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 321(9):846–857PubMedPubMedCentralCrossRef Beitler JR, Sarge T, Banner-Goodspeed VM, Gong MN, Cook D, Novack V et al (2019) Effect of titrating positive end-expiratory pressure (PEEP) with an esophageal pressure-guided strategy vs an empirical high PEEP-Fio2 strategy on death and days free from mechanical ventilation among patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 321(9):846–857PubMedPubMedCentralCrossRef
11.
Zurück zum Zitat Hodgson CL, Cooper DJ, Arabi Y, King V, Bersten A, Bihari S et al (2019) Maximal recruitment open lung ventilation in acute respiratory distress syndrome (PHARLAP). A phase II, multicenter randomized controlled clinical trial. Am J Respir Crit Care Med 200(11):1363–1372PubMedCrossRef Hodgson CL, Cooper DJ, Arabi Y, King V, Bersten A, Bihari S et al (2019) Maximal recruitment open lung ventilation in acute respiratory distress syndrome (PHARLAP). A phase II, multicenter randomized controlled clinical trial. Am J Respir Crit Care Med 200(11):1363–1372PubMedCrossRef
12.
Zurück zum Zitat Gattinoni L, Pesenti A, Kolobow T, Damia G (1983) A new look at therapy of the adult respiratory distress syndrome: motionless lungs. Int Anesthesiol Clin 21(2):97–117PubMedCrossRef Gattinoni L, Pesenti A, Kolobow T, Damia G (1983) A new look at therapy of the adult respiratory distress syndrome: motionless lungs. Int Anesthesiol Clin 21(2):97–117PubMedCrossRef
13.
Zurück zum Zitat Writing Group for the PReVENT Investigators, Simonis FD, Serpa Neto A, Binnekade JM, Braber A, Bruin KCM et al (2018) Effect of a low vs intermediate tidal volume strategy on ventilator-free days in intensive care unit patients without ARDS: a randomized clinical trial. JAMA 320(18):1872–1880PubMedCentralCrossRef Writing Group for the PReVENT Investigators, Simonis FD, Serpa Neto A, Binnekade JM, Braber A, Bruin KCM et al (2018) Effect of a low vs intermediate tidal volume strategy on ventilator-free days in intensive care unit patients without ARDS: a randomized clinical trial. JAMA 320(18):1872–1880PubMedCentralCrossRef
14.
Zurück zum Zitat Frank JA, Gutierrez JA, Jones KD, Allen L, Dobbs L, Matthay MA (2002) Low tidal volume reduces epithelial and endothelial injury in acid-injured rat lungs. Am J Respir Crit Care Med 165(2):242–249PubMedCrossRef Frank JA, Gutierrez JA, Jones KD, Allen L, Dobbs L, Matthay MA (2002) Low tidal volume reduces epithelial and endothelial injury in acid-injured rat lungs. Am J Respir Crit Care Med 165(2):242–249PubMedCrossRef
15.
Zurück zum Zitat Johannes A, Kredel M, Zollhoefer B, Schlegel N, Von Kirschbaum C, Brederlau J et al (2014) Influence of apneic oxygenation and minimal tidal volumes on ventilator-associated lung injury. Minerva Anestesiol 80(5):526–536PubMed Johannes A, Kredel M, Zollhoefer B, Schlegel N, Von Kirschbaum C, Brederlau J et al (2014) Influence of apneic oxygenation and minimal tidal volumes on ventilator-associated lung injury. Minerva Anestesiol 80(5):526–536PubMed
16.
Zurück zum Zitat Güldner A, Kiss T, Bluth T, Uhlig C, Braune A, Carvalho N et al (2015) Effects of ultraprotective ventilation, extracorporeal carbon dioxide removal, and spontaneous breathing on lung morphofunction and inflammation in experimental severe acute respiratory distress syndrome. Anesthesiology 122(3):631–646PubMedCrossRef Güldner A, Kiss T, Bluth T, Uhlig C, Braune A, Carvalho N et al (2015) Effects of ultraprotective ventilation, extracorporeal carbon dioxide removal, and spontaneous breathing on lung morphofunction and inflammation in experimental severe acute respiratory distress syndrome. Anesthesiology 122(3):631–646PubMedCrossRef
17.
Zurück zum Zitat Araos J, Alegria L, Garcia P, Cruces P, Soto D, Erranz B et al (2019) Near-apneic ventilation decreases lung injury and fibroproliferation in an acute respiratory distress syndrome model with extracorporeal membrane oxygenation. Am J Respir Crit Care Med 199(5):603–612PubMedCrossRef Araos J, Alegria L, Garcia P, Cruces P, Soto D, Erranz B et al (2019) Near-apneic ventilation decreases lung injury and fibroproliferation in an acute respiratory distress syndrome model with extracorporeal membrane oxygenation. Am J Respir Crit Care Med 199(5):603–612PubMedCrossRef
18.
Zurück zum Zitat Terragni PP, Del Sorbo L, Mascia L, Urbino R, Martin EL, Birocco A et al (2009) Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology 111(4):826–835PubMedCrossRef Terragni PP, Del Sorbo L, Mascia L, Urbino R, Martin EL, Birocco A et al (2009) Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology 111(4):826–835PubMedCrossRef
19.
Zurück zum Zitat Needham DM, Colantuoni E, Mendez-Tellez PA, Dinglas VD, Sevransky JE, Dennison Himmelfarb CR et al (2012) Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study. BMJ 344:e2124PubMedPubMedCentralCrossRef Needham DM, Colantuoni E, Mendez-Tellez PA, Dinglas VD, Sevransky JE, Dennison Himmelfarb CR et al (2012) Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study. BMJ 344:e2124PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat Retamal J, Libuy J, Jiménez M, Delgado M, Besa C, Bugedo G et al (2013) Preliminary study of ventilation with 4 ml/kg tidal volume in acute respiratory distress syndrome: feasibility and effects on cyclic recruitment—derecruitment and hyperinflation. Crit Care 17(1):R16PubMedPubMedCentralCrossRef Retamal J, Libuy J, Jiménez M, Delgado M, Besa C, Bugedo G et al (2013) Preliminary study of ventilation with 4 ml/kg tidal volume in acute respiratory distress syndrome: feasibility and effects on cyclic recruitment—derecruitment and hyperinflation. Crit Care 17(1):R16PubMedPubMedCentralCrossRef
21.
Zurück zum Zitat Rozencwajg S, Guihot A, Franchineau G, Lescroat M, Bréchot N, Hékimian G et al (2019) Ultra-protective ventilation reduces biotrauma in patients on venovenous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Crit Care Med 47(11):1505–1512PubMedCrossRef Rozencwajg S, Guihot A, Franchineau G, Lescroat M, Bréchot N, Hékimian G et al (2019) Ultra-protective ventilation reduces biotrauma in patients on venovenous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Crit Care Med 47(11):1505–1512PubMedCrossRef
22.
Zurück zum Zitat Del Sorbo L, Goffi A, Tomlinson G, Pettenuzzo T, Facchin F, Vendramin A et al (2020) Effect of driving pressure change during extracorporeal membrane oxygenation in adults with acute respiratory distress syndrome: a randomized crossover physiologic study. Crit Care Med 48(12):1771–1778PubMedCrossRef Del Sorbo L, Goffi A, Tomlinson G, Pettenuzzo T, Facchin F, Vendramin A et al (2020) Effect of driving pressure change during extracorporeal membrane oxygenation in adults with acute respiratory distress syndrome: a randomized crossover physiologic study. Crit Care Med 48(12):1771–1778PubMedCrossRef
23.
Zurück zum Zitat Bein T, Weber-Carstens S, Goldmann A, Müller T, Staudinger T, Brederlau J et al (2013) Lower tidal volume strategy (≈3 ml/kg) combined with extracorporeal CO2 removal versus “conventional” protective ventilation (6 ml/kg) in severe ARDS: the prospective randomized Xtravent-study. Intensive Care Med 39(5):847–856PubMedPubMedCentralCrossRef Bein T, Weber-Carstens S, Goldmann A, Müller T, Staudinger T, Brederlau J et al (2013) Lower tidal volume strategy (≈3 ml/kg) combined with extracorporeal CO2 removal versus “conventional” protective ventilation (6 ml/kg) in severe ARDS: the prospective randomized Xtravent-study. Intensive Care Med 39(5):847–856PubMedPubMedCentralCrossRef
24.
Zurück zum Zitat Combes A, Fanelli V, Pham T, Ranieri VM, European Society of Intensive Care Medicine Trials Group, The “Strategy of Ultra-Protective lung ventilation with Extracorporeal CO2 Removal for New-Onset moderate to severe ARDS” (SUPERNOVA) investigators (2019) Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study. Intensive Care Med 45(5):592–600PubMedCrossRef Combes A, Fanelli V, Pham T, Ranieri VM, European Society of Intensive Care Medicine Trials Group, The “Strategy of Ultra-Protective lung ventilation with Extracorporeal CO2 Removal for New-Onset moderate to severe ARDS” (SUPERNOVA) investigators (2019) Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study. Intensive Care Med 45(5):592–600PubMedCrossRef
25.
Zurück zum Zitat McNamee JJ, Gillies MA, Barrett NA, Perkins GD, Tunnicliffe W, Young D et al (2021) Effect of lower tidal volume ventilation facilitated by extracorporeal carbon dioxide removal vs standard care ventilation on 90-day mortality in patients with acute hypoxemic respiratory failure: the REST randomized clinical trial. JAMA 326(11):1013–1023PubMedPubMedCentralCrossRef McNamee JJ, Gillies MA, Barrett NA, Perkins GD, Tunnicliffe W, Young D et al (2021) Effect of lower tidal volume ventilation facilitated by extracorporeal carbon dioxide removal vs standard care ventilation on 90-day mortality in patients with acute hypoxemic respiratory failure: the REST randomized clinical trial. JAMA 326(11):1013–1023PubMedPubMedCentralCrossRef
26.
Zurück zum Zitat Schmidt M, Pham T, Arcadipane A, Agerstrand C, Ohshimo S, Pellegrino V et al (2019) Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome. An international multicenter prospective cohort. Am J Respir Crit Care Med 200(8):1002–1012PubMedCrossRef Schmidt M, Pham T, Arcadipane A, Agerstrand C, Ohshimo S, Pellegrino V et al (2019) Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome. An international multicenter prospective cohort. Am J Respir Crit Care Med 200(8):1002–1012PubMedCrossRef
27.
Zurück zum Zitat Serpa Neto A, Deliberato RO, Johnson AEW, Bos LD, Amorim P, Pereira SM et al (2018) Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med 44(11):1914–1922PubMedCrossRef Serpa Neto A, Deliberato RO, Johnson AEW, Bos LD, Amorim P, Pereira SM et al (2018) Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Med 44(11):1914–1922PubMedCrossRef
28.
Zurück zum Zitat Gannon WD, Stokes JW, Francois SA, Patel YJ, Pugh ME, Benson C et al (2022) Association between availability of extracorporeal membrane oxygenation and mortality in patients with COVID-19 eligible for extracorporeal membrane oxygenation: a natural experiment. Am J Respir Crit Care Med 205(11):1354–1357PubMedPubMedCentralCrossRef Gannon WD, Stokes JW, Francois SA, Patel YJ, Pugh ME, Benson C et al (2022) Association between availability of extracorporeal membrane oxygenation and mortality in patients with COVID-19 eligible for extracorporeal membrane oxygenation: a natural experiment. Am J Respir Crit Care Med 205(11):1354–1357PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Friedrichson B, Kloka JA, Neef V, Mutlak H, Old O, Zacharowski K et al (2022) Extracorporeal membrane oxygenation in coronavirus disease 2019: a nationwide cohort analysis of 4279 runs from Germany. Eur J Anaesthesiol 39(5):445–451PubMedCrossRef Friedrichson B, Kloka JA, Neef V, Mutlak H, Old O, Zacharowski K et al (2022) Extracorporeal membrane oxygenation in coronavirus disease 2019: a nationwide cohort analysis of 4279 runs from Germany. Eur J Anaesthesiol 39(5):445–451PubMedCrossRef
30.
Zurück zum Zitat Schmidt M, Stewart C, Bailey M, Nieszkowska A, Kelly J, Murphy L et al (2015) Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome: a retrospective international multicenter study. Crit Care Med 43(3):654–664PubMedCrossRef Schmidt M, Stewart C, Bailey M, Nieszkowska A, Kelly J, Murphy L et al (2015) Mechanical ventilation management during extracorporeal membrane oxygenation for acute respiratory distress syndrome: a retrospective international multicenter study. Crit Care Med 43(3):654–664PubMedCrossRef
31.
Zurück zum Zitat Serpa Neto A, Schmidt M, Azevedo LCP, Bein T, Brochard L, Beutel G et al (2016) Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis : Mechanical ventilation during ECMO. Intensive Care Med 42(11):1672–1684PubMedPubMedCentralCrossRef Serpa Neto A, Schmidt M, Azevedo LCP, Bein T, Brochard L, Beutel G et al (2016) Associations between ventilator settings during extracorporeal membrane oxygenation for refractory hypoxemia and outcome in patients with acute respiratory distress syndrome: a pooled individual patient data analysis : Mechanical ventilation during ECMO. Intensive Care Med 42(11):1672–1684PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Goligher EC, Tomlinson G, Hajage D, Wijeysundera DN, Fan E, Jüni P et al (2018) Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome and posterior probability of mortality benefit in a post hoc Bayesian analysis of a randomized clinical trial. JAMA 320(21):2251–2259PubMedCrossRef Goligher EC, Tomlinson G, Hajage D, Wijeysundera DN, Fan E, Jüni P et al (2018) Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome and posterior probability of mortality benefit in a post hoc Bayesian analysis of a randomized clinical trial. JAMA 320(21):2251–2259PubMedCrossRef
33.
Zurück zum Zitat Tonna JE, Abrams D, Brodie D, Greenwood JC, Rubio Mateo-Sidron JA, Usman A et al (1992) Management of adult patients supported with venovenous extracorporeal membrane oxygenation (VV ECMO): guideline from the Extracorporeal life support organization (ELSO). ASAIO J 67(6):601–610CrossRef Tonna JE, Abrams D, Brodie D, Greenwood JC, Rubio Mateo-Sidron JA, Usman A et al (1992) Management of adult patients supported with venovenous extracorporeal membrane oxygenation (VV ECMO): guideline from the Extracorporeal life support organization (ELSO). ASAIO J 67(6):601–610CrossRef
34.
Zurück zum Zitat Patroniti N, Bonatti G, Senussi T, Robba C (2018) Mechanical ventilation and respiratory monitoring during extracorporeal membrane oxygenation for respiratory support. Ann Transl Med 6(19):386PubMedPubMedCentralCrossRef Patroniti N, Bonatti G, Senussi T, Robba C (2018) Mechanical ventilation and respiratory monitoring during extracorporeal membrane oxygenation for respiratory support. Ann Transl Med 6(19):386PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat ICU, Mackle D, Bellomo R, Bailey M, Beasley R, Deane A et al (2020) Conservative oxygen therapy during mechanical ventilation in the ICU. N Engl J Med 382(11):989–998CrossRef ICU, Mackle D, Bellomo R, Bailey M, Beasley R, Deane A et al (2020) Conservative oxygen therapy during mechanical ventilation in the ICU. N Engl J Med 382(11):989–998CrossRef
36.
Zurück zum Zitat Schjørring OL, Klitgaard TL, Perner A, Wetterslev J, Lange T, Siegemund M et al (2021) Lower or higher oxygenation targets for acute hypoxemic respiratory failure. N Engl J Med 384(14):1301–1311PubMedCrossRef Schjørring OL, Klitgaard TL, Perner A, Wetterslev J, Lange T, Siegemund M et al (2021) Lower or higher oxygenation targets for acute hypoxemic respiratory failure. N Engl J Med 384(14):1301–1311PubMedCrossRef
37.
Zurück zum Zitat Güldner A, Pelosi P, Gama de Abreu M (2014) Spontaneous breathing in mild and moderate versus severe acute respiratory distress syndrome. Curr Opin Crit Care 20(1):69–76PubMedCrossRef Güldner A, Pelosi P, Gama de Abreu M (2014) Spontaneous breathing in mild and moderate versus severe acute respiratory distress syndrome. Curr Opin Crit Care 20(1):69–76PubMedCrossRef
38.
Zurück zum Zitat Yoshida T, Amato MBP, Kavanagh BP (2018) Understanding spontaneous vs. ventilator breaths: impact and monitoring. Intensive Care Med 44(12):2235–2238PubMedCrossRef Yoshida T, Amato MBP, Kavanagh BP (2018) Understanding spontaneous vs. ventilator breaths: impact and monitoring. Intensive Care Med 44(12):2235–2238PubMedCrossRef
39.
Zurück zum Zitat Spinelli E, Mauri T, Beitler JR, Pesenti A, Brodie D (2020) Respiratory drive in the acute respiratory distress syndrome: pathophysiology, monitoring, and therapeutic interventions. Intensive Care Med 46(4):606–618PubMedPubMedCentralCrossRef Spinelli E, Mauri T, Beitler JR, Pesenti A, Brodie D (2020) Respiratory drive in the acute respiratory distress syndrome: pathophysiology, monitoring, and therapeutic interventions. Intensive Care Med 46(4):606–618PubMedPubMedCentralCrossRef
40.
Zurück zum Zitat Mauri T, Grasselli G, Suriano G, Eronia N, Spadaro S, Turrini C et al (2016) Control of respiratory drive and effort in extracorporeal membrane oxygenation patients recovering from severe acute respiratory distress syndrome. Anesthesiology 125(1):159–167PubMedCrossRef Mauri T, Grasselli G, Suriano G, Eronia N, Spadaro S, Turrini C et al (2016) Control of respiratory drive and effort in extracorporeal membrane oxygenation patients recovering from severe acute respiratory distress syndrome. Anesthesiology 125(1):159–167PubMedCrossRef
41.
Zurück zum Zitat Crotti S, Bottino N, Ruggeri GM, Spinelli E, Tubiolo D, Lissoni A et al (2017) Spontaneous breathing during extracorporeal membrane oxygenation in acute respiratory failure. Anesthesiology 126(4):678–687PubMedCrossRef Crotti S, Bottino N, Ruggeri GM, Spinelli E, Tubiolo D, Lissoni A et al (2017) Spontaneous breathing during extracorporeal membrane oxygenation in acute respiratory failure. Anesthesiology 126(4):678–687PubMedCrossRef
42.
Zurück zum Zitat Brochard L, Slutsky A, Pesenti A (2017) Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 195(4):438–442PubMedCrossRef Brochard L, Slutsky A, Pesenti A (2017) Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med 195(4):438–442PubMedCrossRef
43.
Zurück zum Zitat Papazian L, Forel JM, Gacouin A, Penot-Ragon C, Perrin G, Loundou A et al (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363(12):1107–1116PubMedCrossRef Papazian L, Forel JM, Gacouin A, Penot-Ragon C, Perrin G, Loundou A et al (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363(12):1107–1116PubMedCrossRef
44.
Zurück zum Zitat van Haren F, Pham T, Brochard L, Bellani G, Laffey J, Dres M et al (2019) Spontaneous breathing in early acute respiratory distress syndrome: insights from the large observational study to UNderstand the global impact of severe acute respiratory FailurE study. Crit Care Med 47(2):229–238PubMedPubMedCentralCrossRef van Haren F, Pham T, Brochard L, Bellani G, Laffey J, Dres M et al (2019) Spontaneous breathing in early acute respiratory distress syndrome: insights from the large observational study to UNderstand the global impact of severe acute respiratory FailurE study. Crit Care Med 47(2):229–238PubMedPubMedCentralCrossRef
45.
Zurück zum Zitat Zhou Y, Jin X, Lv Y, Wang P, Yang Y, Liang G et al (2017) Early application of airway pressure release ventilation may reduce the duration of mechanical ventilation in acute respiratory distress syndrome. Intensive Care Med 43(11):1648–1659PubMedPubMedCentralCrossRef Zhou Y, Jin X, Lv Y, Wang P, Yang Y, Liang G et al (2017) Early application of airway pressure release ventilation may reduce the duration of mechanical ventilation in acute respiratory distress syndrome. Intensive Care Med 43(11):1648–1659PubMedPubMedCentralCrossRef
46.
Zurück zum Zitat Sun X, Liu Y, Li N, You D, Zhao Y (2020) The safety and efficacy of airway pressure release ventilation in acute respiratory distress syndrome patients: A PRISMA-compliant systematic review and meta-analysis. Medicine 99(1):e18586PubMedPubMedCentralCrossRef Sun X, Liu Y, Li N, You D, Zhao Y (2020) The safety and efficacy of airway pressure release ventilation in acute respiratory distress syndrome patients: A PRISMA-compliant systematic review and meta-analysis. Medicine 99(1):e18586PubMedPubMedCentralCrossRef
47.
Zurück zum Zitat Diniz-Silva F, Moriya HT, Alencar AM, Amato MBP, Carvalho CRR, Ferreira JC (2020) Neurally adjusted ventilatory assist vs. pressure support to deliver protective mechanical ventilation in patients with acute respiratory distress syndrome: a randomized crossover trial. Ann Intensive Care 10(1):18PubMedPubMedCentralCrossRef Diniz-Silva F, Moriya HT, Alencar AM, Amato MBP, Carvalho CRR, Ferreira JC (2020) Neurally adjusted ventilatory assist vs. pressure support to deliver protective mechanical ventilation in patients with acute respiratory distress syndrome: a randomized crossover trial. Ann Intensive Care 10(1):18PubMedPubMedCentralCrossRef
48.
Zurück zum Zitat Dianti J, Fard S, Wong J, Chan TCY, Del Sorbo L, Fan E et al (2022) Strategies for lung- and diaphragm-protective ventilation in acute hypoxemic respiratory failure: a physiological trial. Crit Care 26(1):259PubMedPubMedCentralCrossRef Dianti J, Fard S, Wong J, Chan TCY, Del Sorbo L, Fan E et al (2022) Strategies for lung- and diaphragm-protective ventilation in acute hypoxemic respiratory failure: a physiological trial. Crit Care 26(1):259PubMedPubMedCentralCrossRef
49.
Zurück zum Zitat Doorduin J, Nollet JL, Roesthuis LH, van Hees HWH, Brochard LJ, Sinderby CA et al (2017) Partial neuromuscular blockade during partial ventilatory support in sedated patients with high tidal volumes. Am J Respir Crit Care Med 195(8):1033–1042PubMedCrossRef Doorduin J, Nollet JL, Roesthuis LH, van Hees HWH, Brochard LJ, Sinderby CA et al (2017) Partial neuromuscular blockade during partial ventilatory support in sedated patients with high tidal volumes. Am J Respir Crit Care Med 195(8):1033–1042PubMedCrossRef
50.
Zurück zum Zitat Holzgraefe B, Andersson C, Kalzén H, von Bahr V, Mosskin M, Larsson EM et al (2017) Does permissive hypoxaemia during extracorporeal membrane oxygenation cause long-term neurological impairment?: A study in patients with H1N1-induced severe respiratory failure. Eur J Anaesthesiol 34(2):98–103PubMedCrossRef Holzgraefe B, Andersson C, Kalzén H, von Bahr V, Mosskin M, Larsson EM et al (2017) Does permissive hypoxaemia during extracorporeal membrane oxygenation cause long-term neurological impairment?: A study in patients with H1N1-induced severe respiratory failure. Eur J Anaesthesiol 34(2):98–103PubMedCrossRef
51.
Zurück zum Zitat von Bahr V, Kalzén H, Hultman J, Frenckner B, Andersson C, Mosskin M et al (2018) Long-term cognitive outcome and brain imaging in adults after extracorporeal membrane oxygenation. Crit Care Med 46(5):e351–e358CrossRef von Bahr V, Kalzén H, Hultman J, Frenckner B, Andersson C, Mosskin M et al (2018) Long-term cognitive outcome and brain imaging in adults after extracorporeal membrane oxygenation. Crit Care Med 46(5):e351–e358CrossRef
52.
Zurück zum Zitat Cashen K, Reeder R, Dalton HJ, Berg RA, Shanley TP, Newth CJL et al (2018) Hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation: associations with complications, mortality, and functional status among survivors. Pediatr Crit Care Med 19(3):245–253PubMedPubMedCentralCrossRef Cashen K, Reeder R, Dalton HJ, Berg RA, Shanley TP, Newth CJL et al (2018) Hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation: associations with complications, mortality, and functional status among survivors. Pediatr Crit Care Med 19(3):245–253PubMedPubMedCentralCrossRef
53.
Zurück zum Zitat Munshi L, Kiss A, Cypel M, Keshavjee S, Ferguson ND, Fan E (2017) Oxygen thresholds and mortality during extracorporeal life support in adult patients. Crit Care Med 45(12):1997–2005PubMedCrossRef Munshi L, Kiss A, Cypel M, Keshavjee S, Ferguson ND, Fan E (2017) Oxygen thresholds and mortality during extracorporeal life support in adult patients. Crit Care Med 45(12):1997–2005PubMedCrossRef
54.
Zurück zum Zitat Girardis M, Busani S, Damiani E, Donati A, Rinaldi L, Marudi A et al (2016) Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 316(15):1583–1589PubMedCrossRef Girardis M, Busani S, Damiani E, Donati A, Rinaldi L, Marudi A et al (2016) Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 316(15):1583–1589PubMedCrossRef
55.
Zurück zum Zitat Barrot L, Asfar P, Mauny F, Winiszewski H, Montini F, Badie J et al (2020) Liberal or conservative oxygen therapy for acute respiratory distress syndrome. N Engl J Med 382(11):999–1008PubMedCrossRef Barrot L, Asfar P, Mauny F, Winiszewski H, Montini F, Badie J et al (2020) Liberal or conservative oxygen therapy for acute respiratory distress syndrome. N Engl J Med 382(11):999–1008PubMedCrossRef
Metadaten
Titel
Beatmungskonzepte unter extrakorporaler Membranoxygenierung bei akutem Lungenversagen
verfasst von
Thomas Bluth
Andreas Güldner
Prof. Dr. med. Peter M. Spieth, MSc
Publikationsdatum
16.04.2024
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-024-01407-3

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.