Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Medizinische Klinik - Intensivmedizin und Notfallmedizin
Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin 5/2020

05.07.2019 | Pflege | Leitlinien und Empfehlungen

Geriatrische Intensivmedizin

Konsensuspapier der DGIIN, DIVI, DGAI, DGGG, ÖGGG, ÖGIAIN, DGP, DGEM, DGD, DGNI, DGIM, DGKliPha und DGG

verfasst von: Prof. Dr. med. Guido Michels, Cornel C. Sieber, Gernot Marx, Regina Roller-Wirnsberger, Michael Joannidis, Ursula Müller-Werdan, Wolfgang Müllges, Georg Gahn, Roman Pfister, Petra A. Thürmann, Rainer Wirth, Jana Fresenborg, Ludwig Kuntz, Steffen T. Simon, Uwe Janssens, Hans Jürgen Heppner

Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Zusammenfassung

Der Anteil älterer, gebrechlicher und multimorbider Menschen hat in den letzten Jahrzehnten aufgrund der demographischen Entwicklung stark zugenommen bzw. wird weiter dramatisch zunehmen, was sich auf die medizinische Akutversorgung auswirken wird. Prospektive randomisierte Studien zum Themengebiet der geriatrischen Intensivmedizin fehlen bis heute. Es existieren zudem weder internationale noch nationale Empfehlungen bezüglich des Managements von kritisch kranken älteren Patienten. Das vorliegende Konsensuspapier liefert basierend auf einer konsentierten Expertenmeinung 16 Aussagen, die beim Umgang mit geriatrischen Intensivpatienten beachtet werden sollten.
Literatur
1.
Adler K, Schlieper D, Kindgen-Milles D et al (2017) Integration of palliative care into intensive care: Systematic review. Anaesthesist 66(9):660–666PubMedCrossRef
2.
Ahrens D, Behrens G, Himmel W, Kochen MM, Chenot JF (2012) Appropriateness of proton pump inhibitor recommendations at hospital discharge and continuation in primary care. Int J Clin Pract 66:767–773PubMedCrossRef
3.
Al-Dorzi HM, Tamim HM, Mundekkadan S, Sohail MR, Arabi YM (2014) Characteristics, management and outcomes of critically ill patients who are 80 years and older: a retrospective comparative cohort study. BMC Anesthesiol 14:126PubMedPubMedCentralCrossRef
4.
Alt-Epping B, Sitte T, Nauck F, Radbruch L (2010) Sedation in palliative medicine: Guidelines for the use of sedation in palliative care: European Association for Palliative Care (EAPC). Schmerz 24(4):342–3546PubMedCrossRef
5.
6.
Andersen FH, Kvåle R (2012) Do elderly intensive care unit patients receive less intensive care treatment and have higher mortality? Acta Anaesthesiol Scand 56(10):1298–1305PubMedCrossRef
7.
8.
Bagshaw SM, Webb SA, Delaney A et al (2009) Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis. Crit Care 13(2):R45PubMedPubMedCentralCrossRef
9.
Bainum TB, Fike DS, Mechelay D, Haase KK (2017) Effect of abrupt discontinuation of antidepressants in critically ill hospitalized adults. Pharmacotherapy 37:1231–1240PubMedCrossRef
10.
Baldwin MR, Wunsch H, Reyfman PA et al (2013) High burden of palliative needs among older intensive care unit survivors transferred to post-acute care facilities. A single-center study. Ann Am Thorac Soc 10(5):458–465PubMedPubMedCentralCrossRef
11.
Barbieri M, Ferrucci L, Ragno E et al (2003) Chronic inflammation and the effect of IGF-1 on muscle strength and power in older persons. Am J Physiol Endocrinol Metab 284:E481–E487PubMedCrossRef
12.
Barnett K, Mercer SW, Norbury M et al (2012) Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 380(9836):37–43PubMedCrossRef
13.
Baron R, Binder A, Biniek R et al (2015) Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Revision 2015 (DAS-Guideline 2015)—short version. Ger Med Sci 13:Doc19PubMedPubMedCentral
14.
Bauer J, Biolo G, Cederholm T et al (2013) Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 14(8):542–559PubMedCrossRef
15.
Beauchamp TL, Childress J (2013) Principles of biomedical ethics, 7. Aufl. Oxford University, Oxford
16.
Becker S, Müller J, de Heer G, Braune S, Fuhrmann V, Kluge S (2015) Clinical characteristics and outcome of very elderly patients ≥90 year in intensive care: a retrospective observational study. Ann Intensive Care 5(1):53PubMedPubMedCentralCrossRef
17.
Bein T, Bischoff M, Brückner U et al (2015) S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders: Revision 2015: S2e guideline of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). Anaesthesist 64(Suppl 1):1–26PubMedPubMedCentralCrossRef
18.
Blot S, Koulenti D, Dimopoulos G (2014) Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients. Crit Care Med 42(3):601–609PubMedCrossRef
19.
Boumendil A, Maury E, Reinhard I et al (2004) Prognosis of Patients aged 80 and over admitted in ICU. Intensive Care Med 30:647–654PubMedCrossRef
20.
Boumendil A, Aegerter P, Guidet B, CUB-Rea Network (2005) Treatment intensity and outcome of patients aged 80 and older in intensive care units: a multicenter matched-cohort study. J Am Geriatr Soc 53(1):88–93PubMedCrossRef
21.
Braus N, Campbell TC, Kwekkeboom KL et al (2016) Prospective study of a proactive palliative care rounding intervention in a medical ICU. Intensive Care Med 42(1):54–62PubMedCrossRef
22.
Buurman BM, Hoogerduijn JG, de Haan RJ et al (2011) Geriatric conditions in acutely hospitalized older patients: prevalence and one-year survival and functional decline. PLoS ONE 6(11):e26951PubMedPubMedCentralCrossRef
23.
24.
Christ M, Störk S, Dörr M et al (2016) Heart failure epidemiology 2000–2013: insights from the German Federal Health Monitoring System. Eur J Heart Fail 18(8):1009–1018PubMedCrossRef
25.
Christensen CM, Grossman JH, Hwang J (2009) The innovator’s prescription: a disruptive solution for health care. McGraw-Hill, New York
26.
Chronopoulos A, Rosner MH, Cruz DN, Ronco C (2010) Acute kidney injury in elderly intensive care patients: a review. Intensive Care Med 36:1454–1464PubMedCrossRef
27.
Cicerchia M, Ceci M, Locatelli C et al (2010) Geriatric syndromes in peri-operative elderly cancer patients. Surg Oncol 19:131–139PubMedCrossRef
28.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013) Frailty in elderly people. Lancet 381(9868):752–762PubMedCrossRef
29.
Collamati A, Martone AM, Poscia A et al (2016) Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence. Aging Clin Exp Res 28(1):25–35PubMedCrossRef
30.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423PubMedPubMedCentralCrossRef
31.
32.
Doig GS, Simpson F, Heighes PT et al (2015) Restricted versus continued standard caloric intake during the management of refeeding syndrome in critically ill adults: a randomised, parallel-group, multicentre, single-blind controlled trial. Lancet Respir Med 3(12):943–952PubMedCrossRef
33.
Druml W, Valentin A (2013) Wir alle wollen alt werden – auch mit Hilfe der Intensivmedizin. Intensiv News 1(13):1–2
34.
Ely EW, Margolin R, Francis J et al (2001) Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med 29(7):1370–1379PubMedCrossRef
35.
Flaatten H, Clegg A (2018) Frailty: we need valid and reliable tools in critical care. Intensive Care Med 44(11):1973–1975PubMedCrossRef
36.
Flaatten H, de Lange DW, Artigas A et al (2017) The status of intensive care medicine research and a future agenda for very old patients in the ICU. Intensive Care Med 43(9):1319–1328PubMedCrossRef
37.
38.
Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146–156PubMedCrossRef
39.
Fronczek J, Polok KJ, Nowak-Kózka I et al (2018) Frailty is associated with an increased mortality among patients ≥ 80 years old treated in Polish ICUs. Anaesthesiol Intensive Ther 50(4):245–251PubMedCrossRef
40.
Guidet B, Leblanc G, Simon T et al (2017) Effect of systematic intensive care unit triage on long-term mortality among critically ill elderly patients in France: a randomized clinical trial. JAMA 318(15):1450–1459PubMedPubMedCentralCrossRef
41.
Guidet B, Flaatten H, Boumendil A et al (2018a) Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit. Intensive Care Med 44(7):1027–1038PubMedCrossRef
42.
Guidet B, Vallet H, Boddaert J et al (2018b) Caring for the critically ill patients over 80: a narrative review. Ann Intensive Care 8(1):114PubMedPubMedCentralCrossRef
43.
Haas LE, Karakus A, Holman R et al (2015) Trends in hospital and intensive care admissions in the Netherlands attributable to the very elderly in an ageing population. Crit Care 19:353PubMedPubMedCentralCrossRef
44.
Hager K, Krause O (2016) Frailty: Neuer Begriff – altes Problem. Allgemeinarzt 38(20):48–52
45.
Heppner HJ, Bauer JM, Sieber CC et al (2010) Laboratory aspects relating to the detection and prevention of frailty. Int J Prev Med 1(3):149–157PubMedPubMedCentral
46.
Heppner HJ, Schmitt K, Esslinger AS (2008) Frailty and modern intensive care. Ther Umsch 65:455–458PubMedCrossRef
47.
Heppner HJ, Singler K, Gosch M, Doviak P (2015) Ethics in the emergency care of geriatric patients—when is enough enough? Dtsch Med Wochenschr 140(23):1780–1782PubMedCrossRef
48.
Hermans G, Van Mechelen H, Clerckx B et al (2014) Acute outcomes and 1‑year mortality of intensive care unit-acquired weakness. A cohort study and propensity-matched analysis. Am J Respir Crit Care Med 190(4):410–420PubMedCrossRef
49.
Herridge MS, Tansey CM, Matté A et al (2011) Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 364(14):1293–1304PubMedCrossRef
50.
De Hert S, Staender S, Fritsch G et al (2018) Pre-operative evaluation of adults undergoing elective noncardiac surgery. Updated guideline from the European Society of Anaesthesiology. Eur J Anaesthesiol 35:407–465PubMedCrossRef
51.
Higginson IJ, Koffman J, Hopkins P et al (2013) Development and evaluation of the feasibility and effects on staff, patients, and families of a new tool, the Psychosocial Assessment and Communication Evaluation (PACE), to improve communication and palliative care in intensive care and during clinical uncertainty. BMC Med 11:213PubMedPubMedCentralCrossRef
52.
Hoste EA, Bagshaw SM, Bellomo R et al (2015) Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 41(8):1411–1423PubMedCrossRef
53.
Hshieh TT, Yue J, Oh E et al (2015) Effectiveness of multicomponent nonpharmacological delirium interventions: a meta-analysis. JAMA Intern Med 175(4):512–520PubMedPubMedCentralCrossRef
54.
Huang D, Ma H, Zhong W et al (2017) Using M‑mode ultrasonography to assess diaphragm dysfunction and predict the success of mechanical ventilation weaning in elderly patients. J Thorac Dis 9(9):3177–3186PubMedPubMedCentralCrossRef
55.
Ibanez B, James S, Agewall S et al (2018) 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 39:119–177PubMedCrossRef
56.
Ihra GC, Lehberger J, Hochrieser H et al (2012) Development of demographics and outcome of very old critically ill patients admitted to intensive care units. Intensive Care Med 38(4):620–626PubMedCrossRef
57.
Inouye SK, Westendorp RG, Saczynski JS (2014) Delirium in elderly people. Lancet 383:911–922PubMedCrossRef
58.
Janssens U, Burchardi N, Duttge G et al (2012) Therapiezieländerung und Therapiebegrenzung in der Intensivmedizin. Dtsch Interdiszip Ver Intensiv Notfallmed 3:103–107
59.
Janssens U, Burchardi H, Duttge G et al (2013) Change in therapy target and therapy limitations in intensive care medicine. Position paper of the Ethics Section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine. Anaesthesist 62(1):47–52PubMedCrossRef
60.
Janssens U, Lücking KM, Böll B et al (2019) Amendment to the documentation of decisions to withhold or withdraw life-sustaining therapies in consideration of wish to donate organs : Recommendation of the Ethics Section and the Organ Donation and Transplantation Section of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) in collaboration with the Ethics Section of the German Society of Medical Intensive Care Medicine and Emergency Medicine (DGIIN). Med Klin Intensivmed Notfmed 114(1):53–55PubMedCrossRef
61.
Joannidis M, Klein SJ, John S et al (2018) Prevention of acute kidney injury in critically ill patients: recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI. Med Klin Intensivmed Notfmed 113(5):358–369PubMedCrossRef
62.
Kaiser MJ, Bauer JM, Ramsch C et al (2010) Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 58(9):1734–1738CrossRefPubMed
63.
Kämmerer W (2012) Clinically relevant pharmacokinetic drug interactions in the intensive care unit: an overview. Med Klin Intensivmed Notfmed 107:128–140PubMedCrossRef
64.
Kang MC, Kim JH, Ryu SW et al (2018) Prevalence of malnutrition in hospitalized patients: a multicenter cross-sectional study. J Korean Med Sci 33(2):e10CrossRefPubMed
65.
Karagiannidis C, Hermes C, Krakau M et al (2019) Versorgung der Bevölkerung in Gefahr. Dtsch Arztebl 116(10):A462–A466
66.
Kasper P, Janssens U, Michels G (2019) How important are proton pump inhibitors in the prevention of stress ulcers and stress-associated gastrointestinal bleeding in ICU patients? Med Klin Intensivmed Notfmed 114(4):350–354PubMedCrossRef
67.
Kelly JM, Rubenfeld GD, Masson N, Min A, Adhikari NKJ (2017) Using selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in critical care: a systematic review of the evidence for benefit or harm. Crit Care Med 45:e607–e616PubMedCrossRef
68.
Klein C, Heckel M, Treibig T et al (2012) The palliative care team in the intensive care unit. Med Klin Intensivmed Notfmed 107(4):240–243PubMed
69.
Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003) ESPEN guidelines for nutrition screening 2002. Clin Nutr 22(4):415–421CrossRefPubMed
70.
Kondrup J, Rasmussen HH, Hamberg OLE, Stanga Z (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22(3):321–336PubMedCrossRef
71.
Koo YW, Kõlves K, De Leo D (2017) Suicide in older adults: differences between the young-old, middle-old, and oldest old. Int Psychogeriatr 29(8):1297–1306PubMedCrossRef
72.
Laake JH, Dybwik K, Flaatten HK et al (2010) Impact of the post-World War II generation on intensive care needs in Norway. Acta Anaesthesiol Scand 54(4):479–484PubMedCrossRef
73.
Lapin A, Böhmer F (2005) Laboratory diagnosis and geriatrics: more than just reference intervals for the elderly. Wien Med Wochenschr 155(1–2):30–35PubMedCrossRef
74.
Leblanc G, Boumendil A, Guidet B (2017) Ten things to know about critically ill elderly patients. Intensive Care Med 43:217–219PubMedCrossRef
75.
Leng S, Chaves P, Koenig K, Walston J (2002) Serum Interleukin-6 and haemoglobin as physiological correlates in the geriatric syndrom of frailty: a pilot study. J Am Geriatr Soc 50:1268–1271PubMedCrossRef
76.
Lew CCH, Yandell R, Fraser RJL et al (2017) Association between malnutrition and clinical outcomes in the intensive care unit: a systematic review. JPEN J Parenter Enteral Nutr 41(5):744–758PubMedCrossRef
77.
Macht M, Wimbish T, Clark BJ et al (2011) Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 15(5):R231PubMedPubMedCentralCrossRef
78.
Macht M, Wimbish T, Bodine C, Moss M (2013) ICU-acquired swallowing disorders. Crit Care Med 41(10):2396–2405PubMedCrossRef
79.
Marik PE (2006) Management of the critically ill geriatric patient. Crit Care Med 34(9 Suppl):S176–S182PubMedCrossRef
80.
McCaig L, Bunt C (2004) National ambulatory hospital medical survey. 2002 Emergency department summary. Adv Data 340:1–34
81.
Michels G, Motzko M, Weinert M et al (2015) Management of dysphagia in internal intensive-care medicine. Med Klin Intensivmed Notfmed 110(3):174–181PubMedCrossRef
82.
Michels G, Nies R, Ortmann S, Pfister R, Salomon F (2018) Management of an elderly patient in the emergency room at the end of life: a medical ethics challenge. Med Klin Intensivmed Notfmed 113(3):208–211PubMedCrossRef
83.
Michels G, Müller-Werdan U (2019) Intensive care in elderly patients—consideration of age-related organ dysfunction and vulnerability. Dtsch Med Wochenschr (in press)
84.
Muessig JM, Nia AM, Masyuk M et al (2018) Clinical Frailty Scale (CFS) reliably stratifies octogenarians in German ICUs: a multicentre prospective cohort study. BMC Geriatr 18(1):162PubMedPubMedCentralCrossRef
85.
Müller-Werdan U, Heppner HJ, Michels G (2018) Geriatric intensive care patients: perspectives and limits of geriatric intensive care medicine. Med Klin Intensivmed Notfmed 113(4):256–259PubMedCrossRef
86.
Müllges W (2014) Ätiologie und Therapie des Delirs. Aktuelle Neurol 41:586–596
87.
Müllges W, Stoll G (2011) Critical illness polyneuropathy and myopathy. Dtsch Med Wochenschr 136(15):769–774PubMedCrossRef
88.
Muscedere J, Waters B, Varambally A et al (2017) The impact of frailty on intensive care unit outcomes: a systematic review and meta-analysis. Intensive Care Med 43(8):1105–1122PubMedPubMedCentralCrossRef
89.
Neitzke G, Burchardi H, Duttge G et al (2016) Limits of the meaningfulness of intensive care medicine: position paper of the ethics section of DIVI. Med Klin Intensivmed Notfmed 111(6):486–492PubMedCrossRef
90.
Neitzke G, Böll B, Burchardi H et al (2017) Documentation of decisions to withhold or withdraw life-sustaining therapies: Recommendation of the Ethics Section of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) in collaboration with the Ethics Section of the German Society for Medical Intensive Care and Emergency Medicine (DGIIN). Med Klin Intensivmed Notfmed 112(6):527–530PubMedCrossRef
91.
Neitzke G, Burchardi H, Duttge G et al (2019) Limits to the appropriateness of intensive care: policy statement of the German Interdisciplinary Association of Intensive Care and Emergency Medicine (DIVI). Med Klin Intensivmed Notfmed 114(1):46–52PubMedCrossRef
92.
Nelson JE, Mathews KS, Weissman DE et al (2015) Integration of palliative care in the context of rapid response: a report from the Improving Palliative Care in the ICU advisory board. Chest 147(2):560–569PubMedPubMedCentralCrossRef
93.
Nielsson MS, Christiansen CF, Johansen MB et al (2014) Mortality in elderly ICU patients: a cohort study. Acta Anaesthesiol Scand 58(1):19–26PubMedCrossRef
94.
Nordheim J, Maaz A, Winter MHJ et al (2006) Vielnutzung von Krankenversicherungsleistungen im Alter – eine Analyse von Krankenhaus- und. Arzneimitteldaten Z Ärztl Fortb Qual Gesundhwes 100:609–615
95.
Oczkowski SJ, Chung HO, Hanvey L, Mbuagbaw L, You JJ (2016) Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis. Crit Care 20:97PubMedPubMedCentralCrossRef
96.
Phillips SM, Dickerson RN, Moore FA, Paddon-Jones D, Weijs PJ (2017) Protein turnover and metabolism in the elderly intensive care unit patient. Nutr Clin Pract 32(1_suppl):112S–120SPubMedCrossRef
97.
Pisani MA, Kong SY, Kasl SV et al (2009) Days of delirium are associated with 1‑year mortality in an older intensive care unit population. Am J Respir Crit Care Med 180(11):1092–1097PubMedPubMedCentralCrossRef
98.
Pourhassan M, Cuvelier I, Gehrke I et al (2018a) Prevalence of risk factors for the refeeding syndrome in older hospitalized patients. J Nutr Health Aging 22(3):321–327PubMedCrossRef
99.
Pourhassan M, Cuvelier I, Gehrke I et al (2018b) Risk factors of refeeding syndrome in malnourished older hospitalized patients. Clin Nutr 37(4):1354–1359PubMedCrossRef
100.
Pourhassan M, Böttger S, Janssen G, Sieske L, Wirth R (2018) The association of inflammation with food intake in older hospitalized patients. J Nutr Health Aging 22(5):589–593PubMedCrossRef
101.
Puntillo K, Nelson JE, Weissman D et al (2014) Palliative care in the ICU: relief of pain, dyspnea, and thirst—a report from the IPAL-ICU Advisory Board. Intensive Care Med 40(2):235–248PubMedCrossRef
102.
Puthucheary ZA, Rawal J, McPhail M et al (2013) Acute skeletal muscle wasting in critical illness. JAMA 310(15):1591–1600PubMedCrossRef
103.
104.
Raynaud-Simon A, Cohen-Bittan J, Gouronnec A et al (2010) Scurvy in hospitalized elderly patients. J Nutr Health Aging 14(6):407–410PubMedCrossRef
105.
Reeve E, Wiese MD, Mangoni AA (2015) Alterations in drug disposition in older adults. Expert Opin Drug Metab Toxicol 11:491–508PubMedCrossRef
106.
Reinikainen M, Uusaro A, Niskanen M, Ruokonen E (2007) Intensive care of the elderly in Finland. Acta Anaesthesiol Scand 51(5):522–529PubMedCrossRef
107.
Resnick NM, Marcantonio ER (1997) How should clinical care of the aged differ? Lancet 350:1157–1158PubMedCrossRef
108.
Rich MW, Chyun DA, Skolnick AH et al (2016) Knowledge gaps in cardiovascular care of older adults: a scientific statement from the American Heart Association, American College of Cardiology, and American Geriatrics Society: executive summary. J Am Geriatr Soc 64:2185–2192PubMedCrossRef
109.
Riessen R, Bantlin C, Wiesing U, Haap M (2013) End-of life decisions in intensive care units. Influence of patient wishes on therapeutic decision making. Med Klin Intensivmed Notfmed 108(5):412–418PubMedCrossRef
110.
111.
Roffi M, Patrono C, Collet JP et al (2016) 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 37:267–315PubMedCrossRef
112.
Rutschmann OT, Cevalley T, Zumwald C, Luthy C, Vermeulen B (2005) Pittfals in the emergency department triage of frail elederly patients without specific complaints. Swiss Med Wkly 135:145–150PubMed
113.
114.
Sacanella E, Pérez-Castejón JM, Nicolás JM et al (2011) Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study. Crit Care 5:R105CrossRef
115.
Scheel R, Pisegna JM, McNally E, Noordzij JP, Langmore SE (2016) Endoscopic assessment of swallowing after prolonged Intubation in the ICU setting. Ann Otol Rhinol Laryngol 125(1):43–52PubMedCrossRef
116.
Schmid H, Schiffl H, Lederer SR (2011) Die akute Nierenschädigung. Intensivmed 48:468–473CrossRef
117.
Schmiedl S, Kohl V, Thürmann P (2014) Gleichzeitige Verordnung von Analgetika und Psychopharmaka. Welche Interaktionen sind relevant? Angew Schmerzther Palliativmed 7:27CrossRef
118.
Schuster M, Ferner M, Bodenstein M, Laufenberg-Feldmann R (2017) Palliative therapy concepts in intensive care medicine. Anaesthesist 66(4):233–239PubMedCrossRef
119.
Shears M, Takaoka A, Rochwerg B et al (2018) Assessing frailty in the intensive care unit: A reliability and validity study. J Crit Care 45:197–203PubMedCrossRef
120.
Shi S, Mörike K, Klotz U (2008) The clinical implications of ageing for rational drug therapy. Eur J Clin Pharmacol 64:183–199PubMedCrossRef
121.
Simon A (2011) Alte Patienten in der Intensivmedizin: Ethische Aspekte. Med Klin Intensivmed Notfmed 106:24–28PubMedCrossRef
122.
Singler K, Thiem U, Christ M et al (2014) Aspects and assessment of delirium in old age. First data from a German interdisciplinary emergency department. Z Gerontol Geriatr 47(8):680–685PubMedCrossRef
123.
Sligl WI, Eurich DT, Marrie TJ, Majumdar SR (2010) Age still matters: Prognosticating short- and long-term mortality for critically ill patients with pneumonia. Crit Care Med 38:2126–2132PubMedCrossRef
124.
Soderstrom L, Rosenblad A, Thors Adolfsson E, Bergkvist L (2017) Malnutrition is associated with increased mortality in older adults regardless of the cause of death. Br J Nutr 117(4):532–540PubMedCrossRef
125.
Sprung CL, Artigas A, Kesecioglu J et al (2012) The Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: intensive care benefit for the elderly. Crit Care Med 40(1):132–138PubMedCrossRef
126.
127.
128.
Thibault R, Pichard C (2010) Nutrition and clinical outcome in intensive care patients. Curr Opin Clin Nutr Metab Care 13(2):177–183PubMedCrossRef
129.
Thürmann PA (2014) Polypharmazie. Treiben Sie den Teufel nicht mit dem Beelzebub aus! MMW Fortschr Med 156:56–61PubMedCrossRef
130.
Thürmann PA, Schmiedl S (2011) Pharmakotherapie alter Patienten. Med Klin Intensivmed Notfmed 106:16–23PubMedCrossRef
131.
Tran D, Rajwani K, Berlin DA (2018) Pulmonary effects of aging. Curr Opin Anaesthesiol 31(1):19–23PubMedCrossRef
132.
133.
Vargas N, Vargas M, Galluccio V et al (2014) Non-invasive ventilation for very old patients with limitations to respiratory care in half-open geriatric ward: experience on a consecutive cohort of patients. Aging Clin Exp Res 26(6):615–623PubMedCrossRef
134.
Vargas N, Tibullo L, Landi E et al (2017) Caring for critically ill oldest old patients: a clinical review. Aging Clin Exp Res 29(5):833–845PubMedCrossRef
135.
Volkert D, Bauer JM, Frühwald T et al (2013) Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESEKES, der AKE und DGG: Kinische Ernährung in der Geriatrie. Aktuel Ernährungsmed 38:1–48
136.
Volkert D, Beck AM, Cederholm T et al (2019) ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr 38(1):10–47PubMedCrossRef
137.
Walker DM, Gale CP, Lip G et al (2018) Editor’s Choice—Frailty and the management of patients with acute cardiovascular disease: a position paper from the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care 7(2):176–193PubMedCrossRef
138.
Walston J, McBurnie MA, Newman A et al (2002) Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities. Arch Intern Med 162:2333–2341PubMedCrossRef
139.
140.
Wirth R, Sieber CC (2012) Health care professionals underestimate the mean life expectancy of older people. Gerontology 58(1):56–59PubMedCrossRef
141.
Wirth R, Dziewas R, Beck AM et al (2016) Oropharyngeal dysphagia in older persons—from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging 11:189–208PubMedPubMedCentralCrossRef
142.
Wirth R, Diekmann R, Janssen G et al (2018) Refeeding syndrome: Pathophysiology, risk factors, prevention, and treatment. Internist (Berl) 59(4):326–333CrossRef
143.
Wirth R, Bauer J, Sieber C (2007) Erythrocyte volume is a poor predictor of cobalamin and folate deficiency in geriatric patients. J Am Geriatr Soc 55(12):2100–2101PubMedCrossRef
144.
Yatabe T, Nishigaki A, Tamura T, Yokoyama M (2018) Mortality and physical status at hospital discharge in Japanese elderly critically ill patients: a single-center retrospective study. JA Clin Rep 4:1PubMedPubMedCentralCrossRef
145.
146.
Yoshioka N, Takagi K, Morita Y et al (2019) Impact of the clinical frailty scale on mid-term mortality in patients with ST-elevated myocardial infarction. Int J Cardiol Heart Vasc 22:192–198PubMedPubMedCentral
147.
von Zglinicki T (2010) Alter und Altern. In: Schmidt, Lang, Heckmann (Hrsg) Physiologie des Menschen, 31. Aufl. Kapitel 41, S 877–891CrossRef
Metadaten
Titel
Geriatrische Intensivmedizin
Konsensuspapier der DGIIN, DIVI, DGAI, DGGG, ÖGGG, ÖGIAIN, DGP, DGEM, DGD, DGNI, DGIM, DGKliPha und DGG
verfasst von
Prof. Dr. med. Guido Michels
Cornel C. Sieber
Gernot Marx
Regina Roller-Wirnsberger
Michael Joannidis
Ursula Müller-Werdan
Wolfgang Müllges
Georg Gahn
Roman Pfister
Petra A. Thürmann
Rainer Wirth
Jana Fresenborg
Ludwig Kuntz
Steffen T. Simon
Uwe Janssens
Hans Jürgen Heppner
Publikationsdatum
05.07.2019
Verlag
Springer Medizin
Schlagwort
Pflege
Erschienen in
Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 5/2020
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226
DOI
https://doi.org/10.1007/s00063-019-0590-7

Weitere Artikel der Ausgabe 5/2020

Medizinische Klinik - Intensivmedizin und Notfallmedizin 5/2020 Zur Ausgabe

CME

Klinische Ernährung in der Intensivmedizin

Nachrufe

Nachruf Prof. Dr. Wolfgang Huber

Kasuistiken

Ansteigende Laktatwerte im Verlauf der Therapie einer diabetischen Ketoacidose

Pflege

Protokoll einer Studie zur Qualitätsverbesserung des Delirmanagements auf der Intensivstation

Bild und Fall

Akutes Atemnotsyndrom nach Gadoliniumanwendung

Innovationen in der Intensivmedizin

Frühe Optimierung der Antibiotikatherapie durch den schnellen Nachweis von Erregern und Empfindlichkeit

Neu im Fachgebiet AINS

11.04.2024 | Rückenschmerzen | Nachrichten

Diclofenac-Gel versus Ibuprofen bei akuten Rückenschmerzen

10.04.2024 | Postoperative Schmerztherapie | Nachrichten

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

08.04.2024 | Andrologie | Nachrichten

Wie toxische Männlichkeit der Gesundheit von Männern schadet

04.04.2024 | DGP 2024 | Kongressbericht | Nachrichten

Neue NIV-Leitlinie mit Anleitung zur Beatmungseinstellung vorgestellt
weitere anzeigen

Update AINS

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

hier abonnieren