[Ventilation concepts under extracorporeal membrane oxygenation (ECMO) in acute respiratory distress syndrome (ARDS)].
Beatmungskonzepte unter extrakorporaler Membranoxygenierung bei akutem Lungenversagen.
Acute lung failure
Invasiveness of mechanical ventilation
Mechanical ventilation
Spontaneous breathing
Ultraprotective ventilation
Journal
Die Anaesthesiologie
ISSN: 2731-6866
Titre abrégé: Anaesthesiologie
Pays: Germany
ID NLM: 9918384886806676
Informations de publication
Date de publication:
16 Apr 2024
16 Apr 2024
Historique:
medline:
16
4
2024
pubmed:
16
4
2024
entrez:
16
4
2024
Statut:
aheadofprint
Résumé
Extracorporeal membrane oxygenation (ECMO) is often the last resort for escalation of treatment in patients with severe acute respiratory distress syndrome (ARDS). The success of treatment is mainly determined by patient-specific factors, such as age, comorbidities, duration and invasiveness of the pre-existing ventilation treatment as well as the expertise of the treating ECMO center. In particular, the adjustment of mechanical ventilation during ongoing ECMO treatment remains controversial. Although a reduction of invasiveness of mechanical ventilation seems to be reasonable due to physiological considerations, no improvement in outcome has been demonstrated so far for the use of ultraprotective ventilation regimens. 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.
Autres résumés
Type: Publisher
(ger)
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.
Identifiants
pubmed: 38625538
doi: 10.1007/s00101-024-01407-3
pii: 10.1007/s00101-024-01407-3
doi:
Types de publication
English Abstract
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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