S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz

  • Michael Westhoff
  • Peter Neumann
  • Jens Geiseler
  • Johannes Bickenbach
  • Michael Arzt
  • Martin Bachmann
  • Stephan Braune
  • Sandra Delis
  • Dominic Dellweg
  • Michael Dreher
  • Rolf Dubb
  • Hans Fuchs
  • Nina Hämäläinen
  • Hans Heppner
  • Stefan Kluge
  • Matthias Kochanek
  • Philipp M Lepper
  • F Joachim Meyer
  • Bernhard Neumann
  • Christian Putensen
  • Dorit Schimandl
  • Bernd Schönhofer
  • Dierk Schreiter
  • Stephan Walterspacher
  • Wolfram Windisch
  • Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) e. V.
  • Deutsche Gesellschaft für Chirurgie (DGCh) e. V.
  • Deutsche Gesellschaft für Fachkrankenpflege und Funktionsdienste (DGF) e. V.
  • Deutsche Gesellschaft für Innere Medizin (DGIM) e. V.
  • Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN) e. V.
  • Deutsche Gesellschaft für Kardiologie (DGK) e. V.
  • Deutsche Gesellschaft für Neurologie (DGN) e. V.
  • Deutsche Gesellschaft für Neurologische Intensiv- und Notfallmedizin (DGNI) e. V.
  • Deutsche Gesellschaft für Palliativmedizin (DGP) e. V.
  • Deutsche Interdiszipläre Gesellschaft für Ausserklinische Beatmung (DIGAB) e. V.
  • Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI) e. V.
  • Gesellschaft für Neonatologie und pädiatrische Intensivmedizin (GNPI) e. V.

Beteiligte Einrichtungen

Abstract

The guideline update outlines the advantages as well as the limitations of NIV in the treatment of acute respiratory failure in daily clinical practice and in different indications.Non-invasive ventilation (NIV) has a high value in therapy of hypercapnic acute respiratory failure, as it significantly reduces the length of ICU stay and hospitalization as well as mortality.Patients with cardiopulmonary edema and acute respiratory failure should be treated with continuous positive airway pressure (CPAP) and oxygen in addition to necessary cardiological interventions. This should be done already prehospital and in the emergency department.In case of other forms of acute hypoxaemic respiratory failure with only mild or moderately disturbed gas exchange (PaO2/FiO2 > 150 mmHg) there is no significant advantage or disadvantage compared to high flow nasal oxygen (HFNO). In severe forms of ARDS NIV is associated with high rates of treatment failure and mortality, especially in cases with NIV-failure and delayed intubation.NIV should be used for preoxygenation before intubation. In patients at risk, NIV is recommended to reduce extubation failure. In the weaning process from invasive ventilation NIV essentially reduces the risk of reintubation in hypercapnic patients. NIV is regarded useful within palliative care for reduction of dyspnea and improving quality of life, but here in concurrence to HFNO, which is regarded as more comfortable. Meanwhile NIV is also recommended in prehospital setting, especially in hypercapnic respiratory failure and pulmonary edema.With appropriate monitoring in an intensive care unit NIV can also be successfully applied in pediatric patients with acute respiratory insufficiency.

Bibliografische Daten

Titel in ÜbersetzungNon-invasive Mechanical Ventilation in Acute Respiratory Failure. Clinical Practice Guidelines - on behalf of the German Society of Pneumology and Ventilatory Medicine: on behalf of the German Society of Pneumology and Ventilatory Medicine
OriginalspracheDeutsch
ISSN0934-8387
DOIs
StatusVeröffentlicht - 07.2024
PubMed 37832578