{"id":12394,"date":"2020-10-30T04:18:43","date_gmt":"2020-10-30T03:18:43","guid":{"rendered":"http:\/\/news-papers.eu\/?p=12394"},"modified":"2020-10-16T11:23:23","modified_gmt":"2020-10-16T09:23:23","slug":"neue-empfehlungen-zum-physiological-difficult-airway-teil-4","status":"publish","type":"post","link":"http:\/\/news-papers.eu\/?p=12394","title":{"rendered":"Neue Empfehlungen zum &#8222;Physiological Difficult Airway&#8220; &#8211; Teil 4"},"content":{"rendered":"<p style=\"text-align: justify;\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"9773\" data-permalink=\"http:\/\/news-papers.eu\/?attachment_id=9773\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/07\/TEE2-e1560879581378.jpeg?fit=300%2C169\" data-orig-size=\"300,169\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;1.9&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;SM-G920F&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1471264667&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;4.3&quot;,&quot;iso&quot;:&quot;200&quot;,&quot;shutter_speed&quot;:&quot;0.071428571428571&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"TEE2\" data-image-description=\"\" data-image-caption=\"\" data-medium-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/07\/TEE2-e1560879581378.jpeg?fit=300%2C169\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/07\/TEE2-e1560879581378.jpeg?fit=1024%2C576\" class=\"size-medium wp-image-9773 alignright\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/07\/TEE2.jpeg?resize=300%2C169\" alt=\"\" width=\"300\" height=\"169\" \/>Schauen wir heute doch noch mal etwas genauer in die neuen Empfehlungen zum Vorgehen f\u00fcr den &#8222;physiologisch schwierigen Atemweg&#8220;:<\/p>\n<blockquote>\n<p style=\"text-align: justify;\"><strong>Kornas RL et al. Evaluation and Management of the Physiologically\u00a0Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesthesia Analgesia 2020, online<\/strong><\/p>\n<\/blockquote>\n<p><strong>Zum Thema &#8222;RV-Versagen&#8220; finden sich folgende detaillierten Empfehlungen:\u00a0<\/strong><\/p>\n<ol>\n<li>Angesichts des Risikos einer Dekompensation beim \u00dcbergang zur \u00dcberdruckbeatmung sollten die Patienten vor der Intubation auf eine signifikante RV-Dysfunktion untersucht werden.<\/li>\n<li>Bei Vorliegen einer RV-Dysfunktion sollten die Patienten auf die systolische Funktion der RV sowie die Fl\u00fcssigkeits- und Vasopressorvertr\u00e4glichkeit untersucht werden. Empirische Fl\u00fcssigkeitssubstitution ohne diese Bewertung kann die Funktion der RV weiter reduzieren.<\/li>\n<li>Fl\u00fcssigkeits- und vasopressortolerante Patienten sollten entsprechend behandelt werden.<\/li>\n<li>Bei Patienten mit Fl\u00fcssigkeitsintoleranz sollte die RV-Nachlast mit inhalativen oder intraven\u00f6sen pulmonalen Vasodilatatoren reduziert werden.<\/li>\n<li>Eine extrakorporale Membran-Sauerstoff-Kan\u00fclierung (ECMO) vor Atemwegssicherung sollte in Betracht gezogen werden, falls sie bei Patienten mit einem durch RV-Versagen induzierten Schock verf\u00fcgbar ist.<\/li>\n<li>Eine Diuretikatherapie vor Atemwegssicherung sollte bei Patienten mit RV-Volumen\u00fcberlastung in Betracht gezogen werden.<\/li>\n<li>Eine Hyperkapnie sollte vermieden werden.<\/li>\n<li>Der mittlere arterielle Druck (MAP) sollte erh\u00f6ht werden, um den koronaren Perfusionsdruck aufrechtzuerhalten. Bei Patienten mit chronischer pulmonal-arterieller Hypertonie sollte ein h\u00f6herer MAP angestrebt werden, um den MAP &gt; mittleren pulmon\u00e4ren Arteriendruck zu halten.<\/li>\n<li>Die Beatmungsstrategie nach der Intubation sollte einen niedrigen mittleren Atemwegsdruck und einen h\u00f6heren PEEP beinhalten, um Atelektasen zu vermeiden.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Schauen wir heute doch noch mal etwas genauer in die neuen Empfehlungen zum Vorgehen f\u00fcr den &#8222;physiologisch schwierigen Atemweg&#8220;: Kornas RL et al. Evaluation and Management of the Physiologically\u00a0Difficult Airway: [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":9773,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[3],"tags":[1920],"class_list":["post-12394","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-atemwegsmanagement","tag-rv-versagen"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/07\/TEE2-e1560879581378.jpeg?fit=300%2C169","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-3dU","jetpack-related-posts":[{"id":12389,"url":"http:\/\/news-papers.eu\/?p=12389","url_meta":{"origin":12394,"position":0},"title":"Neue Empfehlungen zum &#8222;Physiological Difficult Airway&#8220; &#8211; Teil 3","author":"Michael Bernhard","date":"Oktober 28, 2020","format":false,"excerpt":"Schauen wir heute doch noch mal etwas genauer in die neuen Empfehlungen zum Vorgehen f\u00fcr den \"physiologisch schwierigen Atemweg\": Kornas RL et al. 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