{"id":3476,"date":"2017-03-27T04:23:51","date_gmt":"2017-03-27T02:23:51","guid":{"rendered":"http:\/\/news-papers.eu\/?p=3476"},"modified":"2016-12-30T14:51:49","modified_gmt":"2016-12-30T13:51:49","slug":"the-art-of-preoxygenation-teil-3","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=3476","title":{"rendered":"The art of preoxygenation&#8230; Teil 3"},"content":{"rendered":"<p style=\"text-align: justify;\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"3491\" data-permalink=\"https:\/\/news-papers.eu\/?attachment_id=3491\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Bildschirmfoto-2016-12-30-um-14.48.21-e1483105731719.png?fit=500%2C243&amp;ssl=1\" data-orig-size=\"500,243\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"bildschirmfoto-2016-12-30-um-14-48-21\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Bildschirmfoto-2016-12-30-um-14.48.21-e1483105731719.png?fit=1024%2C497&amp;ssl=1\" class=\"size-medium wp-image-3491 alignright\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Bildschirmfoto-2016-12-30-um-14.48.21.png?resize=300%2C146\" alt=\"bildschirmfoto-2016-12-30-um-14-48-21\" width=\"300\" height=\"146\" \/>In dem \u00dcbersichtsartikel von Usharani Nimmagadda und Kollegen wurden auch Empfehlungen zur\u00a0<strong>Pr\u00e4oxygenierung von morbid-adip\u00f6sen Patienten<\/strong>\u00a0gemacht:<\/p>\n<blockquote><p><strong>Nimmagadda U, et al.\u00a0Preoxygenation: Physiologic Basis, Benefits, and\u00a0Potential Risks. Anesth Analg 2016,\u00a0DOI: 10.1213\/ANE.0000000000001589<\/strong><\/p><\/blockquote>\n<hr \/>\n<p style=\"text-align: justify;\">Usharani Nimmagadda und Kollegen fassen zur <strong>Pr\u00e4oxygenierung schwer adipose Patienten<\/strong> zusammen:<\/p>\n<ul>\n<li style=\"text-align: justify;\">bei schwer adip\u00f6sen Patienten (<a href=\"https:\/\/de.wikipedia.org\/wiki\/Body-Mass-Index\" target=\"_blank\"><strong>BMI<\/strong><\/a> &gt;40 kg\/m\u00b2) ist die <strong>Zeit bis zur Desaturierung in Apnoe<\/strong> nach 3 min Pr\u00e4oxygenierung im Vergleich zu normalgewichtigen Patienten <strong>deutlich verk\u00fcrzt<\/strong>: 2,7 vs. 6 min.<\/li>\n<li style=\"text-align: justify;\">erschwerend liegt bei diesen Patienten h\u00e4ufig ein <strong>OSAS<\/strong> (obstruktives Schlafapnoesyndrom) vor, einem Risikofaktor for eine schwierige Maskenbeatmung und Intubation<\/li>\n<li style=\"text-align: justify;\">die <strong>rasche Desaturierung<\/strong> wird durch relevante \u00c4nderungen der Physiologie begr\u00fcndet: erh\u00f6hte Sauerstoffaussch\u00f6pfung (VO2) und reduzierte <em><strong><a href=\"https:\/\/viamedici.thieme.de\/api\/images\/l\/g\/r\/a\/m\/m\/physio_006300_spirogramm.png\" target=\"_blank\">funktionelle Residualkapazit\u00e4t<\/a>,\u00a0<\/strong><\/em>durch eine R\u00fccklage des Patienten wird diese physiologische \u00c4nderung der Lungenvolumina noch weiter perpetuiert<\/li>\n<li style=\"text-align: justify;\"><strong>Oberk\u00f6rperhochlagerung von 25\u00b0<\/strong>\u00a0kann das Zeitfenster bis zur Desaturierung um 50 Sekunden verl\u00e4ngern<\/li>\n<li style=\"text-align: justify;\">teilweise wird die <strong>wach fiberoptische Intubation<\/strong> bei schwer adip\u00f6sen Patienten empfohlen (BMI &gt;50 kg\/m\u00b2), insbesondere wenn weitere Probleme vorliegen<\/li>\n<li><strong>apnoeische Oxygenierung<\/strong> (O2-Flow von 5lO2\/min) wird empfohlen.<\/li>\n<\/ul>\n<hr \/>\n<p><a href=\"https:\/\/twitter.com\/news_papers_eu?refsrc=email&amp;s=11\" target=\"_blank\"><strong>News-Papers.eu auf TWITTER<\/strong><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In dem \u00dcbersichtsartikel von Usharani Nimmagadda und Kollegen wurden auch Empfehlungen zur\u00a0Pr\u00e4oxygenierung von morbid-adip\u00f6sen Patienten\u00a0gemacht: Nimmagadda U, et al.\u00a0Preoxygenation: Physiologic Basis, Benefits, and\u00a0Potential Risks. Anesth Analg 2016,\u00a0DOI: 10.1213\/ANE.0000000000001589 Usharani Nimmagadda [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":3491,"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},"_wpas_customize_per_network":false},"categories":[3],"tags":[756,767],"class_list":["post-3476","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-atemwegsmanagement","tag-praeoxygenierung","tag-schwer-adipoeser-patienten"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Bildschirmfoto-2016-12-30-um-14.48.21-e1483105731719.png?fit=500%2C243&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-U4","jetpack-related-posts":[{"id":3483,"url":"https:\/\/news-papers.eu\/?p=3483","url_meta":{"origin":3476,"position":0},"title":"The art of preoxygenation&#8230; Teil 4","author":"Michael Bernhard","date":"M\u00e4rz 29, 2017","format":false,"excerpt":"In dem \u00dcbersichtsartikel von Usharani Nimmagadda und Kollegen wurden auch Tipps und Tricks\u00a0zur\u00a0Pr\u00e4oxygenierung vorgestellt: Nimmagadda U, et al.\u00a0Preoxygenation: Physiologic Basis, Benefits, and\u00a0Potential Risks. Anesth Analg 2016,\u00a0DOI: 10.1213\/ANE.0000000000001589 Apnoeische Oxygenierung: ist eine Technik, um das Sicherheitsintervall bis zur Desaturierung zu verl\u00e4ngern physiologische Grundlage: w\u00e4hrend der Apnoephase eines Erwachsenen betr\u00e4gt die durchschnittliche\u2026","rel":"","context":"In &quot;Atemwegsmanagement&quot;","block_context":{"text":"Atemwegsmanagement","link":"https:\/\/news-papers.eu\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Bildschirmfoto-2016-12-30-um-14.48.21-e1483105731719.png?fit=500%2C243&ssl=1&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":3446,"url":"https:\/\/news-papers.eu\/?p=3446","url_meta":{"origin":3476,"position":1},"title":"The art of preoxygenation&#8230; Teil 2","author":"Michael Bernhard","date":"M\u00e4rz 19, 2017","format":false,"excerpt":"In dem \u00dcbersichtsartikel von Usharani Nimmagadda und Kollegen wurden auch Empfehlungen zur Pr\u00e4oxygenierung der schwangeren Patienten gemacht: Nimmagadda U, et al.\u00a0Preoxygenation: Physiologic Basis, Benefits, and\u00a0Potential Risks. Anesth Analg 2016,\u00a0DOI: 10.1213\/ANE.0000000000001589 Usharani Nimmagadda und Kollegen schildern folgendes: Eine Rapid Sequence Induction\/Intubation wird \u00fcberlichweise bei Schwangeren durchgef\u00fchrt und eine Pr\u00e4oxygenierung dieser Patienten\u2026","rel":"","context":"In &quot;Atemwegsmanagement&quot;","block_context":{"text":"Atemwegsmanagement","link":"https:\/\/news-papers.eu\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/IMG_3824.jpg?fit=1200%2C801&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/IMG_3824.jpg?fit=1200%2C801&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/IMG_3824.jpg?fit=1200%2C801&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/IMG_3824.jpg?fit=1200%2C801&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/05\/IMG_3824.jpg?fit=1200%2C801&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":3887,"url":"https:\/\/news-papers.eu\/?p=3887","url_meta":{"origin":3476,"position":2},"title":"The art of preoxygenation&#8230; Intro","author":"Bj\u00f6rn Hossfeld","date":"M\u00e4rz 12, 2017","format":false,"excerpt":"In der Rubrik \"Understanding the desease\" der aktuellen Ausgabe des Springer-Journals Intensiv Care Medicine haben Jarrod Mosier und Kollegen eine lesenswerte \u00dcbersicht zur Pr\u00e4oxygenierung publiziert: Mosier JM, Hypes CD, Sakles JC. Understanding preoxygenation and apneic oxygenation during intubation in the critically ill.\u00a0 Intensive Care Medicine 2017; 43: 226\u20138,\u00a0 http:\/\/doi.org\/10.1007\/s00134-016-4426-0 In\u2026","rel":"","context":"In &quot;Atemwegsmanagement&quot;","block_context":{"text":"Atemwegsmanagement","link":"https:\/\/news-papers.eu\/?cat=3"},"img":{"alt_text":"Preoxygenation","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/02\/Bildschirmfoto-2017-02-19-um-14.12.19.png?fit=1200%2C782&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/02\/Bildschirmfoto-2017-02-19-um-14.12.19.png?fit=1200%2C782&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/02\/Bildschirmfoto-2017-02-19-um-14.12.19.png?fit=1200%2C782&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/02\/Bildschirmfoto-2017-02-19-um-14.12.19.png?fit=1200%2C782&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/02\/Bildschirmfoto-2017-02-19-um-14.12.19.png?fit=1200%2C782&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":3408,"url":"https:\/\/news-papers.eu\/?p=3408","url_meta":{"origin":3476,"position":3},"title":"The art of preoxygenation&#8230; Teil 1","author":"Michael Bernhard","date":"M\u00e4rz 15, 2017","format":false,"excerpt":"Usharani Nimmagadda formulierten unl\u00e4ngst einen \u00dcbersichtsartikel zum Thema Pr\u00e4oxygenierung in Anesthesia Analgesia: Nimmagadda U, et al.\u00a0Preoxygenation: Physiologic Basis, Benefits, and\u00a0Potential Risks. Anesth Analg 2016,\u00a0DOI: 10.1213\/ANE.0000000000001589 \u00a0 Hier eine kurze Zusammenfassung der wesentlichen Punkte: Pr\u00e4oxygenierung z\u00e4hlt vor der Narkoseeinleitung und endotrachealen Intubation zu einer weithin akzeptierten Massnahme, um die Sauerstoffreserve des\u2026","rel":"","context":"In &quot;Atemwegsmanagement&quot;","block_context":{"text":"Atemwegsmanagement","link":"https:\/\/news-papers.eu\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":12056,"url":"https:\/\/news-papers.eu\/?p=12056","url_meta":{"origin":3476,"position":4},"title":"Pr\u00e4oxygenierungstechniken im Notfall: Nasale-Sauerstoffkan\u00fcle belassen&#8230;","author":"Michael Bernhard","date":"September 19, 2020","format":false,"excerpt":"Bei Patienten, die eine Rapid-Sequence-Induction ben\u00f6tigen, wird h\u00e4ufig 100% Sauerstoff zur Pr\u00e4oxygenierung gegeben, mit dem Ziel den alveol\u00e4ren Stickstoff durch Sauerstoff zu ersetzen (Denitrogenisierung). Manchmal werden jedoch die Pr\u00e4oxygenierungsdevices aber vor dem Einsetzen der Apnoe vorzeitig vom Patienten entfernt, was zu einem raschen Verlust der erfolgreichen Pr\u00e4oxygenierung f\u00fchren kann. Mosier\u2026","rel":"","context":"In &quot;Atemwegsmanagement&quot;","block_context":{"text":"Atemwegsmanagement","link":"https:\/\/news-papers.eu\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/03\/Sauerstoffflasche.jpg?fit=720%2C720&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":19661,"url":"https:\/\/news-papers.eu\/?p=19661","url_meta":{"origin":3476,"position":5},"title":"Pr\u00e4oxygenierung in der Pr\u00e4klinik: PEEP bringt klaren Vorteil","author":"Bj\u00f6rn Hossfeld","date":"Mai 30, 2025","format":false,"excerpt":"Ein Gastbeitrag von Simon Kahlen, Ulm\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Nahezu jeder f\u00fcnfte kritisch kranke Patient, der in der Notaufnahme oder auf der Intensivstation intubiert wird, erleidet eine Hypox\u00e4mie.[1] Eine effektive Pr\u00e4oxygenierung vor der Narkoseeinleitung ist daher entscheidend, um diese potenziell lebensbedrohliche Komplikation zu vermeiden. W\u00e4hrend klinische Studien gezeigt haben,\u2026","rel":"","context":"In &quot;Notfallnarkose&quot;","block_context":{"text":"Notfallnarkose","link":"https:\/\/news-papers.eu\/?cat=49"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/03\/NIV3-e1457202855158.png?fit=300%2C403&ssl=1&resize=350%2C200","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/3476","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3476"}],"version-history":[{"count":7,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/3476\/revisions"}],"predecessor-version":[{"id":3493,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/3476\/revisions\/3493"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/3491"}],"wp:attachment":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3476"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3476"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3476"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}