Beatmung nach dem 'open-lung'-Konzept bei polytraumatisierten Patienten*
| Autor: | M. Bayeff-Filloff, C. Knothe, G. Regel, T. Huber, P. Hiltl |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Osteosynthesis
Lung business.industry General Medicine Oxygenation respiratory system Critical Care and Intensive Care Medicine respiratory tract diseases Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Emergency Medicine Breathing Medicine business Multiple fractures Thoracic trauma Organ system Lung function |
| Zdroj: | ains · Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie. 35:306-315 |
| ISSN: | 1439-1074 0939-2661 |
| DOI: | 10.1055/s-2000-326 |
| Popis: | OBJECTIVE The ventilation mode clearly influences the course of patients with multiple trauma on the ICU. Ventilation according the "open lung" approach rapidly opens up atelectatic lung regions. Generation of an adequate intrinsic PEEP enables to keep the lung open. We studied the consequences of the "open lung" approach on the lung function and monitored its side effects on patients with multiple trauma. METHODS 18 consecutive patients with multiple trauma and additional thoracic trauma were routinely ventilated according the "open lung" approach between May and November 1999. We were mainly interested in data of lung mechanics, oxygenation and ventilation. Side effects on other organ systems and consequence for the infection rate were monitored. RESULTS Ventilation according the "open lung" approach enables early sufficient oxygenation and ventilation of patients with severe multiple trauma and accompanying thoracic trauma. The ventilation mode helps to prevent baro-, volu- and atelectrauma and thus fulfils the requirements for a present-day ventilation mode. An immediate complete healing of the lung damages was not found. Nevertheless, as a trend the length of ventilation support seems short. Even extensive osteosynthesis at multiple fractures was possible without delay. Side effects of the high opening pressure on the lung or other organs as well as sequels of the high intrinsic PEEP on liver, kidney or intestine were not found. The infection rate was low, therapeutic doses of antibiotics were necessary only in less than half of the ICU-stay. CONCLUSION Ventilation according the "open lung" approach is a very effective and safe way to ventilate patients after severe multiple trauma with accompanying thoracic trauma. |
| Databáze: | OpenAIRE |
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