Zusammenfassung
Goldstandard zur Sicherung der Atemwege ist die endotracheale Intubation (möglich als orotracheale oder nasotracheale Intubation), mit der eine mechanische Verlegung der Atemwege zuverlässig verhindert oder beseitigt wird. Gleichzeitig eröffnet sie die Möglichkeit, den Patienten an ein Beatmungsgerät anzuschließen und eine positive Druckbeatmung durchzuführen. Sie erleichtert die Bronchialtoilette und erlaubt diagnostische/therapeutische Bronchoskopien sowie die endotracheale Medikamentenapplikation. Die Dilatationstracheotomie ist einer der weltweit häufigsten invasiven Eingriffe auf Intensivstationen. Ziele jeder rechtzeitig innerhalb der Langzeitbeatmung durchgeführten Tracheotomie sind Vermeidung von Kehlkopf- und Stimmbandschäden, schnellere Entwöhnung vom Respirator, bessere Pflege und ein besserer Patientenkomfort. Neben der klassischen chirurgischen Tracheotomie stehen verschiedene Verfahren der perkutanen Tracheotomie zur Verfügung (Ciaglia, Griggs, Fantoni, Frova, Zgoda).
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Quintel, M., Fiedler, F., Utzolino, S., Prause, A. (2015). Atemwegsmanagement. In: Marx, G., Muhl, E., Zacharowski, K., Zeuzem, S. (eds) Die Intensivmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54953-3_24
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