Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
Review[Current concepts of weaning children from invasive ventilation].
Timely weaning from invasive ventilation is of major importance to limit time of invasive ventilation and improve outcomes. However, in pediatrics only limited knowledge on the optimal weaning approach is available. ⋯ Standardized daily evaluation of weaning readiness, daily interruption of sedation, use of pediatric sedation protocols, application of noninvasive ventilation and prophylactic treatment with steroids of patients with high risk for post-extubation upper airway obstruction have been shown to decrease duration of invasive ventilation or to decrease the risk of extubation failure. However, due to the heterogeneous patient population in pediatric intensive care units, an individual approach might be necessary for certain subgroups of pediatric patients.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
[Weaning - Defintion and clinical context from the neurologist's view].
Special conditions in neurologic patients arise, first, from abnormal breathing patterns with brain lesions. These however may be managed effectively by adaptive ventilator settings together with special drugs thus not ultimatively precluding weaning. ⋯ In acute neuromuscular diseases during the weaning process special attention should be payed to the parameters of muscle strength, and for disturbances of swallowing at least after extubation. In degenerative terminally decompensated neuromuscular disease, an exact diagnosis and information is essential to help the patient in decision-making towards terminal weaning or long-term home ventilatory support.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2013
[Weaning - Definition and clinical context from the anesthetic point of view].
Independent from the mode of mechanical ventilation, particularly a quick termination of mechanical ventilation is essential for the weaning progress. Respirator-associated complications need to be early detected and treated. Thus it is important to know correspondent pathomechanisms as they have a crucial influence on the weaning process. To facilitate a holistic treatment approach for patients in prolonged weaning, a tight junction of intensive care within specialized units seems mandatory.