Welte T
Bereich Pneumologie und internistische Intensivmedizin, Otto-von Guericke Universität Magdeburg.
Pneumologie. 2000 Jan;54(1):5-9. doi: 10.1055/s-2000-9062.
In many ICU's in these days non-invasive mask ventilation is a technique in addition to the traditional invasive ventilation via endotracheal tube if the patient is able to cooperate. If contraindication (mucus retention, swallowing disorders, acute neurologic disorders, circulatory instability) and definition of interruption criteria are regarded, the method is safe. Besides its use for exacerbation of chronic obstructive pulmonary disease, especially the cardiogenic, pulmonary oedema is an indication which is supported by several studies. Other conditions such as pneumonia and ARDS have only been observed in relatively small studies. According to pathophysiologic pathways the use of non-invasive techniques seems limited to not-so-advanced stages of the disease in these cases. Considering the growing importance of this technique for the weaning procedure after long-term mechanical ventilation should be established at every ICU.
如今,在许多重症监护病房中,如果患者能够配合,除了通过气管插管进行传统的有创通气外,无创面罩通气也是一种技术。如果考虑到禁忌症(痰液潴留、吞咽障碍、急性神经疾病、循环不稳定)和中断标准的定义,该方法是安全的。除了用于慢性阻塞性肺疾病急性加重期外,尤其是心源性肺水肿,多项研究也支持将其作为一种适应症。其他情况如肺炎和急性呼吸窘迫综合征仅在相对较小的研究中观察到。根据病理生理途径,在这些情况下,无创技术的使用似乎仅限于疾病不太严重的阶段。考虑到该技术对于长期机械通气后撤机过程的重要性日益增加,每个重症监护病房都应确立相关操作规范。