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Sekretmanagement

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Neurologische Beatmungsmedizin

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Zusammenfassung

Ein suffizientes Sekretmanagement ist die wichtigste Voraussetzung für eine erfolgreiche Beatmungstherapie bei neurologischen Erkrankungen. Bei neuromuskulären Erkrankungen kommt es aufgrund eines Kraftverlusts der inspiratorischen und exspiratorischen Muskulatur zum hypoxämischen Versagen durch verminderte Sekretclearance und zur ventilatorischen Insuffizienz mit Beatmungspflichtigkeit. Eine akute, vitale Gefährdung der betroffenen Patienten ist immer bedingt durch das hypoxämische Versagen im Rahmen der Sekretretention, nicht durch die ventilatorische Insuffizienz. Aus diesem Grund kommt dem Sekretmanagement bei diesen Erkrankungen eine lebenswichtige Bedeutung zu. Patienten mit Erkrankungen des Gehirns leiden trotz unterschiedlicher Pathophysiologie an analogen klinischen Symptomen: Infolge von Dysphagie mit Speichelaspiration und Husteninsuffizienz kann bei zerebral erkrankten Patienten ähnlich wie bei neuromuskulären Patienten eine Sekretretention auftreten, welche in Pneumonien resultieren und die Entfernung einer Trachealkanüle – wenn vorhanden – unmöglich machen kann. In diesem Kapitel werden Methoden für das strukturierte Sekretmanagement bei neuromuskulär und zerebral erkrankten neurologischen Beatmungspatienten abgeleitet.

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Author information

Authors and Affiliations

  1. Beatmungszentrum, Asklepios Klinikum Harburg, Hamburg, Deutschland

    Martin Bachmann

  2. Klinik für Neurologische Intensivmedizin und Frührehabilitation und Interdisziplinäres Palliativzentrum, Evangelisches Krankenhaus Oldenburg, Oldenburg, Deutschland

    Martin Groß

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  1. Martin Bachmann
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Editors and Affiliations

  1. Klinik für Neurologische Intensivmedizin und Frührehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany

    Martin Groß

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Bachmann, M., Groß, M. (2020). Sekretmanagement. In: Groß, M. (eds) Neurologische Beatmungsmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59014-0_7

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  • DOI: https://doi.org/10.1007/978-3-662-59014-0_7

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-59013-3

  • Online ISBN: 978-3-662-59014-0

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