Zusammenfassung
Patienten mit chronischen Erkrankungen der Lunge, wie chronisch obstruktive Lungenerkrankung (COPD) oder Asthma, werden nach epidemiologischen Schätzungen zunehmen, sodass auch von einer weiter wachsenden Zahl von intensivpflichtigen Patienten mit vorbestehenden pulmonalen Erkrankungen auszugehen ist. Diese Patienten sind meist komplex krank und nach Intubation schwer von der mechanischen Beatmung zu entwöhnen. Nicht selten bedürfen sie nach der akuten Erkrankungsphase weiterhin einer dauerhaften Beatmungsunterstützung. Auch die Frage der Therapiebegrenzung, der Notwendigkeit einer Behandlung mit palliativer Zielsetzung und die Begleitung sowohl der Patienten als auch der Angehörigen am Lebensende sind Herausforderungen an den Intensivmediziner, wenn er akut kranke Patienten mit chronischen Erkrankungen der Lunge behandelt.
Abstract
Epidemiological estimates predict an increase in patients with chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) or asthma; therefore, increasing numbers of patients with preexisting lung diseases who require intensive care treatment are to be expected. These patients tend to have complex disease patterns and are difficult to wean from mechanical ventilation after intubation. It is not uncommon for these patients to need permanent mechanical ventilation after an acute illness. Also the question of limiting therapy, the need for treatment with a palliative objective and supervision of patients as well as their relatives at the end of life is a challenge for intensive care physicians when treating acutely ill patients with chronic pulmonary diseases.
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Pfeifer, M. Der kritisch chronisch kranke Patient aus pneumologischer Sicht. Med Klin Intensivmed Notfmed 108, 279–284 (2013). https://doi.org/10.1007/s00063-012-0192-0
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DOI: https://doi.org/10.1007/s00063-012-0192-0