Skip to main content
Erschienen in:

01.02.2016 | intensivpflege

Patientensymptome kritisch hinterfragen

Toleranz des endotrachealen Tubus bei beatmeten Intensivpatienten

verfasst von: Peter Nydahl, Carsten Hermes, Rolf Dubb, Arnold Kaltwasser, Danny Schuchhardt

Erschienen in: PRO CARE | Ausgabe 1-2/2016

Einloggen, um Zugang zu erhalten

Auszug

Beatmete Patienten auf Intensivstationen sind in einer kritischen Situation, die potenziell lebensbedrohlich ist. Sie werden auch im Zeitalter moderner Sedierungskonzepte medikamentös analgosediert, um sie dabei zu unterstützen, verschiedene Interventionen, wie die Beatmung mittels eines endotrachealen Tubus (ETT), während ihres Aufenthalts besser zu tolerieren [31]. Aufgrund technischer Entwicklungen, sind Patienten heute überwiegend nicht mehr tief sediert und daher in der Lage zu kommunizieren. …
Literatur
1.
Zurück zum Zitat Abildgren-Schultz L (2011) Beatmet, aber nicht sediert. PflegenIntensiv 4(8):30–33 Abildgren-Schultz L (2011) Beatmet, aber nicht sediert. PflegenIntensiv 4(8):30–33
2.
Zurück zum Zitat Aitken LM, Marshall AP, Elliott R, McKinley S (2009) Critical care nurses‘ decision making: sedation assessment and management in intensive care. J Clin Nurs 18(1):36–45CrossRefPubMed Aitken LM, Marshall AP, Elliott R, McKinley S (2009) Critical care nurses‘ decision making: sedation assessment and management in intensive care. J Clin Nurs 18(1):36–45CrossRefPubMed
3.
Zurück zum Zitat Anbeh T (2002) Psychologische Aspekte einer Intensivstation, 2. Aufl. HeWeTra, Augsburg Anbeh T (2002) Psychologische Aspekte einer Intensivstation, 2. Aufl. HeWeTra, Augsburg
4.
Zurück zum Zitat Bailey P, Thomsen GE, Spuhler VJ et al (2007) Early activity is feasible and safe in respiratory failure patients. Crit Care Med 35(1):139–145CrossRefPubMed Bailey P, Thomsen GE, Spuhler VJ et al (2007) Early activity is feasible and safe in respiratory failure patients. Crit Care Med 35(1):139–145CrossRefPubMed
5.
Zurück zum Zitat Balas MC, Vasilevskis EE, Olsen KM et al (2014) Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med 42(5):1024–1036PubMedCentralCrossRefPubMed Balas MC, Vasilevskis EE, Olsen KM et al (2014) Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle. Crit Care Med 42(5):1024–1036PubMedCentralCrossRefPubMed
6.
Zurück zum Zitat Brower RG (2009) Consequences of bed rest. Crit Care Med 37(10 Suppl):422–428CrossRef Brower RG (2009) Consequences of bed rest. Crit Care Med 37(10 Suppl):422–428CrossRef
7.
Zurück zum Zitat Brown W (2000) Reflexionen über Toleranz im Zeitalter der Identität. In: Forst R (Hrsg) Toleranz. Philosophische Grundlagen und gesellschaftliche Grundlagen einer umstrittenen Tugend. Campus, Frankfurt a. M. Brown W (2000) Reflexionen über Toleranz im Zeitalter der Identität. In: Forst R (Hrsg) Toleranz. Philosophische Grundlagen und gesellschaftliche Grundlagen einer umstrittenen Tugend. Campus, Frankfurt a. M.
9.
Zurück zum Zitat Carrión MI, Ayuso D, Marcos M et al (2000) Accidental removal of endotracheal and nasogastric tubes and intravascular catheters. Crit Care Med 28(1):63–66CrossRefPubMed Carrión MI, Ayuso D, Marcos M et al (2000) Accidental removal of endotracheal and nasogastric tubes and intravascular catheters. Crit Care Med 28(1):63–66CrossRefPubMed
10.
Zurück zum Zitat Clukey L, Weyant RA, Roberts M, Henderson A (2014) Discovery of unexpected pain in intubated and sedated patients. Am J Crit Care 23(3):216–220CrossRefPubMed Clukey L, Weyant RA, Roberts M, Henderson A (2014) Discovery of unexpected pain in intubated and sedated patients. Am J Crit Care 23(3):216–220CrossRefPubMed
11.
Zurück zum Zitat Devlin JW, Nava S, Fong JJ et al (2007) Survey of sedation practices during noninvasive positive-pressure ventilation to treat acute respiratory failure. Crit Care Med 35(10):2289–2303CrossRef Devlin JW, Nava S, Fong JJ et al (2007) Survey of sedation practices during noninvasive positive-pressure ventilation to treat acute respiratory failure. Crit Care Med 35(10):2289–2303CrossRef
12.
Zurück zum Zitat Dewes M, Hermes C (2014) Die Mär von Sedierung und Delir. PflegenIntensiv 3:6–12 Dewes M, Hermes C (2014) Die Mär von Sedierung und Delir. PflegenIntensiv 3:6–12
13.
Zurück zum Zitat Fullwood D, Sargent S (2010) An overview of sedation for adult patients in hospital. Nursing Standard 24(39):48–56CrossRefPubMed Fullwood D, Sargent S (2010) An overview of sedation for adult patients in hospital. Nursing Standard 24(39):48–56CrossRefPubMed
14.
Zurück zum Zitat Gardner A, Hughes D, Cook R et al (2005) Best practice in stabilisation of oral endotracheal tubes: a systematic review. Aust Crit Care 18(4):158, 160–165CrossRefPubMed Gardner A, Hughes D, Cook R et al (2005) Best practice in stabilisation of oral endotracheal tubes: a systematic review. Aust Crit Care 18(4):158, 160–165CrossRefPubMed
15.
Zurück zum Zitat Grap MJ, Blecha T, Munro C (2002) A description of patients‘ report of endotracheal tube discomfort. Intensive Crit Care Nurs 18:244–249CrossRefPubMed Grap MJ, Blecha T, Munro C (2002) A description of patients‘ report of endotracheal tube discomfort. Intensive Crit Care Nurs 18:244–249CrossRefPubMed
16.
Zurück zum Zitat Greenough A, Morley CJ, Pool J (1986) Fighting the ventilator-are fast rates an effective alternative to paralysis? Early Hum Dev 13(2):189–194CrossRefPubMed Greenough A, Morley CJ, Pool J (1986) Fighting the ventilator-are fast rates an effective alternative to paralysis? Early Hum Dev 13(2):189–194CrossRefPubMed
17.
Zurück zum Zitat Grossbach I, Chlan L, Tracy MF (2011) Overview of mechanical ventilatory support and management of patient- and ventilator-related responses. Crit Care Nurse 31(3):30–44CrossRefPubMed Grossbach I, Chlan L, Tracy MF (2011) Overview of mechanical ventilatory support and management of patient- and ventilator-related responses. Crit Care Nurse 31(3):30–44CrossRefPubMed
19.
Zurück zum Zitat Jenabzadeh NE, Clan N (2011) A nurse’s experience being intubated and receiving mechanical ventilation. Crit Care Nurse 31(6):51–54CrossRefPubMed Jenabzadeh NE, Clan N (2011) A nurse’s experience being intubated and receiving mechanical ventilation. Crit Care Nurse 31(6):51–54CrossRefPubMed
20.
Zurück zum Zitat Johnson P, John WS, Moyle W (2006) Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world. J Adv Nurs 53(5):551–558CrossRefPubMed Johnson P, John WS, Moyle W (2006) Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world. J Adv Nurs 53(5):551–558CrossRefPubMed
21.
Zurück zum Zitat Karlsson V, Bergbom I, Forsberg A (2012) The lived experience of adult intensive care patients who were consicous during mechanical ventilation: a hermeneutic approach. Intensive Crit Care Nurs 28:6–15CrossRefPubMed Karlsson V, Bergbom I, Forsberg A (2012) The lived experience of adult intensive care patients who were consicous during mechanical ventilation: a hermeneutic approach. Intensive Crit Care Nurs 28:6–15CrossRefPubMed
22.
Zurück zum Zitat Khalaila R, Zbidat W, Anwar K et al (2011) Communication difficulties and psychoemotional distress in patients receiving mechanical ventilation. Am J Crit Care 20(6):470–479CrossRefPubMed Khalaila R, Zbidat W, Anwar K et al (2011) Communication difficulties and psychoemotional distress in patients receiving mechanical ventilation. Am J Crit Care 20(6):470–479CrossRefPubMed
23.
Zurück zum Zitat Kress JP (2009) Clinical trials of early mobilization of critically ill patients. Crit Care Med 37(10 Suppl):442–447CrossRef Kress JP (2009) Clinical trials of early mobilization of critically ill patients. Crit Care Med 37(10 Suppl):442–447CrossRef
24.
Zurück zum Zitat Leur van de J, Schans van der C, Loef BG et al (2004) Discomfort and factual recollection in intensive care unit patients. Crit Care 8:R467–R473PubMedCentralCrossRefPubMed Leur van de J, Schans van der C, Loef BG et al (2004) Discomfort and factual recollection in intensive care unit patients. Crit Care 8:R467–R473PubMedCentralCrossRefPubMed
25.
Zurück zum Zitat Machata AM, Illievich UM, Gustorff B et al (2007) Remifentanil for tracheal tube tolerance: a case control study. Anaesthesia 62:796–801CrossRefPubMed Machata AM, Illievich UM, Gustorff B et al (2007) Remifentanil for tracheal tube tolerance: a case control study. Anaesthesia 62:796–801CrossRefPubMed
26.
Zurück zum Zitat Mayring P (2002) Einführung in die Qualitative Sozialforschung, 5. Aufl. Beltz, Weinheim Mayring P (2002) Einführung in die Qualitative Sozialforschung, 5. Aufl. Beltz, Weinheim
27.
Zurück zum Zitat Moore HK, Walker CA (2011) Tolerance: a concept analysis. J Theory Constr Test 15(2):48–52 Moore HK, Walker CA (2011) Tolerance: a concept analysis. J Theory Constr Test 15(2):48–52
28.
29.
Zurück zum Zitat Needham DM, Korupolu R, Zanni JM et al (2010) Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil 91:536–542CrossRefPubMed Needham DM, Korupolu R, Zanni JM et al (2010) Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil 91:536–542CrossRefPubMed
30.
Zurück zum Zitat Needham DM (2011) Interview mit Dale M. Needham. In: Nydahl P, Müller S (Hrsg) Mobilisierung auf der Intensivstation. Herausforderung in der interdisziplinären Frührehabilitation: Gehen mit beatmeten Patienten. Zeitschrift für Physiotherapeuten (63) 6: Sonderbeilage: 1–5 Needham DM (2011) Interview mit Dale M. Needham. In: Nydahl P, Müller S (Hrsg) Mobilisierung auf der Intensivstation. Herausforderung in der interdisziplinären Frührehabilitation: Gehen mit beatmeten Patienten. Zeitschrift für Physiotherapeuten (63) 6: Sonderbeilage: 1–5
31.
Zurück zum Zitat Newmarch C (2006) Caring for the mechanically ventilated patient: part one. Nurs Stand 20(17):55–64CrossRefPubMed Newmarch C (2006) Caring for the mechanically ventilated patient: part one. Nurs Stand 20(17):55–64CrossRefPubMed
32.
Zurück zum Zitat Patak L, Gawlinski A, Fung NJ et al (2004) Patients‘ reports of health Carey practioner interventions that are related to communication during mechanical ventilation. Heart Lung 33(5):308–320CrossRefPubMed Patak L, Gawlinski A, Fung NJ et al (2004) Patients‘ reports of health Carey practioner interventions that are related to communication during mechanical ventilation. Heart Lung 33(5):308–320CrossRefPubMed
33.
Zurück zum Zitat Pinder S, Christensen M (2008) Sedation breaks: are they good for the critically ill patient? A review. Nurs Crit Care 13(2):64–70CrossRefPubMed Pinder S, Christensen M (2008) Sedation breaks: are they good for the critically ill patient? A review. Nurs Crit Care 13(2):64–70CrossRefPubMed
35.
Zurück zum Zitat Rothaug O, Müller-Wolff T, Kaltwasser A et al (2014) Praxis der Fixierung des Endotrachealtubus. Med Klin Intensivmed Notfmed 108 (6):507–515CrossRef Rothaug O, Müller-Wolff T, Kaltwasser A et al (2014) Praxis der Fixierung des Endotrachealtubus. Med Klin Intensivmed Notfmed 108 (6):507–515CrossRef
36.
Zurück zum Zitat Rotondi AJ, Chelluri L, Sirio C et al (2002) Patients‘ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med 4(30):746–752CrossRef Rotondi AJ, Chelluri L, Sirio C et al (2002) Patients‘ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med 4(30):746–752CrossRef
37.
Zurück zum Zitat Samuelson KAM, Lundberg D, Fridlund B (2007) Stressful experiences in relation to depth of sedation in mechanically ventilated patients. Nurs Crit Care 2(17):93–104CrossRef Samuelson KAM, Lundberg D, Fridlund B (2007) Stressful experiences in relation to depth of sedation in mechanically ventilated patients. Nurs Crit Care 2(17):93–104CrossRef
38.
Zurück zum Zitat Samuelson KAM, Lundberg D, Fridlund B (2008) Light vs. Heavy sedation during mechanical ventilation after oesophagectomy — a pilot experimental study focusing on memory. Acta Anaesthesiol Scand 52:1116–1123CrossRefPubMed Samuelson KAM, Lundberg D, Fridlund B (2008) Light vs. Heavy sedation during mechanical ventilation after oesophagectomy — a pilot experimental study focusing on memory. Acta Anaesthesiol Scand 52:1116–1123CrossRefPubMed
39.
Zurück zum Zitat Samuelson KA (2011) Adult intensive care patients‘ perception of endotracheal tube-related discomforts: a prospective evaluation. Heart Lung 40(1):49–55CrossRefPubMed Samuelson KA (2011) Adult intensive care patients‘ perception of endotracheal tube-related discomforts: a prospective evaluation. Heart Lung 40(1):49–55CrossRefPubMed
40.
Zurück zum Zitat Saur P, Gatzert S, Kettler D (2009) Angst, Befindlichkeit und Depression: Vergleich zwischen tracheotomierten und intubierten Patienten einer Intensivstation. Intensivmed 46:85–91CrossRef Saur P, Gatzert S, Kettler D (2009) Angst, Befindlichkeit und Depression: Vergleich zwischen tracheotomierten und intubierten Patienten einer Intensivstation. Intensivmed 46:85–91CrossRef
41.
Zurück zum Zitat Schou L, Egerod I (2008) A qualitative study into the lived experience of post-CABG patients during mechanical ventilator weaning. Intensive Crit Care Nurs 24:171–179CrossRefPubMed Schou L, Egerod I (2008) A qualitative study into the lived experience of post-CABG patients during mechanical ventilator weaning. Intensive Crit Care Nurs 24:171–179CrossRefPubMed
42.
Zurück zum Zitat Svenningsen H, Egerod I, Videbech P et al (2013) Fluctuations in sedation levels may contribute to delirium in ICU patients. Acta Anaesthesiol Scand 3:288–293CrossRef Svenningsen H, Egerod I, Videbech P et al (2013) Fluctuations in sedation levels may contribute to delirium in ICU patients. Acta Anaesthesiol Scand 3:288–293CrossRef
43.
Zurück zum Zitat Schweickert WD, Pohlman MC, Pohlman AS et al (2009) Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 373:1874–1882CrossRefPubMed Schweickert WD, Pohlman MC, Pohlman AS et al (2009) Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 373:1874–1882CrossRefPubMed
44.
Zurück zum Zitat Strøm T, Martinussen T, Toft P (2010) A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 375(9713):475–480CrossRefPubMed Strøm T, Martinussen T, Toft P (2010) A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 375(9713):475–480CrossRefPubMed
45.
Zurück zum Zitat Tanios MA, Wit M de, Epstein SK et al (2009) Perceived barriers to the use of sedation protocols and daily sedation interruption: a multidisciplinary survey. J Crit Care 24(1):66–73CrossRefPubMed Tanios MA, Wit M de, Epstein SK et al (2009) Perceived barriers to the use of sedation protocols and daily sedation interruption: a multidisciplinary survey. J Crit Care 24(1):66–73CrossRefPubMed
46.
Zurück zum Zitat Trouillet JL, Luyt CE, Guiguet M et al (2011) Early percutaneous tracheotomy versus prolonged intubation of mechanically ventilated patients after cardiac surgery: a randomized trial. Ann Intern Med 154(6):373–383CrossRefPubMed Trouillet JL, Luyt CE, Guiguet M et al (2011) Early percutaneous tracheotomy versus prolonged intubation of mechanically ventilated patients after cardiac surgery: a randomized trial. Ann Intern Med 154(6):373–383CrossRefPubMed
47.
Zurück zum Zitat Ullrich L, Stolecki D, Grünewald M (2005) Thiemes Intensivpflege und Anästhesie. Stuttgart, Thieme Ullrich L, Stolecki D, Grünewald M (2005) Thiemes Intensivpflege und Anästhesie. Stuttgart, Thieme
48.
Zurück zum Zitat Vasilevskis EE, Ely WE, Speroff T et al (2010) Reducing Iatrogenic risks. ICU-acquired delirium and weakness — crossing the quality chasm. Chest 138:1224–1233PubMedCentralCrossRefPubMed Vasilevskis EE, Ely WE, Speroff T et al (2010) Reducing Iatrogenic risks. ICU-acquired delirium and weakness — crossing the quality chasm. Chest 138:1224–1233PubMedCentralCrossRefPubMed
Metadaten
Titel
Patientensymptome kritisch hinterfragen
Toleranz des endotrachealen Tubus bei beatmeten Intensivpatienten
verfasst von
Peter Nydahl
Carsten Hermes
Rolf Dubb
Arnold Kaltwasser
Danny Schuchhardt
Publikationsdatum
01.02.2016
Verlag
Springer Vienna
Erschienen in
PRO CARE / Ausgabe 1-2/2016
Print ISSN: 0949-7323
Elektronische ISSN: 1613-7574
DOI
https://doi.org/10.1007/s00735-016-0598-7

Weitere Artikel der Ausgabe 1-2/2016

ProCare 1-2/2016 Zur Ausgabe

pflege & wissenschaft

Cochrane Pflege Forum