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CC BY-NC-ND 4.0 · Klin Padiatr 2024; 236(02): 57-63
DOI: 10.1055/a-2235-7805
Diagnostic and Treatment Recommendation

Notfallpläne zum Management von Notfällen bei Kindern mit außerklinischer Beatmung

Emergency Care Plans for the Management of Emergencies in Children on Home Mechanical Ventilation
Florian Stehling
1   Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, University Hospital Essen, Essen, Germany
,
Anke Wendt
2   Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charite University Hospital Berlin, Berlin, Germany
,
Michael Berger
3   Division of Pediatric Surgery, Department of General, Abdominal and Transplant Surgery, University Hospital Essen, Essen, Germany
,
Sebastian Kerzel
4   Department of Pediatric Pneumology and Allergy, University Hospital Regensburg, Regensburg, Germany
,
Dejan Vlajnic
5   Department of Pediatrics, Vest Children's Hospital Datteln, Datteln, Germany
,
Hans Fuchs
6   Center for Pediatrics, Department of Neonatology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
,
Lennart Gunst
6   Center for Pediatrics, Department of Neonatology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
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Zusammenfassung

Die chronisch respiratorische Insuffizienz wird auch in der Pädiatrie zunehmend ambulant mit außerklinischer Beatmung behandelt. Die oft komplex, erkrankten Kinder werden in der Häuslichkeit durch pflegerische und ärztliche Teams unterschiedlichster Zusammensetzung betreut. Strukturierte Behandlungsprozesse, speziell Notfallpläne zum Management des respiratorischen Notfalls von außerklinisch beatmeten Kindern fehlen. Dieser Beitrag ist ein Vorschlag zum Notfallmanagement bei Atemwegsinfekten, Notfällen bei außerklinisch nicht-invasiv-beatmeten und invasiv-beatmeten, tracheotomierten Kindern. Neben den Reanimationsmaßnahmen nach ERC/AHA liegt der Schwerpunkt vor allem auf dem Sekretmanagement, aber auch dem Umgang mit Beatmungsgeräten und Devices.

Abstract

In pediatrics chronic respiratory insufficiency is increasingly treated on an outpatient basis with home mechanical ventilation. Nursing and medical teams with different structures take care of the often complex ill children in the outpatient setting. Structured treatment processes, especially emergency plans for the management of respiratory emergencies of home mechanical ventilated children are lacking. This article is a proposal for emergency management of respiratory infections, emergencies of non-invasively ventilated and invasively ventilated, tracheotomized children. In addition to resuscitation measures according to ERC/AHA, the focus is primarily on secretion management, as well as on the handling of ventilators and devices.

Schlüsselwörter

Notfall - Kinder - Heimbeatmung - außerklinische Beatmung - Tracheostoma - Trachealkanüle

Key words

Emergency - children - home mechanical ventilation - tracheostomy - tracheal cannula


Publication History

Article published online:
29 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • Literatur

  • 1 Eagle M, Baudouin SV, Chandler C. et al. Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscul Disord 2002; 12: 926-929
    CrossrefPubMedGoogle Scholar
  • 2 Dohna-Schwake C, Podlewski P, Voit T. et al. Non-invasive ventilation reduces respiratory tract infections in children with neuromuscular disorders. Pediatr Pulmonol 2008; 43: 67-71
    CrossrefPubMedGoogle Scholar
  • 3 Gergin O, Adil EA, Kawai K. et al. Indications of pediatric tracheostomy over the last 30 years: Has anything changed?. Int J Pediatr Otorhinolaryngol 2016; 87: 144-147
    CrossrefPubMedGoogle Scholar
  • 4 Villanueva AMOJ, Cuscó MG, Blokpoel R. et al. Handbook of paediatric and neonatal mechanical ventilation: Collaborative work of the SECIP respiratory working group and ESPNIC. Las Palmas de Gran Canaria. Tesela Ediciones. 2021
    PubMedGoogle Scholar
  • 5 https://register.awmf.org/de/leitlinien/detail/048-018 DGfPIEzBuAbKuJmsnBSLVAfVu. S1-Leitlinie Behandlung von unteren Atemwegsinfektionen von Kindern und Jugendlichen mit schweren neurologischen Beeinträchtigungen. 31.03.2023:
    PubMed
  • 6 McCaleb R, Warren RH, Willis D. et al. Description of Respiratory Microbiology of Children With Long-Term Tracheostomies. Respir Care 2016; 61: 447-452
    CrossrefPubMedGoogle Scholar
  • 7 Servera E, Sancho J, Bañuls P. et al. Bulbar impairment score predicts noninvasive volume-cycled ventilation failure during an acute lower respiratory tract infection in ALS. J Neurol Sci 2015; 358: 87-91
    CrossrefPubMedGoogle Scholar
  • 8 Deis JN, Abramo TJ, Crawley L. Noninvasive respiratory support. Pediatr Emerg Care 2008; 24: 331-338
    CrossrefPubMedGoogle Scholar
  • 9 Topjian AA, Raymond TT, Atkins D. et al. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142: S469-s523
    CrossrefPubMedGoogle Scholar
  • 10 Ogilvie LN, Kozak JK, Chiu S. et al. Changes in pediatric tracheostomy 1982-2011: a Canadian tertiary children’s hospital review. J Pediatr Surg 2014; 49: 1549-1553
    CrossrefPubMedGoogle Scholar
  • 11 Funamura JL, Yuen S, Kawai K. et al. Characterizing mortality in pediatric tracheostomy patients. Laryngoscope 2017; 127: 1701-1706
    CrossrefPubMedGoogle Scholar
  • 12 Teplitzky TB, Brown AF, Brooks RL. et al. Mortality Among Children with a Tracheostomy. Laryngoscope 2023; 133: 403-409
    CrossrefPubMedGoogle Scholar
  • 13 Lubianca Neto JF, Castagno OC, Schuster AK. Complications of tracheostomy in children: a systematic review. Braz J Otorhinolaryngol 2022; 88: 882-890
    CrossrefPubMedGoogle Scholar
  • 14 Sterni LM, Collaco JM, Baker CD. et al. An Official American Thoracic Society Clinical Practice Guideline: Pediatric Chronic Home Invasive Ventilation. Am J Respir Crit Care Med 2016; 193: e16-e35
    CrossrefPubMedGoogle Scholar
  • 15 Amin R, Zabih W, Syed F. et al. What families have in the emergency tracheostomy kits: Identifying gaps to improve patient safety. Pediatr Pulmonol 2017; 52: 1605-1609
    CrossrefPubMedGoogle Scholar
  • 16 Doherty C, Neal R, English C. et al. Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies. Anaesthesia 2018; 73: 1400-1417
    CrossrefPubMedGoogle Scholar