S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz

Westhoff M, Neumann P, Geiseler J, Bickenbach J, Arzt M, Bachmann M, Braune S, Delis S, Dellweg D, Dreher M, Dubb R, Fuchs H, Hämäläinen N, Heppner HJ, Kluge S, Kochanek M, Lepper PM, Meyer FJ, Neumann B, Putensen C, Schimandl D, Schönhofer B, Schreiter D, Walterspacher S, Windisch W (2023)

Publication Type: Journal article

Publication year: 2023

Journal

DOI: 10.1055/a-2148-3323

Abstract

The guideline update outlines the advantages as well as the limitations of NIV in the treatment of acute respiratory failure in daily clinical practice and in different indications. Non-invasive ventilation (NIV) has a high value in therapy of hypercapnic acute respiratory failure, as it significantly reduces the length of ICU stay and hospitalization as well as mortality. Patients with cardiopulmonary edema and acute respiratory failure should be treated with continuous positive airway pressure (CPAP) and oxygen in addition to necessary cardiological interventions. This should be done already prehospital and in the emergency department. In case of other forms of acute hypoxaemic respiratory failure with only mild or moderately disturbed gas exchange (PaO2/FiO2 >150mmHg) there is no significant advantage or disadvantage compared to high flow nasal oxygen (HFNO). In severe forms of ARDS NIV is associated with high rates of treatment failure and mortality, especially in cases with NIV-failure and delayed intubation. NIV should be used for preoxygenation before intubation. In patients at risk, NIV is recommended to reduce extubation failure. In the weaning process from invasive ventilation NIV essentially reduces the risk of reintubation in hypercapnic patients. NIV is regarded useful within palliative care for reduction of dyspnea and improving quality of life, but here in concurrence to HFNO, which is regarded as more comfortable. Meanwhile NIV is also recommended in prehospital setting, especially in hypercapnic respiratory failure and pulmonary edema. With appropriate monitoring in an intensive care unit NIV can also be successfully applied in pediatric patients with acute respiratory insufficiency.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Regensburg Germany (DE) Universitätsklinikum Bonn Germany (DE) Zentralklinikum Bad Berka Germany (DE) Evangelisches Klinikum Bethel Germany (DE) München Klinik Bogenhausen Germany (DE) HELIOS Kliniken Germany (DE) Universität Witten/Herdecke Germany (DE) Lungenklinik Hemer Germany (DE) Evangelisches Krankenhaus Göttingen-Weende Germany (DE) Paracelsus-Klinik in Marl Germany (DE) Universitätsklinikum Aachen (UKA) Germany (DE) Asklepios Kliniken Germany (DE) St. Franziskus-Hospital Münster Germany (DE) Pius-Hospital Oldenburg Germany (DE) Kreiskliniken Reutlingen Germany (DE) Universitätsklinikum Freiburg Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Köln Germany (DE) Universitätsklinikum des Saarlandes (UKS) Germany (DE)

How to cite

APA:

Westhoff, M., Neumann, P., Geiseler, J., Bickenbach, J., Arzt, M., Bachmann, M.,... Windisch, W. (2023). S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz. Pneumologie. https://dx.doi.org/10.1055/a-2148-3323

MLA:

Westhoff, Michael, et al. "S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz." Pneumologie (2023).

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