Dtsch Med Wochenschr 2020; 145(13): 926-931
DOI: 10.1055/a-0944-9670
Schritt für Schritt

Invasive Beatmungstherapie im Sterbeprozess beenden – Schritt für Schritt

Invasive Mechanical Ventilation Therapy in the Dying Process – Step by Step
Jacqueline Schwartz
,
Stefan Meier
,
Steffen T. Simon
,
Guido Michels

Abstract

Invasive mechanical ventilation can be terminated by immediate (palliative) extubation or by gradual reduction of ventilation with the ventilation access left open (terminal weaning). Both procedures are ethically equivalent and can be performed in everyday life, so that individual patient factors and the experience of the treatment team are decisive. However, the primary goal is to ensure that the patient and relatives do not suffer. This article presents step by step which aspects are relevant: communication, adjust or stop monitoring, selection and implementation of the appropriate procedure, preparatory measures, recognition and treatment of distressing symptoms by means of drug or non-drug therapy options and last but not least accurate documentation.

Eine invasive mechanische Beatmung kann beendet werden durch sofortige (palliative) Extubation oder durch schrittweise Reduktion der Beatmung mit Belassen des Beatmungszugangs (terminales Weaning). Beide Verfahren sind ethisch gleichwertig und im Alltag durchführbar, sodass individuelle Patientenfaktoren und die Erfahrung des Behandlungsteams ausschlaggebend sind. Im Vordergrund steht immer das Ziel: Patient und Angehörige sollen nicht leiden.



Publication History

Article published online:
02 July 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 
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