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2017 | OriginalPaper | Hoofdstuk

7. Strategieën en technieken bij het acute respiratory distress syndrome

Auteur : Hans ter Haar

Gepubliceerd in: Mechanische beademing op de intensive care

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

Het acute respiratory distress syndrome gaat gepaard met een ernstig verstoorde gaswisseling en een hoge mortaliteit. Oxygenatieproblemen door shunting zijn het meest opvallend, hoewel de klaring van kooldioxide ook problematisch kan zijn door alveolaire dode ruimte ventilatie en het gebruik van kleine teugvolumes. Beademing bij ARDS moet, net als elke andere beademing, voldoen aan de hoofddoelen van mechanische beademing, adequate gaswisseling, veiligheid, comfort en een zo kort mogelijke beademingsduur. Beademing alleen gericht op het verbeteren van de gaswisseling kan de prognose verslechteren, terwijl beademing gericht op het beperken van longschade de prognose verbetert. Longbeschermend beademen spaart niet alleen longen maar ook andere orgaansystemen en vormt de basis van een state of the art ARDS-behandeling. Vaak is echter meer noodzakelijk om de balans in het voordeel van de patiënt uit te laten slaan; zo kunnen aanvullende strategieën en technieken worden toegepast die de prognose verder verbeteren, zoals buikligging en het toepassen van spierverslapping.
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Metagegevens
Titel
Strategieën en technieken bij het acute respiratory distress syndrome
Auteur
Hans ter Haar
Copyright
2017
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-1590-1_7