Intraossäre Infusion beim Erwachsenen
Tóm tắt
In der Notfallmedizin ist bei Säuglingen und Kindern die Anwendung intraossärer Infusionstechniken weit verbreitet. Bereits 1998 haben sie als etablierte Maßnahme Eingang in die Empfehlungen und Leitlinien des European Resuscitation Council (ERC) gefunden. Ihre Bedeutung in der notfallmedizinischen Behandlung Erwachsener ist bis heute weit geringer. Die hier vorliegende Literaturübersicht stellt die Bedeutung intraossärer Infusionstechniken beim Erwachsenen dar und beschreibt die heute auf dem Markt verfügbaren und am häufigsten eingesetzten Systeme. Obwohl jedes dieser Systeme Stärken und Grenzen aufweist, lässt sich mit allen selbst unter widrigen Bedingungen rasch ein Gefäßzugang etablieren. Dabei bieten intraossäre (IO-)Zugänge nicht nur therapeutische, sondern auch diagnostische Möglichkeiten, wie zahlreiche Anwenderuntersuchungen in der Präklinik und Klinik zeigen. Mittels IO-Techniken lässt sich meist innerhalb von 1–2 min ein Gefäßzugang etablieren, ihre Handhabung ist einfach und zuverlässig. Die Flussraten sind zwar geringer als die großlumiger peripherer Venenzugänge, aber mit einer Druckmanschette sind auch Infusionen zur Volumentherapie möglich. Die meisten intravenös applizierbaren Medikamente können auch intraossär gegeben werden, in gleicher Dosierung und mit gleicher Wirkung. Dennoch sind Grenzen und Risiken der intraossären Infusionstechniken zu beachten.
Tài liệu tham khảo
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