{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T18:58:58Z","timestamp":1732042738031},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n            Pulsoxymetrie und Blutgasanalysen Die Pulsoxymetrie hat eine hohe Sensitivit\u00e4t, aber nur eine geringe Spezifit\u00e4t zur Erfassung von Hypox\u00e4mien. Arterielle Blutgasanalysen sind der Goldstandard zur \u00dcberwachung einer O2-Therapie. Ven\u00f6se Blutgasanalysen sollten zur O2-Steuerung nicht zum Einsatz kommen.<\/jats:p><jats:p>\n            Zielwerte der O2-Therapie Der Zielbereich der akuten O2-Therapie f\u00fcr beatmete Patienten und nicht beatmete Patienten ohne Hyperkapnie-Risiko soll bei einer pulsoxymetrisch gemessenen Sauerstoffs\u00e4ttigung (SpO2) zwischen 92% und 96% liegen. Indikationen einer hochdosierten O2-Therapie ohne Zielbereich sind in der Intensivmedizin die Kohlenmonoxidvergiftung und Patienten mit schwerer Atemnot, wenn keine SpO2 ableitbar ist. Eine Hyperox\u00e4mie, d.h. SpO2-Werte \u00fcber 96%, hat in randomisierten Studien an \u00fcberwiegend beatmeten Intensivpatienten das \u00dcberleben nicht verbessert. Unter einer Hyperox\u00e4mie bei nicht beatmeten Patienten mit Hyperkapnie-Risiko (z.B. Patienten mit chronisch-obstruktiver Lungenerkrankung) besteht bei jedem dritten Patienten das Risiko eines zunehmenden Kohlendioxidanstiegs. Deswegen soll bei diesen Patienten eine Ziel-SpO2 von 88\u201392% angestrebt werden.<\/jats:p><jats:p>\n            O2-Zielbereiche an extrakorporalen Verfahren Es gibt keine randomisierten Studien, die andere SpO2-Zielbereiche f\u00fcr Patienten an extrakorporalen Verfahren empfehlen. Diese Patienten sollen immer mit arteriellen Blutgasen \u2013 bei peripherer VA-ECMO am rechten Arm und hinter dem Oxygenator \u2013 \u00fcberwacht werden.<\/jats:p><jats:p>\n            High-Flow-Sauerstoff-Therapie beim akuten hyperkapnischen Atemversagen Die High-Flow-Sauerstoff-Therapie (HFNC) war in einer Metaanalyse \u00fcberwiegend bei Patienten mit akuter Hypox\u00e4mie (Typ-I-Atemversagen) gegen\u00fcber konventionellem O2 nicht mit einer reduzierten Krankenhaussterblichkeit assoziiert, allerdings wurde die Intubationsrate reduziert. Auch beim moderaten hyperkapnischen Atemversagen (Typ II) ist die HFNC mit hohen Flussraten der nicht invasiven Beatmung (NIV) nicht unterlegen.<\/jats:p>","DOI":"10.1055\/a-1940-0553","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T22:46:05Z","timestamp":1685573165000},"page":"759-766","source":"Crossref","is-referenced-by-count":1,"title":["Sauerstofftherapie in der Intensivmedizin"],"prefix":"10.1055","volume":"148","author":[{"given":"Jens","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Pneumologie, Medizinische Hochschule Hannover; Deutsches Zentrum f\u00fcr Lungenforschung (DZL), Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), Hannover,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/S0140-6736(16)32585-5","article-title":"Evidence for overuse of medical services around the world","volume":"390","author":"S Brownlee","year":"2017","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1055\/a-1554-2625","article-title":"German S3 Guideline \u2013 Oxygen Therapy in the Acute Care of Adult Patients","volume":"76","author":"J Gottlieb","year":"2022","journal-title":"Pneumologie"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1016\/j.resuscitation.2012.06.002","article-title":"S(p)O(2) values in acute medical admissions breathing air \u2013 implications for the British Thoracic Society guideline for emergency oxygen use in adult patients?","volume":"83","author":"GB Smith","year":"2012","journal-title":"Resuscitation"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1177\/0310057X1804600307","article-title":"A two centre observational study of simultaneous pulse oximetry and arterial oxygen saturation recordings in intensive care unit patients","volume":"46","author":"SJ Ebmeier","year":"2018","journal-title":"Anaesth Intensive Care"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1152\/jappl.1979.46.3.599","article-title":"Simple, accurate equations for human blood O2 dissociation computations","volume":"46","author":"JW Severinghaus","year":"1979","journal-title":"J Appl Physiol Respir Environ Exerc Physiol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2477","DOI":"10.1056\/NEJMc2029240","article-title":"Racial Bias in Pulse Oximetry Measurement","volume":"383","author":"MW Sjoding","year":"2020","journal-title":"N Engl J Med"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1097\/CCM.0000000000005394","article-title":"Disparities in Hypoxemia Detection by Pulse Oximetry Across Self-Identified Racial Groups and Associations With Clinical Outcomes","volume":"50","author":"NR Henry","year":"2022","journal-title":"Crit Care Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/1471-2431-11-6","article-title":"NeOProM: Neonatal Oxygenation Prospective Meta-analysis Collaboration study protocol","volume":"11","author":"LM Askie","year":"2011","journal-title":"BMC Pediatr"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1007\/s00134-021-06385-3","article-title":"Randomised controlled trial of oxygen therapy and high-flow nasal therapy in African children with pneumonia","volume":"47","author":"K Maitland","year":"2021","journal-title":"Intensive Care Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"123","DOI":"10.4187\/respcare.01963","article-title":"Hyperoxic acute lung injury","volume":"58","author":"RH Kallet","year":"2013","journal-title":"Respir Care"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1016\/S0140-6736(18)30479-3","article-title":"Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis","volume":"391","author":"DK Chu","year":"2018","journal-title":"Lancet"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1164\/rccm.201505-1019OC","article-title":"Conservative versus Liberal Oxygenation Targets for Mechanically Ventilated Patients. A Pilot Multicenter Randomized Controlled Trial","volume":"193","author":"R Panwar","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1001\/jama.2016.11993","article-title":"Effect of Conservative vs Conventional Oxygen Therapy on Mortality Among Patients in an Intensive Care Unit: The Oxygen-ICU Randomized Clinical Trial","volume":"316","author":"M Girardis","year":"2016","journal-title":"JAMA"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/S2213-2600(17)30046-2","article-title":"Hyperoxia and hypertonic saline in patients with septic shock (HYPERS2S): a two-by-two factorial, multicentre, randomised, clinical trial","volume":"5","author":"P Asfar","year":"2017","journal-title":"Lancet Respir Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1056\/NEJMoa1903297","article-title":"Conservative Oxygen Therapy during Mechanical Ventilation in the ICU","volume":"382","author":"D Mackle","year":"2020","journal-title":"N Engl J Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1056\/NEJMoa1916431","article-title":"Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome","volume":"382","author":"L Barrot","year":"2020","journal-title":"N Engl J Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1056\/NEJMoa2032510","article-title":"Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure","volume":"384","author":"OL Schjorring","year":"2021","journal-title":"N Engl J Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1001\/jama.2021.13011","article-title":"Effect of Low-Normal vs High-Normal Oxygenation Targets on Organ Dysfunction in Critically Ill Patients","volume":"326","author":"H Gelissen","year":"2021","journal-title":"JAMA"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1056\/NEJMoa2208415","article-title":"Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation","volume":"387","author":"MW Semler","year":"2022","journal-title":"N Engl J Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1136\/thx.2006.068866","article-title":"Is it time to change the approach to oxygen therapy in the breathless patient?","volume":"62","author":"R Beasley","year":"2007","journal-title":"Thorax"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"k4169","DOI":"10.1136\/bmj.k4169","article-title":"Oxygen therapy for acutely ill medical patients: a clinical practice guideline","volume":"363","author":"RAC Siemieniuk","year":"2018","journal-title":"BMJ"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"CD008884","DOI":"10.1002\/14651858.CD008884.pub2","article-title":"The effects of high perioperative inspiratory oxygen fraction for adult surgical patients","volume":"2015","author":"J Wetterslev","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.10.019","article-title":"Arterial oxygen and carbon dioxide tension and acute brain injury in extracorporeal cardiopulmonary resuscitation patients: Analysis of the extracorporeal life support organization registry","author":"BL Shou","year":"2022","journal-title":"J Heart Lung Transplant"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"CD004104","DOI":"10.1002\/14651858.CD004104.pub4","article-title":"Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease","volume":"7","author":"CR Osadnik","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"c5462","DOI":"10.1136\/bmj.c5462","article-title":"Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial","volume":"341","author":"MA Austin","year":"2010","journal-title":"BMJ"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"CD005534","DOI":"10.1002\/14651858.CD005534.pub3","article-title":"Oxygen therapy in the pre-hospital setting for acute exacerbations of chronic obstructive pulmonary disease","volume":"1","author":"Z Kopsaftis","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"CD010172","DOI":"10.1002\/14651858.CD010172.pub3","article-title":"High-flow nasal cannulae for respiratory support in adult intensive care patients","volume":"3","author":"SR Lewis","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1186\/s13054-022-04218-3","article-title":"High-flow nasal cannula versus non-invasive ventilation for acute hypercapnic respiratory failure in adults: a systematic review and meta-analysis of randomized trials","volume":"26","author":"N Ovtcharenko","year":"2022","journal-title":"Crit Care"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"CD004769","DOI":"10.1002\/14651858.CD004769.pub2","article-title":"Oxygen therapy for dyspnoea in adults","volume":"3","author":"JM Cranston","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"ref30","first-page":"CD006429","article-title":"Symptomatic oxygen for non-hypoxaemic chronic obstructive pulmonary disease","volume":"6","author":"H Uronis","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1038\/sj.bjc.6604161","article-title":"Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis","volume":"98","author":"HE Uronis","year":"2008","journal-title":"Br J Cancer"}],"container-title":["DMW - Deutsche Medizinische Wochenschrift"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1940-0553.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T22:49:58Z","timestamp":1685573398000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1940-0553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,31]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,5,31]]},"published-print":{"date-parts":[[2023,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1940-0553","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0012-0472","1439-4413"],"issn-type":[{"value":"0012-0472","type":"print"},{"value":"1439-4413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,31]]}}}