{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:18:11Z","timestamp":1789532291721,"version":"build-2803163510"},"reference-count":590,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Leitlinienaktualisierung zeigt die Vorteile sowie die Grenzen der NIV bei der Behandlung von akutem Atemversagen im klinischen Alltag und bei unterschiedlichen Indikationen auf.<\/jats:p><jats:p>Die nichtinvasive Beatmung (NIV) hat einen hohen Stellenwert bei der Therapie des hyperkapnischen akuten Atemversagens, da sie die Aufenthaltsdauer und den Krankenhausaufenthalt auf der Intensivstation sowie die Mortalit\u00e4t deutlich reduziert.<\/jats:p><jats:p>Patienten mit kardiopulmonalem \u00d6dem und akutem Atemversagen sollten zus\u00e4tzlich zu notwendigen kardiologischen Eingriffen mit kontinuierlichem positivem Atemwegsdruck (CPAP) und Sauerstoff behandelt werden. Dies sollte bereits pr\u00e4klinisch und in der Notaufnahme erfolgen.<\/jats:p><jats:p>Bei anderen Formen des akuten hypox\u00e4mischen Atemversagens mit nur leicht bis m\u00e4\u00dfig gest\u00f6rtem Gasaustausch (PaO2\/FiO2\u200a&gt;\u200a150\u200ammHg) ergibt sich kein signifikanter Vor- oder Nachteil gegen\u00fcber nasaler Sauerstoff-High-Flow-Therapie (HFNO). Bei schweren Formen des ARDS ist die NIV mit einer hohen Rate an Behandlungsversagen und Mortalit\u00e4t verbunden, insbesondere in F\u00e4llen mit NIV-Versagen und verz\u00f6gerter Intubation.<\/jats:p><jats:p>Zur Pr\u00e4oxygenierung vor der Intubation sollte NIV verwendet werden. Bei Risikopatienten wird eine NIV empfohlen, um Extubationsversagen zu reduzieren. Im Entw\u00f6hnungsprozess von der invasiven Beatmung reduziert NIV das Risiko einer Reintubation bei hyperkapnischen Patienten wesentlich. NIV gilt in der Palliativversorgung als n\u00fctzlich zur Reduzierung von Dyspnoe und zur Verbesserung der Lebensqualit\u00e4t, hier aber in Konkurrenz zur HFNO, das als komfortabler gilt. Mittlerweile wird die NIV auch im pr\u00e4klinischen Bereich empfohlen, insbesondere bei hyperkapnischem Atemversagen und beim Lungen\u00f6dem.<\/jats:p><jats:p>Bei entsprechender \u00dcberwachung auf einer Intensivstation kann NIV auch bei p\u00e4diatrischen Patienten mit akuter Ateminsuffizienz erfolgreich eingesetzt werden.<\/jats:p>","DOI":"10.1055\/a-2148-3323","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T23:00:08Z","timestamp":1697238008000},"page":"453-514","source":"Crossref","is-referenced-by-count":20,"title":["S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz"],"prefix":"10.1055","volume":"78","author":[{"given":"Michael","family":"Westhoff","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Pneumologie, Lungenklinik Hemer \u2013 Zentrum f\u00fcr Pneumologie und Thoraxchirurgie, Hemer"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Neumann","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Klinische An\u00e4sthesiologie und Operative Intensivmedizin, Evangelisches Krankenhaus G\u00f6ttingen-Weende gGmbH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Geiseler","sequence":"additional","affiliation":[{"name":"Medizinische Klinik IV \u2013 Pneumologie, Beatmungs- und Schlafmedizin, Paracelsus-Klinik Marl, Marl"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Bickenbach","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Operative Intensivmedizin und Intermediate Care, Uniklinik RWTH Aachen, Aachen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Arzt","sequence":"additional","affiliation":[{"name":"Schlafmedizinisches Zentrum der Klinik und Poliklinik f\u00fcr Innere Medizin II, Universit\u00e4tsklinikum Regensburg, Regensburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bachmann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Atemwegs-, Lungen- und\u00a0Thoraxmedizin, Beatmungszentrum Hamburg-Harburg, Asklepios Klinikum Harburg, Hamburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Braune","sequence":"additional","affiliation":[{"name":"IV. 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