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2018 | OriginalPaper | Buchkapitel

23. Atemwegsmanagement

verfasst von : Prof. Dr. J. Hinkelbein, Dr. H. Drinhaus

Erschienen in: Die geburtshilfliche Anästhesie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Während der Schwangerschaft treten zahlreiche physiologische und anatomische Veränderungen in verschiedenen Organsystemen auf. Eine Ödemneigung im Verlauf kann auch die Atemwege betreffen und zu einer Verschlechterung des Mallampati-Status beitragen. Besonders ausgeprägt und rasch progredient kann sich die ödematöse Schwellung der Atemwege bei Patientinnen mit Präeklampsie oder HELLP-Syndrom darstellen. Die schwangerschaftsassoziierten respiratorischen Veränderungen, insbesondere die deutlich reduzierte funktionelle Residualkapazität zusammen mit einem erhöhten Sauerstoffbedarf, bewirken eine bedeutsame Abnahme der Apnoetoleranzzeit und damit eine schnellere Entwicklung von Sättigungsabfällen bzw. Hypoxien in Apnoephasen. Der sicherste Atemweg ist der einer suffizient atmenden Patientin mit erhaltenen Schutzreflexen unter Regionalanästhesie. Grundsätzlich sollte daher, sofern keine Kontraindikationen vorliegen, eine Regionalanästhesie zur Schnittentbindung angestrebt werden.
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Metadaten
Titel
Atemwegsmanagement
verfasst von
Prof. Dr. J. Hinkelbein
Dr. H. Drinhaus
Copyright-Jahr
2018
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-54375-7_23

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