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Artificial ventilation is becoming increasingly necessary


On the one hand, people are getting older - this increases the risk of suffering from diseases that require artificial ventilation. On the other hand, medicine is making enormous advances and can keep people alive whom it could not help a few years ago.

People may be able to put off some things - but not breathing. The first brain cells die after just three minutes without oxygen, permanent damage threatens after four minutes, and often death after five minutes. If breathing fails, help is needed quickly. "Then we maintain the heart functions with artificial ventilation and thus ensure that the body is supplied with sufficient oxygen," explains Prof. Stefan Kluge, member of the Presidium of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) and President of the 16th DIVI -Congress.

Artificial ventilation is required when the patient is no longer breathing independently. This can be the case after a major operation, after a serious accident or in the event of a serious illness. "Patients come to an intensive care unit for this measure," explains the expert, who is also director of the Clinic for Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf. “The appropriate ventilation and monitoring equipment as well as a trained team are available there. The latter take care of the patient around the clock. ”In practice, it often looks like this: Doctors insert a tube, called a tube, through the mouth or sometimes through the nose into the windpipe. If the patient is given artificial respiration for a longer period of time, for example due to a serious illness or if the lungs are directly affected, the doctors perform a trachea incision.

The number of artificially ventilated patients has increased steadily in recent years and will continue to increase. Of the 2.15 million people who had to go to intensive care in 2015, 412,000 received artificial respiration. The average duration of ventilation is 164 hours, i.e. just under seven days. For comparison: In 2005 there were 1.9 million patients in the intensive care unit, 325,963 of whom were ventilated. “There are several reasons for this,” explains Prof. Kluge. “On the one hand, people are getting older and the risk of developing diseases that require artificial respiration increases. According to the latest calculations, a girl born now has a life expectancy of 83 years - ten years older than the current official life table suggests! On the other hand, medicine is making enormous progress and so we can keep people alive today who we could not help a few years ago. This is especially true for the often old people who suffer from several serious illnesses at the same time. We call this polymorbidity. "

The greatest risk with artificial respiration are pathogens that can enter the lungs through the ventilation tubes. In rare cases, injuries to the windpipe or lungs can occur. “Whenever possible, we therefore prefer a particularly gentle form of ventilation, which is also known as non-invasive ventilation,” emphasizes the Hamburg intensive care doctor. "For example, oxygen is supplied to the patient via a special, pressure-tight breathing mask." Studies confirm the effectiveness, especially since the lungs can recover themselves in a kind of biological healing process. In addition, the complication rate is significantly lower.

Source: German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI)