Verkurzung der Weaningphase nach maschineller Beatmung durch kombinierte Gabe von Clonidin und Sufentanil

Abstract

Mechanical ventilation is a well-established strategy in intensive care medicine. ICU trauma patients require analgesia, and sedation mostly consists of benzodiazepines and opioids with increasing doses over time. The weaning period is complicated by the withdrawal syndrome, showing tachycardia, hypertonia, tachypnea and restlessness. Although treatment with clonidine can influence these symptoms, tachypnea still remains the main problem in weaning patients from mechanical ventilation. Adding sufentanil, an opioid with greater effects on analgesia than on respiratory depression compared with fentanyl, tachypnea can be reduced to normal frequency. In this way weaning management can be managed more easily for the benefit of both, the patient and physician. In comparison with a group of 50 patients treated with clonidine alone, 72 patients treated with clonidine/sufentanil showed a shorter period from the start of spontaneous ventilation until extubation (4.8 vs 7.6 days) and until discharge from the ICU (7.7 vs 12.4 days). The number of reintubations caused by respiratory exhaustion decreased from 16.0 to 2.8%.