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Geriatrische Intensivmedizin

Konsensuspapier der DGIIN, DIVI, DGAI, DGGG, ÖGGG, ÖGIAIN, DGP, DGEM, DGD, DGNI, DGIM, DGKliPha und DGG

Geriatric intensive care

Consensus paper of DGIIN, DIVI, DGAI, DGGG, ÖGGG, ÖGIAIN, DGP, DGEM, DGD, DGNI, DGIM, DGKliPha and DGG

  • Positionspapiere
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Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Zusammenfassung

Der Anteil älterer, gebrechlicher und multimorbider Menschen hat in den letzten Jahrzehnten aufgrund der demographischen Entwicklung stark zugenommen bzw. wird weiter dramatisch zunehmen, was sich auf die medizinische Akutversorgung auswirken wird. Prospektive randomisierte Studien zum Themengebiet der geriatrischen Intensivmedizin fehlen bis heute. Es existieren zudem weder internationale noch nationale Empfehlungen bezüglich des Managements von kritisch kranken älteren Patienten. Das vorliegende Konsensuspapier liefert basierend auf einer konsentierten Expertenmeinung 16 Aussagen, die beim Umgang mit geriatrischen Intensivpatienten beachtet werden sollten.

Abstract

The proportion of elderly, frail, and multimorbid people has increased dramatically in recent decades resulting from demographic changes and will further increase, which will impact acute medical care. Prospective, randomized studies on geriatric intensive care are still lacking. There are also no international or national recommendations regarding the management of critically ill elderly patients. Based on an expert opinion, this consensus paper provides 16 statements that should be considered when dealing with geriatric critical care patients.

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Authors and Affiliations

  1. Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland

    Guido Michels & Roman Pfister

  2. Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland

    Cornel C. Sieber & Hans Jürgen Heppner

  3. Klinik für Operative Intensivmedizin und Intermediate Care, Medizinische Fakultät, RWTH Aachen, Aachen, Deutschland

    Gernot Marx

  4. Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich

    Regina Roller-Wirnsberger

  5. Gemeinsame Einrichtung für Internistische Intensiv- und Notfallmedizin, Department Innere Medizin, Medizinische Universität Innsbruck, Innsbruck, Österreich

    Michael Joannidis

  6. Klinik für Geriatrie und Altersmedizin, Evangelisches Geriatriezentrum Berlin, Charité – Universitätsmedizin Berlin, Berlin, Deutschland

    Ursula Müller-Werdan

  7. Neurologische Klinik und Poliklinik, Universitätsklinikum Würzburg, Würzburg, Deutschland

    Wolfgang Müllges

  8. Neurologische Klinik, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Deutschland

    Georg Gahn

  9. Lehrstuhl für Klinische Pharmakologie, Helios Universitätsklinkum Wuppertal, Universität Witten/Herdecke, Wuppertal, Deutschland

    Petra A. Thürmann

  10. Klinik für Altersmedizin und Frührehabilitation, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Herne, Deutschland

    Rainer Wirth

  11. Seminar für Allgemeine BWL und Management im Gesundheitswesen, Universität zu Köln, Köln, Deutschland

    Jana Fresenborg & Ludwig Kuntz

  12. Zentrum für Palliativmedizin, Uniklinik Köln, Köln, Deutschland

    Steffen T. Simon

  13. Klinik für Innere Medizin und Internistische Intensivmedizin, St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland

    Uwe Janssens

  14. Geriatrische Klinik und Tagesklinik, Lehrstuhl für Geriatrie, HELIOS Klinikum Schwelm, Universität Witten/Herdecke, Schwelm, Deutschland

    Hans Jürgen Heppner

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  1. Guido Michels
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  2. Cornel C. Sieber
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  3. Gernot Marx
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  4. Regina Roller-Wirnsberger
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  8. Georg Gahn
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  9. Roman Pfister
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  10. Petra A. Thürmann
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  11. Rainer Wirth
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  13. Ludwig Kuntz
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  14. Steffen T. Simon
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  15. Uwe Janssens
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  16. Hans Jürgen Heppner
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Corresponding author

Correspondence to Guido Michels.

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Interessenkonflikt

G. Michels ist Mitglied des Wissenschaftlichen Beirats der Deutschen Gesellschaft für Internistische Intensiv- und Notfallmedizin e. V. (DGIIN), Sprecher der Arbeitsgruppe Kardiopulmonale Reanimation der Deutschen Gesellschaft für Kardiologie e. V. (DGK), Mitglied des Wissenschaftlichen Beirats der Deutschen Herzstiftung sowie Mitglied der Arbeitsgruppe ECMO/eCPR des Deutschen Rats für Wiederbelebung e. V. (German Resuscitation Council, GRC), Mitglied der Sektion Ethik der DGIIN und der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin e. V. (DIVI); G. Michels erhielt Honorare für Vortragstätigkeiten von Fa. Pfizer, Fa. Novartis, Fa. Servier, Fa. Zoll, Fa. Getinge und Fa. Orion Pharma. Die Interessenkonflikte stehen in keinem Zusammenhang mit dem vorliegenden Konsensuspapier. C.C. Sieber ist Mitglied der Deutschen Gesellschaft für Innere Medizin e. V. (DGIM; Vorsitzender 2017–2018, aktuell 1. stellv. Vorsitzender), der Schweizerischen Gesellschaft für Allgemeine Innere Medizin e. V. (SAGIM), der Deutschen Gesellschaft für Geriatrie e. V. (DGG; 2005–2008 Präsident), der Deutschen Gesellschaft für Gerontologie und Geriatrie e. V. (DGGG), der Schweizerischen Fachgesellschaft für Geriatrie e. V. (SGG), der Österreichischen Gesellschaft für Geriatrie und Gerontology e. V. (ÖGGG), der European Union Geriatric Medicine Society (EUGMS; Executive Board), der Deutschen Gesellschaft für Ernährungsmedizin e. V. (DGEM; Präsident 2010–2012), der European Society of Parenteral and Enteral Nutrition (ESPEN), der European Academy for Medicine of Ageing (EAMA; Präsident 2007–2015), der Deutschen Gesellschaft für Palliativmedizin e. V. (DGP), des Interdisziplinären Zentrums für Gerontologie an der FAU (Vize-Präsident), der Italian Society of Geriatric (SIG). G. Marx ist Vorstandsvorsitzender der Deutschen Gesellschaft für Telemedizin (DGTelemed), Mitglied des engeren Präsidiums der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin e. V. (DGAI e. V.), Mitglied des Präsidiums und President-elect der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI e. V.); G. Marx erhielt Honorare im Rahmen von Beratertätigkeiten für Fa. B. Braun Melsungen und Fa. Adrenomed, Vortragshonorare von Fa. B. Braun Melsungen, Fa. Biotest und Fa. Adrenomed sowie Forschungsgelder von Fa. B. Braun Melsungen, Fa. Biotest und Fa. Adrenomed. Die Interessenkonflikte stehen in keinem Zusammenhang mit dem vorliegenden Konsensuspapier. R. Roller-Wirnsberger ist Mitglied des Vorstands (aktuell Präsidentin) der Österreichischen Gesellschaft für Geriatrie und Gerontologie (ÖGGG). Sie ist zudem Vizepräsidentin der European Academy of Medicine of Aging (EAMA, Sitz Belgien) und Gründungs- und Vorstandsmitglied der Österreichischen Plattform für Interdisziplinäre Alternsforschung (ÖPIA) und des European Interdisciplinary Council on Ageing (EICA, Sitz San Servolo, Italien). M. Joannidis ist Mitglied des Vorstands (aktuell Präsident) der Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin (ÖGIAIN). Er erhielt Vortragshonorare bzw. Beraterhonorare von Fa. Baxter Healthcare Corp, Fa. CLS Behring, Fa. Fresenius, Fa. Astute Medical sowie Forschungsförderung von Fa. Fresenius Kabi Austria. Die Interessenkonflikte stehen in keinem Zusammenhang mit dem vorliegenden Konsensuspapier. U. Müller-Werdan ist Vorstandsmitglied (aktuell Präsidentin) der Deutschen Gesellschaft für Gerontologie und Geriatrie e. V. (DGGG), Mitglied im Wissenschaftlichen Beirat der Bundesärztekammer und Mitglied des Wissenschaftlichen Beirats der Deutschen Gesellschaft für internistische Intensiv- und Notfallmedizin e. V. (DGIIN). R. Wirth ist Mitglied des Vorstands (President-elect) der Deutschen Gesellschaft für Geriatrie e. V. (DGG). Er erhielt gelegentliche Vortragshonorare von Fa. Apetito, Fa. Nutricia, Fa. Fresenius Kabi, Fa. Nestle, Fa. Shire, Fa. Desitin, Fa. Bayer HealthCare, Fa. MSD und Fa. Bristol Meyers Squibb. Weiterhin erhielt er in den letzten 3 Jahren Forschungsförderung von Fa. Nutricia, der Deutschen Gesellschaft für Ernährungsmedizin e. V. (DGEM) und der DGG. U. Janssens ist Mitglied des Vorstands (aktuell Generalsekretär) der Deutschen Gesellschaft für Internistische Intensiv- und Notfallmedizin e. V. (DGIIN), Mitglied des Vorstands (aktuell Präsident) der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin e. V. (DIVI) sowie Sprecher der Sektion Ethik der DIVI. Des Weiteren ist er Mitglied der Deutschen Gesellschaft für Kardiologie e. V. (DGK), Nukleus der AG3 (Arbeitsgruppe Kardiovaskuläre Intensiv- und Notfallmedizin). H.J. Heppner ist Mitglied des Vorstands (aktuell Präsident) der Deutschen Gesellschaft für Geriatrie e. V. (DGG), der Deutschen Gesellschaft für internistische Intensiv- und Notfallmedizin e. V. (DGIIN), der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin e. V. (DIVI) und ist stellvertretender Sprecher der Sektion Geriatrie in der Deutschen Sepsisgesellschaft. Er erhielt gelegentlich Vortragshonorare von Fa. Pfizer Pharma GmbH, Fa. Bayer Health Care, Fa. Infectopharm und Fa. Novartis. Zusätzlich erhielt er Forschungsförderung von Fa. Pfizer Pharma GmbH, Fa. Infectopharm, Fa. Deutsche Bank und Innovationsfonds des GBA. W. Müllges, G. Gahn, R. Pfister, P.A. Thürmann, J. Fresenborg, L. Kuntz und S.T. Simon geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Dieses Konsensuspapier erscheint parallel in den Zeitschriften Medizinische Klinik – Intensivmedizin und Notfallmedizin und in der Zeitschrift für Gerontologie und Geriatrie.

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Michels, G., Sieber, C.C., Marx, G. et al. Geriatrische Intensivmedizin. Z Gerontol Geriat 52, 440–456 (2019). https://doi.org/10.1007/s00391-019-01584-6

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