Pneumologie最新文献

{"title":"[Challenges and opportunities of the Intensive Care and Rehabilitation Strengthening Act (GKV-IPReG): Opinion survey and interprofessional cross-sector dialogue].","authors":"Jana Christina Dahlhoff, Biljana Joves, Benjamin Neetz, Gabriele Iberl, Annett Heinze, Urte Sommerwerck, Jens Geiseler, Konrad Brennauer, Felix Gaiser, Michael Westhoff, Julia Michels, Max Barre, Felix Herth, Franziska Trudzinski","doi":"10.1055/a-2592-0331","DOIUrl":"10.1055/a-2592-0331","url":null,"abstract":"<p><p>The implementation of the requirements of the \"Intensivpflege- und Rehabilitationsstärkungsgesetz (IPReG)\" requires the establishment of new cross-sectoral care structures. As part of an online survey and a multi-professional panel discussion, which took place on April 27, 2024 at the Thorax Clinic of Heidelberg University, this topic was highlighted from various perspectives. Medical representatives from the fields of intensive care medicine and weaning, respiratory therapists and representatives of the WeanNet board, the AOK Baden-Württemberg and the head of an outpatient intensive care service took part in the discussion. The participants in the survey and the panel discussion still saw potential for optimisation in practical implementation to make the task of assessing weaning or decannulation potential more attractive for appropriately qualified doctors, as implementation currently depends very much on the motivation of individuals. Some patients and their relatives also have reservations about ventilator weaning and decannulation, as it often involves a change of care facility. Optimisation potential was seen mainly in including respiratory therapists and using telemedical options; furthermore, a structural, nationwide provision of care would be desirable, but this does not seem feasible everywhere from an infrastructural standpoint. Although telemedicine could be a good option to improve coverage, especially in more rural areas, the legal framework for this, as well as for potential assessment conduction by respiratory therapists, is not sufficient yet. These legal regulations need to be discussed and developed in constructive collaboration with all involved professions and patient representatives. In general, the law was seen as an opportunity to identify patients with weaning and decannulation potential and to improve the situation of patients with long-term ventilation in Germany due to its requirement of regular on-site visits by professionals with expertise in weaning.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"653-660"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[DGP and ÖGP Congress 2024: Highlights from Interventional Pulmonology].","authors":"A Susanne Dittrich, Georg Murauer, Michael Meilinger, Ralf-Harto Hübner, Judith Maria Brock, Daniela Gompelmann","doi":"10.1055/a-2547-5031","DOIUrl":"10.1055/a-2547-5031","url":null,"abstract":"<p><p>This article summarises the highlights in the field of interventional pneumology from the congresses of the German Society of Pneumology (DGP) in March 2024 and the Austrian Society of Pneumology (ÖGP) in September 2024. Developments and numerous studies in the field of endoscopy and interventional pneumology were presented in the diverse programmes of these two congresses. New bronchoscopic techniques for the diagnosis of mediastinal lymphadenopathy were discussed, innovative navigation techniques and the use of new imaging techniques for the diagnosis of peripheral pulmonary nodules were presented and knowledge in the field of endoscopic lung volume reduction in emphysema patients was expanded.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"637-642"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Use of adjuvant treatment options in tobacco and nicotine counseling: results of an anonymous survey].","authors":"Sabina Ulbricht, Christa Rustler, Karin Vitzthum","doi":"10.1055/a-2507-1425","DOIUrl":"10.1055/a-2507-1425","url":null,"abstract":"<p><p>Counseling and treatment of tobacco and nicotine users include classical behavioral therapy and cognitive-behavioral therapy methods. More than half of the quitters after an intervention relapsed into old behavior after 12 months. Discussions with experts have shown that evidence-based interventions are individually supplemented with treatment options without scientific evidence or with inconsistent efficacy. This study examined the use of adjuvant treatment options in the area of smoking cessation such as aromatherapy.The sample for our anonymous online survey (Sosci survey) consisted of 351 experts. All of them had registered with their contact data in a freely accessible database (https://www.anbieter-raucherberatung.de/anbieter.php). A total of 88 experts took part in the survey. Respondents were on average 53 years old, and 71% were female. They reported on average 14 years of experience in smoking cessation counseling. More than half of the participants (66.3%; n=57) had employed at least one adjuvant treatment option. Exercise (49.1%), hypnosis (34.5%) and acupuncture (27.3%) were mentioned most often.Adjuvant treatment options appear to be important in the counseling of tobacco and nicotine users and there should be more discussion on these options among experts. These should also considered in the development of curricula for counsellors on tobacco and nicotine cessation.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"627-631"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Lung Emphysema Registry: Improving quality of care in interventional emphysema therapy and health management for patients with advanced COPD and lung emphysema].","authors":"Monika Rummenholl, Thomas Sgarbossa, Christian Grah, Angelique Holland, Ralf-Harto Hübner","doi":"10.1055/a-2532-4885","DOIUrl":"10.1055/a-2532-4885","url":null,"abstract":"<p><p>The Lungenemphysemregister e.V. (LE-Register) offers a specialized platform for the exchange of knowledge, the promotion of research and the improvement of the quality of care in interventional endoscopic and surgical therapies as well as the consideration of other socio-economic and health aspects of pulmonary emphysema. The current focus is primarily on endoscopic and surgical treatment approaches for patients. Through the networking of experts, the development of specific quality standards and the certification of centers, the LE Registry contributes to the evidence-based further development and optimization of these highly specialized therapies and with a focus on other aspects of health promotion in the future.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"661-666"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Dysphagia and obstructive sleep apnea (OSA): What is the pathophysiological bridge?]","authors":"Ulrich Koehler, Mikail Aykut Degerli, Christian Viniol, Olaf Hildebrandt, Wulf Hildebrandt, Keywan Sohrabi, Janine Sambale, Heike Korbmacher-Steiner","doi":"10.1055/a-2561-9333","DOIUrl":"10.1055/a-2561-9333","url":null,"abstract":"<p><p>There is a high prevalence of dysphagia among patients with obstructive sleep apnea (OSA) and snoring. Swallowing is a complex process requiring fine-tuned neuromuscular coordination. Breathing and swallowing share a common passage in the pharynx. Swallowing process can be divided into an oral, pharyngeal and esophageal phase. When the swallowing reflex starts, hyoid and larynx are pulled up and the glottis covers the entrance to larynx. During swallowing apnea, which is a respiration pause for about 0.5-1.0 seconds, the bolus passes pharyngeal airway. Dysphagia is associated with severe complications such as aspiration and pneumonia. Although the pathophysiology of dysphagia in OSA-patients is not clearly understood, we assume that dysphagia is also a result of sensory and motor changes in the oropharynx caused by snoring vibrations.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"632-636"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Improving Specialist Care for Patients in Out-of-Hospital Intensive Care through Regular Pulmonological Video Consultations: A Real-life Study].","authors":"Claudia Jafari, Nilüfer Orhan, Sören Hammermüller, Gernoth Plappert, Stephan Porten, Alan Strassburg","doi":"10.1055/a-2493-8311","DOIUrl":"10.1055/a-2493-8311","url":null,"abstract":"<p><p>In recent years, there has been a significant increase in the number of patients requiring out-of-hospital intensive care. Although many of these patients are invasively ventilated, pulmonological care is often lacking. Additionally, up to 60-70% of these patients are suspected to have further potential for weaning. A telemedicine approach to assess weaning potential and provide pulmonological care has not yet been studied.From March 2021 to February 2024, we conducted telemedicine pulmonological consultations in four respiratory care groups. A medical history interview and the assessment of parameters such as ventilation measurements were performed via a video portal. In addition, a portable blood gas analysis (BGA) device and a digital stethoscope were used. Treatment recommendations were implemented by the primary care physicians. These data were compared with a control group from four respiratory care groups that did not receive pulmonological care.A total of 71 tracheotomized patients, regardless of their weaning potential, were included in the telemedicine group. Of these, 40 were breathing spontaneously and 31 were mechanically ventilated (weaning stages 3aII and 3cI respectively). The ventilation duration of 23/31 (74%) patients in the telemedicine group was successfully reduced: 5/31 (16%) required only nocturnal ventilation, and in 4/31 (13%), ventilation was completely discontinued. In a control group of 63 patients (3aII: n=34, 3cI: n=29), only 1/29 (3%) experienced a reduction in ventilation time.In the telemedicine group, 11/71 (15%) patients were admitted for decannulation (3aII: n=6, 3cI: n=5). Of these, 7/11 (64%) were successfully decannulated (3aII: n=3, 3cI: n=4), with an average hospital stay reduced to 9 days. In the control group, 3/63 (5%) patients were admitted for decannulation, but none were successfully decannulated. One patient was successfully decannulated during a hospital stay for another reason.In addition, 310 tele-pulmonological therapy modifications were made in the intervention group, corresponding to 978 patient months: 1/3 patients required a therapy modification per month.Tele-pulmonological care in out-of-hospital intensive care allows for the identification of weaning potential, the targeted planning of hospital stays for weaning, and the avoidance of unnecessary hospitalizations. Moreover, it improves patient treatment outcomes. Regular monitoring at individualized intervals is necessary for this approach.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"567-576"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At-home validation of a non-contact, radar-based breathing monitor for long-term care of patients with respiratory diseases: A proof-of-concept study.","authors":"Tobit Fischer, Torsten Eggert, Alina Wildenauer, Sarah Dietz-Terjung, Rainer Voisard, Christoph Schöbel","doi":"10.1055/a-2542-5101","DOIUrl":"10.1055/a-2542-5101","url":null,"abstract":"<p><p>Long-term monitoring of respiratory rate (RR) is an important component in the management of chronic respiratory diseases (CRDs). Specifically, predicting acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is of significant scientific and clinical interest. This study aimed to evaluate the long-term validity of a novel contactless sleep monitor (CSM) in the home environment of CRD patients receiving ventilatory support. Additionally, we assessed patient acceptance, device usability, and RR fluctuations associated with AECOPD to establish a robust foundation for future research.In this prospective proof-of-concept study, nineteen patients requiring non-invasive ventilation (NIV) were provided with the CSM in their home environment for six months and seven patients requiring invasive mechanical ventilation (IMV) for one month. The primary indication for NIV therapy was chronic obstructive pulmonary disease (COPD).The CSM was validated under real-life conditions by comparing its nocturnal RR values with software data from both types of ventilators. Acceptability and usability of the sensor were assessed using a questionnaire. Additionally, COPD exacerbations occurring during the study period were analyzed for potential RR fluctuations preceding these events.Mean absolute error (MAE) of median RR between the NIV device and the CSM, based on 2326 nights, was 0.78 (SD: 1.96) breaths per minute (brpm). MAE between the IMV device and the CSM was 0.12 brpm (SD: 0.52) for 215 nights. The non-contact device was accepted by the patients and proved to be easy in use. In some of the overall only 13 cases of AECOPD, RR time courses showed variations of increased nocturnal respiratory activity a few days before the occurrence of such events.The present CSM is suitable for valid long-term monitoring of nocturnal RR in patients' home environment and is well accepted by the patients. The exploratory findings related to AECOPD events may serve as a starting point for larger studies aimed at developing robust prediction rules.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"557-566"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnosis and treatment of a pulmonary myxoid spindle cell lipoma in a 79-year-old female patient with recurrent retention pneumonia].","authors":"Björn Schwick, José Miguel Sodi Luna, Florian Laenger","doi":"10.1055/a-2569-8616","DOIUrl":"10.1055/a-2569-8616","url":null,"abstract":"<p><p>A 79-year-old female patient presented to our emergency department with a productive cough and shortness of breath that had been present for weeks. Chest CT scan revealed a right upper lobe mass with suspected poststenotic pneumonia and enlarged mediastinal lymph nodes. Bronchoscopically there was an exophytic tumor growth with obstruction of the ostium, macroscopically a carcinoid was suspected. Processing of the biopsies taken from the tumor or from the enlarged lymph nodes initially did not provide a diagnosis despite sufficient sample collection. Despite changing the antibiotic, the poststenotic pneumonia persisted. The tumor being inoperable, rigid bronchoscopy was performed to remove the tumor with a cryoprobe and recanalization was achieved. By examining the cryobiopsies, the rare diagnosis of myxoid spindle cell lipoma as a tumor entity was made. The patient recovered from pneumonia.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"591-595"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Physiotherapy in Primary Ciliary Dyskinesia].","authors":"Christina Krämer, Jasmin Flock, Birgit Borges-Lüke, Johanna Raidt, Felix C Ringshausen","doi":"10.1055/a-2502-8151","DOIUrl":"10.1055/a-2502-8151","url":null,"abstract":"<p><p>Primary ciliary dyskinesia (PCD) is a multisystem disease caused by dysfunction of motile cilia. It is characterized by chronic mucus retention of the upper and lower airways. This results in a destructive lung disease with the development of bronchiectasis. There are a very few evidence-based therapies for patients with PCD. Most treatment concepts are based on other respiratory diseases or expert opinion. This article is about the physiotherapy care of patients with PCD and provides an overview of recommendations from the current literature as well as many years of experience in the physiotherapy treatment of patients with PCD. Currently, no curative therapy for PCD exists. Symptomatic treatment with a focus on mucus management is relevant. This includes inhalation, mobilization of mucus, physical activity and the targeted use of medical aids for chest clearance as well as rehabilitation. Whenever possible, specialized therapists should provide guidance for physiotherapy.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"577-584"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Combination drug therapy in pulmonary hypertension: switch from selexipaq to intravenous trepostinil].","authors":"Alexander Heine, Anne Obst, Christian F Opitz, Michael Halank, Manuel Richter, Tobias Lange, Ralf Ewert","doi":"10.1055/a-2472-0694","DOIUrl":"10.1055/a-2472-0694","url":null,"abstract":"<p><p>A wide range of substances is currently available for the treatment of patients with pulmonary arterial hypertension. The current recommendations for initial drug therapy are based on the patient's risk profile. For patients at high risk, an initial triple combination therapy with different substances including prostanoids is recommended.The aim of the prospective, single-arm, unblinded study was to clarify whether PAH patients on triple therapy benefit from switching from selexipag to intravenous treprostinil. The primary endpoint was the achievement of a \"low-risk\" status after 6 (12) months.27 PAH patients (45 (37; 61) years, 77.8% women) were included. At study entry they were assigned to low-risk (n=1), intermediate (n=12) or high-risk status (n=14). On average, 22 patients were followed for 8 (range 5-11) months. One patient was successfully transplanted after four months, another four patients died (in one case septic complications of unknown origin; in three cases progressive right heart failure). The primary endpoint (reaching \"low-risk\" status) was achieved in 12/21 (57.1%) patients (one further patient remained in \"low-risk\" status).These data indicate (despite the small number of patients) that even with established triple therapy, clinical improvement in individual patients is possible by switching from selexipag to intravenous treprostinil.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"493-500"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}