Pneumologie最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764923","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":"[Epidemiology, diagnosis and treatment of adult patients with nosocomial pneumonia].","authors":"Jessica Rademacher, Santiago Ewig, Béatrice Grabein, Irit Nachtigall, Marianne Abele-Horn, Maria Deja, Martina Gaßner, Sören Gatermann, Christine Geffers, Herwig Gerlach, Stefan Hagel, Claus Peter Heußel, Stefan Kluge, Martin Kolditz, Evelyn Kramme, Hilmar Kühl, Marcus Panning, Peter-Michael Rath, Gernot Rohde, Bernhard Schaaf, Helmut J F Salzer, Dierk Schreiter, Hans Schweisfurth, Susanne Unverzagt, Markus A Weigand, Tobias Welte, Mathias W Pletz","doi":"10.1055/a-2541-9872","DOIUrl":"https://doi.org/10.1055/a-2541-9872","url":null,"abstract":"<p><strong>Background: </strong> Nosocomial pneumonia, encompassing hospital-acquired (HAP) and ventilator-associated pneumonia (VAP), remains a major cause of morbidity and mortality in hospitalized adults. In response to evolving pathogen profiles and emerging resistance patterns, this updated S3 guideline (AWMF Register No. 020-013) provides an evidence-based framework to enhance the diagnosis, risk stratification, and treatment of nosocomial pneumonia.</p><p><strong>Methods: </strong> The guideline update was developed by a multidisciplinary panel representing key German professional societies. A systematic literature review was conducted with subsequent critical appraisal using the GRADE methodology. Structured consensus conferences and external reviews ensured that the recommendations were clinically relevant, methodologically sound, and aligned with current antimicrobial stewardship principles.</p><p><strong>Results: </strong> For the management of nosocomial pneumonia patients should be divided in those with and without risk factors for multidrug-resistant pathogens and/or <i>Pseudomonas aeruginosa</i>. Bacterial multiplex-polymerase chain reaction (PCR) should not be used routinely. Bronchoscopic diagnosis is not considered superior to non-bronchoscopic sampling in terms of main outcomes. Combination antibiotic therapy is now reserved for patients in septic shock and high risk for multidrug-resistant pathogens, while select patients may be managed with monotherapy (e. g., meropenem). In clinically stabilized patients, antibiotic therapy should be de-escalated and focused, as well as duration shortened to 7-8 days. In critically ill patients, prolonged application of suitable beta-lactam antibiotics should be preferred. Patients on the intensive care unit (ICU) are at risk for invasive pulmonary aspergillosis (IPA). Diagnostics for <i>Aspergillus</i> should be performed with an antigen test from bronchial lavage fluid.</p><p><strong>Conclusion: </strong> This updated S3 guideline offers a comprehensive, multidisciplinary approach to the management of nosocomial pneumonia in adults. By integrating novel diagnostic modalities and refined therapeutic strategies, it aims to standardize care, improve patient outcomes, and enhance antimicrobial stewardship to curb the emergence of resistant pathogens.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764943","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":"[17 years of WeanNet - review and perspective].","authors":"Jens Geiseler, Michael Westhoff, Franziska C Trudzinski, Urte Sommwerck, Winfried Randerath","doi":"10.1055/a-2546-1496","DOIUrl":"https://doi.org/10.1055/a-2546-1496","url":null,"abstract":"<p><p>The present article describes the 17-year success story of WeanNet, the Competence Network of Pulmonological Weaning Centers, from its founding and the development of a dedicated certification process to the establishment of a database now comprising more than 55.000 patients undergoing prolonged weaning. It discusses past evaluations of the database as well as an ongoing analysis currently in preparation.Due to the frequent successful weaning (approximately two-thirds of treated patients) WeanNet, alongside other organisations, has been actively involved in developing guidelines, laws and regulations for out-of-hospital intensive care, OPS codes, and further initiatives aimed at reducing the number of patients requiring invasive mechanical ventilation outside clinical settings. The guideline of prolonged weaning is currently being revised and, with the results of AI-supported data analysis, is expected to contribute to further quality improvements in the prolonged weaning process.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764905","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":"[Case report: 38-year-old male with hemoptysis, jaundice and acute kidney injury].","authors":"Ida Lechtenberg","doi":"10.1055/a-2559-9411","DOIUrl":"https://doi.org/10.1055/a-2559-9411","url":null,"abstract":"<p><p>Globally, leptospirosis represents one of the most common zoonotic diseases, with approximately 1 million cases reported annually. It predominantly occurs in tropical and subtropical regions. In light of climate change, raising awareness of such diseases among clinicians in moderate climate zones might become increasingly important.We report the following case of a hybrid presentation of leptospirosis, characterized by predominant pulmonary involvement in the form of diffuse alveolar hemorrhage, as well as jaundice and nephritis.A 38-year-old patient presented one week after a summer riverside barbecue with fever and jaundice. Laboratory tests revealed elevated CRP and procalcitonin levels, direct hyperbilirubinemia and acute kidney injury. The following day he developed diffuse alveolar hemorrhage with rapidly progressive respiratory failure and the need for invasive ventilation. Serological testing for <i>Leptospira</i> was positive and the diagnosis was further confirmed by PCR.With supportive measures and anti-infective therapy with ceftriaxone the patient's condition progressively improved. After 8 days of invasive ventilation he was successfully extubated.This case highlights the importance of considering a broader differential diagnosis in complex and severe disease presentations. Despite the currently sporadic occurrence of this disease in Germany, leptospirosis should be considered in cases of pulmonary hemorrhage in conjunction with kidney failure and jaundice.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764933","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":"https://doi.org/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":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764850","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":"[Context factors for performing endoscopic examinations as an inpatient service in adults].","authors":"Joanna Krist, Lars Hagmeyer, Nicolas Schoenfeld, Kaid Darwiche, Judith Maria Brock, Anne Piening, Dirk Skowasch, Winfried Randerath, Torsten Bauer, Ralf-Harto Hübner","doi":"10.1055/a-2567-4715","DOIUrl":"https://doi.org/10.1055/a-2567-4715","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764920","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":"https://doi.org/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":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"[Representation of respiratory medicine in medical curricula in Germany: an online survey among final-year medical students and chief physicians].","authors":"Erik Büscher, Espen Elias Groth, Julia Wälscher, Thomas Bahmer, Matthias Raspe, Nina Sicker, Katharina Buschulte, Christoph Fisser","doi":"10.1055/a-2533-1546","DOIUrl":"https://doi.org/10.1055/a-2533-1546","url":null,"abstract":"<p><p>Students' experiences in medical school may have a significant influence on their later choice of medical specialty, but so far, there has been a lack of objective data on how the subject of pneumology is perceived at German medical schools and where there may be potential for improvement.From July to November 2022, we conducted an online survey among final-year students at German medical schools, as well as chief physicians in the field of pneumology. Students were invited to participate by e-mail via their faculties and the survey was further advertised by the Federal Representation of Medical Students in Germany (BVMD). Chief physicians were contacted via the mailing list of the German Respiratory Society (DGP).We received n=279 responses from students (from 95% of German medical faculties) and n=53 responses from chief physicians in pneumology. Both groups considered pneumology to be rather underrepresented or underrepresented compared to other specialties in the medical curricula (62% of students, 89% of chief physicians). Students attributed the greatest influence on their career aspirations by far to theoretical knowledge, practical experience during internships, clinical traineeships and the final (practical) year of medical school (89% of responses), with value being attributed to good and appreciative supervision and the opportunity to work independently. In a regression analysis, practical learning experience in the field of pneumology during the final year of medical school was particularly associated with students' later career choice for pneumology. From the students' perspective, practical teaching (91% of responses) as well as other courses requiring personal attendance (51%) should be strengthened. Chief physicians described difficulties recruiting junior staff into the field of pneumology and highlighted the need to stress the importance of the subject and the financing of teaching at medical schools.Implementation of a more comprehensive, practice-oriented training in respiratory medicine seems essential for promoting the recruitment of the next generation of physicians into the field of pneumology. The results presented in this paper form a basis for giving more weight to pneumology in medical school curricula and serve as an aid for decision-makers at medical faculties and teaching hospitals in Germany.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764851","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":"[Prognostic parameters in patients with prolonged weaning from mechanical ventilation: a retrospective analysis].","authors":"Tobias Müller, Jan Mannschreck, Pascal Lennemann, Ingmar Bergs, Benedikt Jörn, Gernot Marx, Tim Philip Simon, Michael Dreher","doi":"10.1055/a-2549-0754","DOIUrl":"https://doi.org/10.1055/a-2549-0754","url":null,"abstract":"<p><p>Weaning from mechanical ventilation of patients treated in an intensive care unit can be difficult and requires transfer to a specialised weaning unit. So far, only limited data are available on parameters associated with survival and successful weaning in this patient group.A retrospective analysis of patients (n=659) treated in the specialised weaning unit at the University Hospital RWTH Aachen during a time period of 8 years was conducted.Multivariate analysis showed an inverse association of patient survival with age (OR 0.958; p<0.001), underlying malignancy (OR 0.422; p=0.008) or chronic renal failure (OR 0.509; p=0.035), cumulative fluid balance (OR 0.948; p<0.001) and lactate levels (OR 0.528; p=0.032). Moreover, age (OR 0.975; p=0.021), chronic renal failure (OR 0.382; p=0.001), cumulative fluid balance (OR 0.953; p<0.001) and lactate levels (OR 0.349; p<0.001) were also associated with weaning failure. In addition, an association of weaning failure was found for underlying neuromuscular disorder (OR 0.212; p=0.01), ventilator days on ICU (OR 0.98; p=0.015) and bicarbonate levels (OR 0.947; p=0.049).Taken together, we were able to identify several parameters associated with survival and successful weaning in a large cohort of patients treated in a specialized weaning unit.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743451","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 Huebner","doi":"10.1055/a-2532-4885","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-03","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}