Pneumologie最新文献

{"title":"Lungensonografie auf der Intensivstation – Schritt für Schritt.","authors":"Thomas Flohr, Christoph Laußer","doi":"10.1055/a-2348-5975","DOIUrl":"https://doi.org/10.1055/a-2348-5975","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811836","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":"[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":"https://doi.org/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":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-08","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":"Negative impact of face masks in patients with interstitial lung disease: A prospective study.","authors":"Arno Mohr, Stefanie Zahn, Florian Geismann, Stefan Blaas, Michael Pfeifer, Maximilian Malfertheiner, Bernd Salzberger, Frank Hanses, Stilla Bauernfeind, Myriam Koch, Florian Hitzenbichler","doi":"10.1055/a-2361-4723","DOIUrl":"10.1055/a-2361-4723","url":null,"abstract":"<p><p>Face masks increase airway resistance, data on the actual extent of this effect are scarce. The aim of this study was to assess the effect of different mask types on clinical parameters during moderate exercise in healthy non-smokers, active smokers and patients with interstitial lung disease (ILD) without the need of oxygen therapy.In a prospective observational pilot study participants performed a six-minute walk test without mask, with a surgical mask, a well-fitted FFP2 mask and with a valved FFP3 mask. Respiratory rate, blood pressure, heart rate, blood gas analysis parameters, dyspnoea and six-minute walk distance were measured. Data were analysed in an ANOVA model.21 healthy participants, 17 active smokers without known pulmonary disease and 15 patients with interstitial lung disease were included. Participants with ILD had a significant lower walking distance, a higher respiratory rate and a lower pO₂ when using FFP2 masks, but not with valved FFP3 masks or surgical masks compared to not wearing a mask.For patients with ILD without the need of oxygen therapy wearing an FFP2 mask had a negative impact on pO₂, respiratory rate and walking distance in the six-minute walk test. This effect was not seen with valved FFP3 masks or surgical masks.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"292-296"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856283","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":"[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":"[Role of respiratory therapists in weaning patients from invasive mechanical ventilation: a description of their responsibilities from a certified weaning centre].","authors":"Benjamin Neetz, Gabriele Iberl, Nicole Kraus, Cornelia Weißmann, Florian Bornitz, Michael Martin Müller, Lars Reinhardt, Felix Herth, Julia Michels, Franziska Trudzinski","doi":"10.1055/a-2529-6367","DOIUrl":"10.1055/a-2529-6367","url":null,"abstract":"<p><p>Respiratory therapists have been trained by the German Respiratory Society (DGP) since 2005. Respiratory therapeutic interventions related to weaning patients from invasive mechanical ventilation are a major focus. Respiratory therapists have been an integral part of the therapeutic team at the Thorax Clinic Heidelberg for more than 10 years. This article describes their tasks and responsibilities in the context of weaning from invasive mechanical ventilation. The acute treatment phase of invasively ventilated patients in the acute intensive care unit and the prolonged weaning phase in the pneumological intensive care unit are presented in chronological order. The therapeutic focus of each phase is presented and described.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"284-291"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503521","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":"[Respiratory therapists in Germany: An analysis of their current training and work situation].","authors":"Dennis Flügge, Matthias Held","doi":"10.1055/a-2510-2625","DOIUrl":"10.1055/a-2510-2625","url":null,"abstract":"<p><p>Although there has been a trainee program for respiratory therapists since 18 years, a representative survey of this field of activity is lacking. The aim of this study was to find out which professional groups felt addressed by the training program, how satisfied they were with the training and where the respiratory therapists were employed, to take a look at the organisation of the working conditions after further training and how cooperation with other professional groups functioned. An investigation into whether there were factors that had an influence on the above-mentioned points should provide an outlook on how respiratory therapy in Germany was likely to develop in the future and what would be important for its future work.In a quantitative cross-sectional study, a partially anonymised electronic survey was conducted among prospective and trained respiratory therapists in Germany. The survey was analysed using the (browser-based) programme \"Online Umfrage.com\" and the spreadsheet programme Microsoft Excel. The open questions were analysed using Mayring's qualitative content analysis.307 prospective and postgraduate respiratory therapists from all federal states and with varying years of continuing education took part in the survey. Most of the respondents worked in the clinical field; 90% of the respondents were rather or very satisfied with their further training. A quarter of them got no time off at all from work or only partially to participate in continuing education. Half of the respondents had not been able to get better salaries following their further training. Nevertheless, 81.25% of respiratory therapists said they would recommend the training programme to others. When asked what was important for the future, the answers varied and ranged from state recognition and better cooperation between training providers to better public relations work.Further training to become a respiratory therapist is seen as very positive. However, there are still significant problems in the areas of remuneration, time off and further training development. The type of supervisor was identified as one of the most important influencing factors. Thus, respiratory therapists who were subordinated to the medical service were more satisfied than those placed under the nursing service management.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"274-283"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441790","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":"Kommentar.","authors":"Detlef Kirsten","doi":"10.1055/a-2486-8070","DOIUrl":"https://doi.org/10.1055/a-2486-8070","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":"79 4","pages":"308"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044662","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":"[Pulmonary mass: Thinking beyond malignant causes - A case of histoplasmosis].","authors":"Elena Terhalle","doi":"10.1055/a-2531-4204","DOIUrl":"10.1055/a-2531-4204","url":null,"abstract":"<p><p>A 49-year-old patient was presented for clarification of a pulmonary nodule and lymphadenopathy. He had undergone surgery for removal of a squamous cell carcinoma from the lip and a renal cell carcinoma. Follow-up examinations showed new changes in the lungs and lymph nodes. An initial suspicion of malignant metastases was not confirmed; instead, fungal organisms were detected. Through a detailed medical history, positive serology, and a specific PCR, the diagnosis of pulmonary histoplasmosis was finally made.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":" ","pages":"302-307"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503517","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}