Pneumologie (Stuttgart, Germany)最新文献

{"title":"[Non-invasive respiratory support for acute respiratory failure with focus on high-flow oxygen therapy and non-invasive Ventilation].","authors":"Christoph Fisser, Maximilian Malfertheiner, Philipp M Lepper, Sebastian Mang","doi":"10.1055/a-2776-7023","DOIUrl":"10.1055/a-2776-7023","url":null,"abstract":"<p><strong>Abstract: </strong>Acute respiratory insufficiency (ARI) is among the most frequent emergencies in emergency and intensive care medicine and is associated with mortality rates of up to 50%. Pathophysiologically, ARI is classified into hypoxemic, hypercapnic, and mixed forms. Hypoxemic insufficiency typically results from parenchymal lung disease or ventilation-perfusion mismatch, whereas hypercapnic insufficiency reflects pump failure. Monitoring includes clinical assessment, respiratory rate, pulse oximetry, and blood gas analysis; capnometry as well as advanced techniques such as electrical impedance tomography or esophageal pressure measurement may be used as adjuncts. Therapeutically, high-flow oxygen therapy (HFOT) and non-invasive ventilation (NIV) have become established. HFOT improves comfort, secretion clearance, and oxygenation, while NIV is particularly effective in hypercapnic insufficiency. Both modalities can reduce the need for intubation but require close monitoring and timely escalation in case of treatment failure.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"493-499"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021270","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":"[Sepsis: Update 2026].","authors":"Lina-Hanne Maria Ko, Axel Nierhaus, Stefan Kluge","doi":"10.1055/a-2853-3828","DOIUrl":"10.1055/a-2853-3828","url":null,"abstract":"<p><strong>Abstract: </strong>Sepsis remains a leading cause of in-hospital mortality and represents a particular challenge in pulmonology, as the respiratory tract is involved in up to 50% of cases. In Germany, approximately 279,000 patients develop sepsis annually, with reported in-hospital mortality approaching 40%, depending on data source and case mix. Delayed diagnosis is associated with worse outcomes, underscoring the importance of structured early recognition, guideline-based therapy, and quality assurance measures.The current Sepsis-3 definition describes sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection, diagnosed by an increase of ≥2 points in the SOFA score. Septic shock is defined as persistent hypotension despite adequate fluid resuscitation, lactate levels >2 mmol/L, and the need for vasopressors to maintain a mean arterial pressure of ≥65 mmHg.Since the beginning of 2026, a nationwide quality assurance procedure has been in place, which covers screening rates, antibiotic administration, standardized treatment procedures, and training of medical staff. Its aim is to improve process quality and patient outcomes.The updated 2025 German sepsis guideline recommends the NEWS2 score as an alternative to qSOFA due to its simplicity and clinical practicality, both of which are accepted within the quality assurance procedure. Early lactate measurement is also advised when sepsis is suspected.Antimicrobial therapy should be preceded by the collection of at least two sets of blood cultures. In septic shock, antibiotics should be initiated within one hour; in sepsis without septic shock, within three hours. Initial hemodynamic stabilization includes administration of 30 ml/kg of balanced crystalloids within the first three hours. If hypotension persists, norepinephrine is the vasopressor of choice.The guideline further emphasizes structured post-sepsis care. Survivors should be informed early about potential long-term sequelae, including post-intensive care syndrome (PICS), and supported through coordinated discharge planning and follow-up.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"522-530"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978582","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":"[Weaning Classification Systems: WIND, ICC and Prolonged Weaning in light of the updated German S3-Guideline on invasive mechanical ventilation].","authors":"Friedrich Anton Hohmann, Onnen Moerer, Bernd Schönhofer","doi":"10.1055/a-2765-9005","DOIUrl":"10.1055/a-2765-9005","url":null,"abstract":"<p><strong>Abstract: </strong>Weaning from invasive mechanical ventilation represents a critical transition in intensive care, accounting for a substantial proportion of total ventilation time in successfully extubated patients. Inadequate assessment may lead either to prolonged ventilation with associated complications or to premature extubation attempts with an increased risk of reintubation. To systematically describe weaning processes, several classification models have been proposed. The established International Concensus Classification (ICC) weaning classification (\"Budapest classification\") categorized weaning courses into three groups (simple, difficult and prolonged) but showed major limitations, including restricted applicability, limited prognostic value, and an overly short observation period. The WIND (Weaning accordIng to a New Definition) classification, introduced in 2017, provides the first time-based and internationally applicable system that allows nearly complete categorization of ventilated patients and demonstrates consistent associations with patient-relevant outcomes. Validation studies across large international cohorts confirmed significantly improved classification rates and prognostic discrimination of WIND compared with the ICC system. In German-speaking countries, however, a more granular differentiation of prolonged weaning remains clinically important. The S2k guideline \"Prolonged Weaning\" addresses this heterogeneity through six specific subgroups, which are essential for prognosis, resource planning, and long-term care. The 2025 revised \"Clinical Guideline for Treating Acute Respiratory Insufficiency with Invasive Ventilation and Extracorporeal Membrane Oxygenation\" therefore recommends a hybrid approach, combining the international standardization of the WIND classification with the detailed subgrouping of prolonged weaning from the German S2k guideline. This model enables both international comparability and the level of detail required in clinical practice within German-speaking countries, thus representing a pragmatic consensus.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"514-521"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109599","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":"Ablauf der roboterassistierten Bronchoskopie – Schritt für Schritt.","authors":"Nenad Patenkovic, Dirk Skowasch, Carmen Pizarro, Joachim Schmidt, Donatas Zalepugas, Melanie Oggiano, Richard Wolf, Santiago Ewig, Erich Hecker","doi":"10.1055/a-2833-2251","DOIUrl":"https://doi.org/10.1055/a-2833-2251","url":null,"abstract":"","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":"80 7","pages":"531-536"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538071","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":"Aerosol therapy during noninvasive ventilation (NIV) and nasal high-flow therapy (HFT): current technology and consensus-based recommendations.","authors":"Michael Dreher, Markus Fischer, Chrisian Karagiannidis, Klaus Rabe, Rembert Koczulla, Frederik Trinkmann, Charalambos Tsagogiorgas, Michael Westhoff, Claus Vogelmeier","doi":"10.1055/a-2873-9563","DOIUrl":"https://doi.org/10.1055/a-2873-9563","url":null,"abstract":"<p><strong>Background: </strong>Aerosol therapy is an essential procedure in the treatment of acute and chronic respiratory diseases. Currently, there are no up-to-date guidelines from German-speaking countries on the selection and use of nebulizer systems in patients undergoing high-flow therapy via nasal cannula (HFT) and non-invasive ventilation (NIV).</p><p><strong>Methods: </strong>An interdisciplinary panel of experts consisting of pulmonologists and intensive care physicians developed practice-oriented recommendations for aerosol therapy under HFT and NIV. The evidence base was derived from a systematic search of the PubMed database of the US National Library of Medicine up to and including November 2025.Publications on clinical studies, reviews, guideline documents, and technical reports were included. The respective level of evidence of the information was evaluated. The recommendations were agreed upon in a multi-stage process.</p><p><strong>Results: </strong>Aerosol administration under HFT and NIV with a vibrating mesh nebulizer (VMN) achieved better lung deposition compared to the use of a jet nebulizer (JN). A JN is suitable if VMNs are not available, if highly viscous drug solutions are to be nebulized, or if there are budgetary limitations.</p><p><strong>Conclusion: </strong>The choice and application of the nebulizer system should be patient-specific, consistent with the indication, taking into account technical, clinical, and economic requirements.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285098","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":"[Correction: Pharmacotherapy for Tobacco Dependence: Implementation of the Current G-BA Resolution - Erratum: Information from Section E3 of the DGP regarding the G-BA Resolution].","authors":"Klaas Frederik Franzen, Matthias Raspe, Matthias Urlbauer, Wulf Pankow, Karin Vitzthum, Natascha Sommer, Alexander Rupp, Stefan Andreas","doi":"10.1055/a-2892-0000","DOIUrl":"https://doi.org/10.1055/a-2892-0000","url":null,"abstract":"","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280831","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":"[Pharmacotherapy for Tobacco Dependence: Implementation of the Current G-BA Resolution - Information from Section E3 of the DGP regarding the G-BA Resolution].","authors":"Klaas Frederik Franzen, Matthias Raspe, Matthias Urlbauer, Wulf Pankow, Karin Vitzthum, Natascha Sommer, Alexander Rupp, Stefan Andreas","doi":"10.1055/a-2819-3448","DOIUrl":"10.1055/a-2819-3448","url":null,"abstract":"<p><strong>Abstract: </strong>The recent resolution of the Federal Joint Committee (G-BA) amending section §14a of the Pharmaceutical Directive and introducing Annex IIa represents a major advancement in the clinical management of tobacco dependence in Germany. This editorial outlines the regulatory prerequisites for prescribing pharmacological smoking-cessation therapies, including the diagnostic confirmation of severe tobacco dependence (ICD-10 F17.2), assessment via the Fagerström Test for Cigarette Dependence, and mandatory participation in an evidence-based cessation program. Approved therapeutic options, such as mono- or combination nicotine replacement therapy and varenicline, are described alongside considerations for implementation in both outpatient and inpatient care settings. The text further discusses current limitations of the resolution, including the three-year restriction on repeat prescriptions and the insufficient integration of users of heated tobacco products and e-cigarettes. Overall, the resolution is assessed as an important milestone toward structured treatment of a chronic relapsing disorder, while highlighting areas for future improvement.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148160391","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 internet as a source of information for patients with sarcoidosis].","authors":"Katharina Buschulte, Philipp Höger, Sarah El-Hadi, Claudia Ganter, Nicolas Kahn, Katharina Kriegsmann, Finn Moritz Wilkens, Markus Polke, Franziska Trudzinski, Felix Herth, Michael Kreuter","doi":"10.1055/a-2868-0156","DOIUrl":"https://doi.org/10.1055/a-2868-0156","url":null,"abstract":"<p><strong>Background: </strong>The internet is often used as a source of information by patients with sarcoidosis, but its reliability has not yet been comprehensively analysed. The aim of this study was to analyse the content and quality of German-language information on sarcoidosis available on the internet.</p><p><strong>Methods: </strong>All German-language hits from the first 200 search results for \"sarcoidosis\" on Google, Yahoo, Bing, and YouTube were saved. Two independent investigators evaluated the content (content score with 25 items, 0-25 points) and quality (DISCERN score with 1-5 points, HONCode score with 0-8 points, JAMA score with 0-4 points).</p><p><strong>Results: </strong>128 websites and 12 videos were included. The median time since the last update was 36 and 9 months. The content score was 17 and 13 points, respectively. Quality was rated with a DISCERN score of 2.4 and 2.1 points, the JAMA score of the websites was 2 points, and the HONCode score of the videos was 4.2 points. Blogs achieved poorer results in terms of content (p=0.040) and DISCERN score (p=0.016), while the JAMA score was best for news/media (p=0.002). There were no differences for the videos.</p><p><strong>Conclusion: </strong>Although some German-language information on sarcoidosis found on the internet was adequate in terms of content, its quality was only moderate. It would be desirable to have a reliable and easily recognisable label for adequate information.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153014","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":"[Cardio-Pulmonary Exercise Testing - Patient Information].","authors":"Thomas Glaab, Alexandra Marita Preisser, Andreas Greiwing, Jürgen Fritsch, F Joachim Meyer","doi":"10.1055/a-2740-6535","DOIUrl":"10.1055/a-2740-6535","url":null,"abstract":"<p><strong>Abstract: </strong>Cardiopulmonary exercise testing (CPET) is an integrative examination of the pulmonary-cardiovascular-muscular system and represents the global gold standard in exercise testing. Due to the relatively complex nature of the test (maximum effort required, wearing a face mask and instructing the patient), it is generally recommended that the patient is given detailed and understandable information in advance. Using written patient information actively during the initial consultation can significantly improve patient-doctor communication. This also improves patient acceptance of the test, thereby enabling the best possible conditions for exercise testing. This interdisciplinary patient information aims to provide patients with clear, easy-to-understand information about CPET to help them prepare adequately for the test.</p>","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"422-425"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489183","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":"[Innovation much later - or not at all? The impact of the Most-Favored-Nation price in the United States on pulmonary medicine in Germany].","authors":"Christian Taube, Wolfram Windisch, Martin Witzenrath","doi":"10.1055/a-2825-3927","DOIUrl":"10.1055/a-2825-3927","url":null,"abstract":"","PeriodicalId":520755,"journal":{"name":"Pneumologie (Stuttgart, Germany)","volume":" ","pages":"420-421"},"PeriodicalIF":1.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461294","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}