Leitlinie zur Langzeit-Sauerstofftherapie

Haidl, P.; Jany, B; Geiseler, Jens; Andreas, Stefan; Arzt, Michael; Dreher, Michael; Frey, Manuel; Hauck, R.; Herth, Felix J.F.; Hämäläinen, Nina; Jehser, Thomas; Kenn, Klaus; Lamprecht, Bernd; Magnet, Friederike Sophie; Oldenburg, Olaf; Schenk, Peter; Schucher, B.; Studnicka, Michael; Voshaar, Thomas; Windisch, Wolfram; Woehrle, Holger; Worth, H.; Beatmung, Deutsche Interdisziplinäre Gesellschaft für Außerklinische; Pneumologen, Schlaf und Beatmungsmediziner Bundesverband der; Pneumologie, Schweizerische Gesellschaft für; Pneumologie, Österreichische Gesellschaft für

doi:10.1055/a-1252-1492

Cited by 30 publications

(17 citation statements)

References 178 publications

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“…Zudem kann bei einer immunsuppressiven oder immunmodulierenden Therapie eine Pneumocystis jirovecii pneumonia (PJP)-Prophylaxe mit Cotrimoxazol erwogen werden. Eine Sauerstofftherapie sollte entsprechend der aktuellen S2k-Leitlinie zur Langzeitsauerstofftherapie erfolgen [60]. Daneben kann eine pulmonale Rehabilitation die Lebensqualität und respiratorische Symptome verbessern [36].…”

Section: Adjuvante Therapienunclassified

Aktuelles zur RA-ILD

Schreiber¹,

Hagmeyer

Kofler

et al. 2022

Pneumologie

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ZusammenfassungDie interstitielle Lungenerkrankung bedingt durch eine rheumatoide Arthritis (RA-ILD) hat eine hohe klinische Relevanz. Sie beeinflusst nicht nur die Lebensqualität, sondern hat auch einen erheblichen Anteil an der Mortalität der rheumatoiden Arthritis. Eine RA-ILD kann sich mit allen radiologischen und histopathologischen Mustern präsentieren, die auch bei anderen interstitiellen Pneumonien auftreten. Dabei hat ein diffuser Alveolarschaden (diffuse alveolar damage, DAD), gefolgt von einer gewöhnlichen interstitiellen Pneumonie (usual interstital pneumonia, UIP) die schlechteste Prognose. Zudem hat eine akute Exazerbation der RA-ILD, welche zu jedem Zeitpunkt der Erkrankung auftreten kann, eine hohe Letalität. Ein Algorithmus zur Diagnostik und Therapie der RA-ILD ist ausstehend und wird in folgendem Beitrag thematisiert. Neben Immunsuppressiva und krankheitsmodifizierenden Medikamenten (disease-modifying antirheumatic drugs, DMARD) gewannen zuletzt Antifibrotika in der Therapie der RA-ILD an Bedeutung.

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Section: Adjuvante Therapienunclassified

Aktuelles zur RA-ILD

Schreiber¹,

Hagmeyer

Kofler

et al. 2022

Pneumologie

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“…Decisions concerning an indication for long-term oxygen therapy should not be made on the basis of blood gas measurements taken during an acute illness. The Guideline for Long-Term Oxygen Therapy recommends following up on oxygen therapy within 12 weeks of starting oxygen therapy, and also as part of the re-evaluation of stable patients [252].…”

Section: Practice Pointsmentioning

confidence: 99%

German S3 Guideline: Oxygen Therapy in the Acute Care of Adult Patients

et al. 2021

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Background: Oxygen (O2) is a drug with specific biochemical and physiological properties, a range of effective doses and may have side effects. In 2015, 14% of over 55,000 hospital patients in the UK were using oxygen. 42% of patients received this supplemental oxygen without a valid prescription. Health care professionals are frequently uncertain about the relevance of hypoxemia and have low awareness about the risks of hyperoxemia. Numerous randomized controlled trials about targets of oxygen therapy have been published in recent years. A national guideline is urgently needed. Methods: A national S3 guideline was developed and published within the Program for National Disease Management Guidelines (AWMF) with participation of 10 medical associations. A literature search was performed until February 1, 2021, to answer 10 key questions. The Oxford Centre for Evidence-Based Medicine (CEBM) System (“The Oxford 2011 Levels of Evidence”) was used to classify types of studies in terms of validity. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for assessing the quality of evidence and for grading guideline recommendation, and a formal consensus-building process was performed. Results: The guideline includes 34 evidence-based recommendations about indications, prescription, monitoring and discontinuation of oxygen therapy in acute care. The main indication for O2 therapy is hypoxemia. In acute care both hypoxemia and hyperoxemia should be avoided. Hyperoxemia also seems to be associated with increased mortality, especially in patients with hypercapnia. The guideline provides recommended target oxygen saturation for acute medicine without differentiating between diagnoses. Target ranges for oxygen saturation are based depending on ventilation status risk for hypercapnia. The guideline provides an overview of available oxygen delivery systems and includes recommendations for their selection based on patient safety and comfort. Conclusion: This is the first national guideline on the use of oxygen in acute care. It addresses health care professionals using oxygen in acute out-of-hospital and in-hospital settings.

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“…Patient adherence defined as the mean time in hours of use per day was determined by a readout of the ventilator's builtin software. Oxygen was supplied both according to the patient's individual needs and based on national and international guidelines [20][21][22].…”

Section: Sample Size and Data Collectionmentioning

confidence: 99%

Living conditions and autonomy levels in COPD patients receiving non-invasive ventilation: impact on health related quality of life

et al. 2021

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Background Research on health-related quality of life (HRQL) has become increasingly important in recent decades. However, the impact of both living conditions and the level of autonomy impairments on HRQL in COPD patients receiving non-invasive ventilation (NIV) is still unclear. Methods The Severe Respiratory Insufficiency Questionnaire (SRI) was used to measure HRQL in a prospective cohort of COPD patients in whom home NIV was already established. Data on sociodemographics, clinical characteristics and standardized levels of autonomy impairment were evaluated. A multiple linear regression analysis was performed to identify the factors associated with a reduced HRQL. Results A total of 137 patients (67.0 ± 7.8 years, 45% female) were assessed. The mean SRI Summary Score was 54.1 ± 16.9 (95%CI: 51.1–57.1; N = 127). Regular ambulatory care was provided in 76% of patients, but only 37% underwent pulmonary rehabilitation. Overall, 69% of patients lived with family members, while 31% lived alone (family situation). Autonomy impairment levels were most serious in 3%, serious in 14%, and significant in 29% of patients, while 54% had no impairments at all. Of note, higher levels of autonomy impairment were markedly associated with lower SRI scores (regression coefficient − 6.5 ± 1.1 per level; P < 0.001). In contrast, family situation (0.2 ± 3.0; P = 0.959), ambulatory care by a respiratory specialist (1.7 ± 3.6; P = 0.638), and pulmonary rehabilitation (− 0.8 ± 3.1; P = 0.802) did not appear to influence HRQL. Possible subgroup effects were evident for the factors “impaired autonomy” and “living in a nursing home” (P = 0.016). Conclusion A higher level of autonomy impairment has been identified as the major determinant of reduced HRQL in COPD-patients receiving long-term NIV, particularly in those living in a nursing home. Trial Registration German Clinical Trials Register (DRKS00008759).

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Leitlinie zur Langzeit-Sauerstofftherapie

Cited by 30 publications

References 178 publications

Aktuelles zur RA-ILD

Aktuelles zur RA-ILD

German S3 Guideline: Oxygen Therapy in the Acute Care of Adult Patients

Living conditions and autonomy levels in COPD patients receiving non-invasive ventilation: impact on health related quality of life

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