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Dellweg D, Siemon K, Höhn E, Barchfeld T, Köhler D. [Early Pulmonary Rehabilitation after Long Term Mechanical Ventilation]. Pneumologie 2021; 75:432-438. [PMID: 34116576 PMCID: PMC8195616 DOI: 10.1055/a-0978-1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Einleitung
Unter Frührehabilitation versteht man eine frühzeitig bei- oder nach akuter Erkrankung einsetzende, rehabilitationsmedizinische Behandlung die im § 39SGB V verankert ist. Ziel dieser Untersuchung ist es, die Ergebnisqualität der pneumologischen Frührehabilitation zu untersuchen und darzustellen.
Methoden
Prospektive Erhebung von funktionellen Parametern, Beatmungsstatus und Entlass-Disposition in einer spezialisierten Abteilung für pneumologische Frührehabilitation über den Zeitraum von einem Jahr.
Ergebnisse
Von den 190 Patienten waren 179 (94,2 %) zuvor invasiv beatmet. Während einer Behandlungsdauer von 39 ± 17 Tagen stieg der FAM-Index von 84,4 ± 19,8 auf 118,5 ± 23,3 (Ci 30,9 – 37,3, Cohen’s d 1,58; p < 0,001), der Barthel-Index von 30,5 ± 13,8 auf 58,3 ± 16,2 (Ci 25,4 – 33,8, Cohen’s d 1,4; p < 0,001) und die Wegstrecke von 12,9 ± 40,1 m auf 131,4 ± 85,2 m (Ci 105,6 – 131,4 m, Cohen’s d 1,78; p < 0,001). Die Patienten wurden weniger häufig in eine weitere Anschlussheilbehandlung verlegt, wenn sie beatmet waren.
Diskussion
Patienten in der pneumologischen Frührehabilitation sind bei Aufnahme schwer kompromittiert, es lässt sich aber eine sehr gute Ergebnisqualität erzielen, die unabhängig davon zu sein scheint, ob der Patient eigenständig atmet oder mittels nicht-invasiver oder invasiver Beatmung versorgt wird. Die weitere Disposition dieser Patienten ist vor allem dann schwierig, wenn eine Beatmung vorliegt.
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Affiliation(s)
- D Dellweg
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie I
| | - K Siemon
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie I
| | - E Höhn
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie I
| | - T Barchfeld
- Klinikum Westfalen, Knappschaftskrankenhaus Dortmund; Medizinische Klinik 2
| | - D Köhler
- Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie I
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2
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Fomenko A, Siemon K, Hykel P, Breuer R, Haidl P. Endobronchiales Chondrohamartom. Pneumologie 2018. [DOI: 10.1055/s-0037-1619201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Fomenko
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
| | - K Siemon
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
| | - P Hykel
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
| | - R Breuer
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
| | - P Haidl
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
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Hardebusch T, Reißig K, Siemon K, Heyse D, Dellweg D, Haidl P. Spontane intercostale Hernie mt Weichteilemphysem. Pneumologie 2018. [DOI: 10.1055/s-0037-1619388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - K Reißig
- Fachkrankenhaus Kloster Grafschaft GmbH
| | - K Siemon
- Fachkrankenhaus Kloster Grafschaft GmbH
| | - D Heyse
- Fachkrankenhaus Kloster Grafschaft GmbH
| | - D Dellweg
- Pneumologie, Krankenhaus Kloster Grafschaft GmbH
| | - P Haidl
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH
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Siemon K, Maltais F, O'Donnell DE, Hamilton A, Zhao Y, Casaburi R. Comparative Measurement Properties of Constant Work-Rate Cycling and Endurance Shuttle Walking in Patients with COPD: Data from the TORRACTO Study. Pneumologie 2018. [DOI: 10.1055/s-0037-1619357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Siemon
- Pneumologie, Fachkrankenhaus Kloster Grafschaft, Schmallenberg
| | - F Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Universite Laval, Quebec, Qc, Canada
| | - DE O'Donnell
- Queen's University and 1 2 Kingston General Hospital, Kingston, ON, Canada
| | - A Hamilton
- Boehringer Ingelheim, Burlington, ON, Canada
| | - Y Zhao
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT
| | - R Casaburi
- Los Angeles Biomedical Research Institute at Harbor-Ucla Medical Center, Torrance, CA, USA
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Windisch W, Dreher M, Geiseler J, Siemon K, Brambring J, Dellweg D, Grolle B, Hirschfeld S, Köhnlein T, Mellies U, Rosseau S, Schönhofer B, Schucher B, Schütz A, Sitter H, Stieglitz S, Storre J, Winterholler M, Young P, Walterspacher S. [Guidelines for Non-Invasive and Invasive Home Mechanical Ventilation for Treatment of Chronic Respiratory Failure - Update 2017]. Pneumologie 2017; 71:722-795. [PMID: 29139100 DOI: 10.1055/s-0043-118040] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published. Thereby, the existing chapters, namely technical issues, organizational structures in Germany, qualification criteria, disease specific recommendations including special features in pediatrics as well as ethical aspects and palliative care, have been updated according to the current literature and the health care developments in Germany. New chapters added to the guidelines include the topics of home mechanical ventilation in paraplegic patients and in those with failure of prolonged weaning.In the current guidelines different societies as well as professional and expert associations have been involved when compared to the 2010 guidelines. Importantly, disease-specific aspects are now covered by the German Interdisciplinary Society of Home Mechanical Ventilation (DIGAB). In addition, societies and associations directly involved in the care of patients receiving home mechanical ventilation have been included in the current process. Importantly, associations responsible for decisions on costs in the health care system and patient organizations have now been involved.The currently updated guidelines are valid for the next three years, following their first online publication on the home page of the Association of the Scientific Medical Societies in German (AWMF) in the beginning of July 2017. A subsequent revision of the guidelines remains the aim for the future.
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Affiliation(s)
- W Windisch
- Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln.,Universität Witten/Herdecke, Fakultät für Gesundheit/Department für Humanmedizin
| | - M Dreher
- Medizinische Klinik I - Sektion Pneumologie, Universitätsklinikum Aachen, Aachen
| | - J Geiseler
- Medizinische Klinik IV, Paracelsus-Klinik Marl, Marl
| | - K Siemon
- Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
| | - J Brambring
- Heimbeatmungsservice Brambring Jaschke GmbH, Unterhaching
| | - D Dellweg
- Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg
| | - B Grolle
- Lufthafen, AKK Altonaer Kinderkrankenhaus gGmbH, Hamburg
| | - S Hirschfeld
- Querschnittgelähmtenzentrum, Berufsgenossenschaftliches Unfallkrankenhaus Hamburg, Hamburg
| | - T Köhnlein
- Klinik für Pneumologie und Intensivmedizin, Klinikum St. Georg, Leipzig
| | - U Mellies
- Klinik für Kinderheilkunde III, Universitätsklinikum Essen, Essen
| | - S Rosseau
- Pneumologisches Beatmungszentrum, Ernst von Bergmann Klinik gGmbH, Bad Belzig
| | - B Schönhofer
- Klinik für Pneumologie, KRH Klinikum Siloah-Oststadt-Heidehaus, Hannover
| | - B Schucher
- Zentrum für Pneumologie und Thoraxchirurgie, Krankenhaus Großhansdorf, Großhansdorf
| | | | - H Sitter
- Institut für theoretische Chirurgie, Universitätsklinikum Giessen und Marburg GmbH, Marburg
| | - S Stieglitz
- Medizinische Klinik I, Petrus Krankenhaus, Wuppertal
| | - J Storre
- Intensiv-, Schlaf- und Beatmungsmedizin, Asklepios Fachkliniken München-Gauting, Gauting.,Klinik für Pneumologie, Universitätsklinikum Freiburg, Freiburg i. Br
| | - M Winterholler
- Klinik für Neurologie, Krankenhaus Rummelsberg gGmbH, Schwarzenbruck
| | - P Young
- Klinik für Schlafmedizin und neuromuskuläre Erkrankungen, Universitätsklinikum Münster, Münster.,Klinik für Beatmungs- und Schlafmedizin, Clemenshospital Münster, Münster
| | - S Walterspacher
- Universität Witten/Herdecke, Fakultät für Gesundheit/Department für Humanmedizin.,II. Medizinische Klinik, Klinikum Konstanz, Konstanz
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Siemon K, Hykel P, Gridina I, Haidl P. Miliarisierung bei M. bovis bei einem Patienten mit myelodysplastischem Syndrom. Pneumologie 2017. [DOI: 10.1055/s-0037-1598494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K Siemon
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH
| | - P Hykel
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH
| | - I Gridina
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH
| | - P Haidl
- Abt. Pneumologie II, Fachkrankenhaus Kloster Grafschaft GmbH
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Hardebusch T, Siemon K, Böckling S, Berndt C, Dellweg D, Straßmann SE. Schwieriges Weaning bei rezidivierenden Haemoptysen/Haemoptoe bei Mitralklappen-Sehnenfadenabriß. Pneumologie 2017. [DOI: 10.1055/s-0037-1598357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - K Siemon
- Fachkrankenhaus Kloster Grafschaft GmbH
| | | | - C Berndt
- Abt. für Kardiologie, Fachkrankenhaus Kloster Grafschaft GmbH
| | - D Dellweg
- Pneumologie, Krankenhaus Kloster Grafschaft GmbH
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Heyse DC, Böckling S, Dellweg D, Siemon K, Köhler D, Barchfeld T, Höhn E. Vorbeatmungszeit, Verwirrtheit, Bicarbonat und Dauer des ersten Spontanatmungsversuches nach Übernahme von Patienten im prolongierten Weaning bestimmen hauptsächlich die Weaningzeit. Pneumologie 2015. [DOI: 10.1055/s-0035-1544597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Böckling S, Heyse DC, Siemon K, Schürholz G, Höhn E, Spiekermann D, Schauerte S, Dellweg D, Köhler D. Tubusentfernung oder stabile Eigenatmung (incl. NIV). Welche Weaningdefinition korreliert besser mit den pathophysiologischen Parametern? Pneumologie 2015. [DOI: 10.1055/s-0035-1544596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Böckling S, Heyse D, Siemon K, Höhn E, Schauerte S, Schuerholz G, Spiekermann D, Dellweg D, Köhler D. Kontrollierte Beatmung senkt die Sauerstoffaufnahme (V'O2) und erhöht die Kohlendioxidabgabe (V'CO2) im Vergleich zur Spontanatmung bei Patienten im prolongiertem Weaning. Pneumologie 2015. [DOI: 10.1055/s-0035-1544884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Siemon K, Graw W, Höhn E, Barchfeld T, Schönhofer B, Köhler D, Dellweg D. Frührehabilitation nach Langzeitbeatmung – Ergebnisse einer Modelleinrichtung. Pneumologie 2015. [DOI: 10.1055/s-0035-1544888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Heyse D, Schürholz G, Böckling S, Siemon K, Dellweg D. Technische Aspekte der Beatmungsmedizin. Pneumologie 2014; 68:811-8; quiz 819-20. [DOI: 10.1055/s-0034-1378072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- D. Heyse
- Klinik für Pneumologie, Krankenhaus Kloster Grafschaft, Schmallenberg
| | - G. Schürholz
- Klinik für Pneumologie, Krankenhaus Kloster Grafschaft, Schmallenberg
| | - S. Böckling
- Klinik für Pneumologie, Krankenhaus Kloster Grafschaft, Schmallenberg
| | - K. Siemon
- Klinik für Pneumologie, Krankenhaus Kloster Grafschaft, Schmallenberg
| | - D. Dellweg
- Klinik für Pneumologie, Krankenhaus Kloster Grafschaft, Schmallenberg
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Al-Kharouf A, Sarma N, Höhn E, Siemon K, Haidl P, Köhler D, Dellweg D. CO2 Rückatmung in den Atemschlauch unter NIV – gefährden wir unsere Patienten? Pneumologie 2014. [DOI: 10.1055/s-0034-1368062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
An overview on the status and function of current spectrometry hardware, of detectors having energy-dispersive (spectrometric) properties as well as of the latest developments in quantitative spectrometry software is presented. Making extensive use of modern computing power, new strategies in high-precision spectrum analysis have been developed which enhance the quality of results and also open new fields of spectrometric applications. Three principles have been newly introduced to spectrum analysis software:
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Dellweg D, Gerhard F, Hoehn E, Brambring J, Grimm M, Bick S, Laier-Groeneveld G, Siemon K, Rosseau S, Windisch W. [Survey of nursing services with regard to mechanical ventilation at home]. Pneumologie 2011; 65:685-91. [PMID: 22006412 DOI: 10.1055/s-0030-1256806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Homecare for mechanically ventilated patients is complex and challenging for homecare institutions. The framework conditions of homecare are regulated by a likewise complex social legislation. The German Respiratory Society (DGP) and the German Interdisciplinary Society for Home Care Ventilation (DIGAB) have published recommendations on the structure of homecare for ventilated patients in their recent guideline and recommended a certification of homecare nursing services. RATIONALE Prior to a certification process, the homecare task force of the DIGAB conducted a survey in order to compare the current structures with the guideline recommendations. METHODS Voluntary disclosure of information by means of a written questionnaire consisting of eleven items was requested. RESULTS 37 homecare institutions with a total of 78 subsidiaries providing service all over Germany returned their questionnaires. While educational standards are mostly in line with the guideline recommendation, it was found that only 43 % of 812 recorded patients followed up with a specialised weaning centre or centre for ventilation. 84 % of these patients were ventilated invasively. In spite of the fact that all homecare institutions took care of invasively ventilated patients, there was a lack of company-owned standards for specific nursing measures. CONCLUSIONS Homecare for ventilated patients in Germany has reached a decent degree of organisation, while follow-up with specialised centres for ventilation, and with that medical specialist care appears to be underserved. The certification process for homecare institutions should be pursued with emphasis in order to create uniform quality standards. The number of invasively ventilated patients in homecare settings is probably higher than previously estimated and could be the result of a lack of weaning capacity.
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Affiliation(s)
- D Dellweg
- Arbeitsgruppe Pflegedienste der Deutschen interdisziplinären Gesellschaft für außerklinische Beatmung.
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Ay M, Siemon K, Haidl P, Köhler D. Lungenödem und Mediastinalemphysem als Folge einer Intubationsnarkose. Pneumologie 2011. [DOI: 10.1055/s-0031-1272267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dellweg D, Gerhard F, Höhn E, Laier-Groeneveld G, Siemon K, Windisch W, Brambring J. Struktur deutscher Pflegedienste in der Betreuung von beatmeten Patienten. Pneumologie 2011. [DOI: 10.1055/s-0031-1272019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Barchfeld T, Dellweg D, Siemon K, Köhler D. Therapiebegrenzung und -rückzug am Lebensende bei invasiv beatmeten Patienten; Daten aus einem großen Weaningzentrum. Pneumologie 2011. [DOI: 10.1055/s-0031-1272016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Windisch W, Walterspacher S, Siemon K, Geiseler J, Sitter H. Guidelines for Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure. Pneumologie 2010; 64:640-52. [PMID: 20799159 DOI: 10.1055/s-0030-1255558] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Windisch W, Brambring J, Budweiser S, Dellweg D, Geiseler J, Gerhard F, Köhnlein T, Mellies U, Schönhofer B, Schucher B, Siemon K, Walterspacher S, Winterholler M, Sitter H. Nichtinvasive und invasive Beatmung als Therapie der chronischen respiratorischen Insuffizienz. Pneumologie 2010; 64:207-40. [DOI: 10.1055/s-0029-1243978] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Barchfeld T, Dellweg D, Siemon K, Conze S, Klauke M, Köhler D. Entwicklung der Ergebnisqualität eines Weaningzentrums vor und nach Einführung der Frührehabilitation nach Langzeitbeatmung. Pneumologie 2010. [DOI: 10.1055/s-0030-1251200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siemon K, Kolokowski T, Haidl P, Köhler D. Pflege außer Atem – Erhebung der Arbeitsbelastung in einer Lungenfachklinik. Pneumologie 2010. [DOI: 10.1055/s-0030-1251252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siemon K, Ay M, Reissig K, Haidl P, Köhler D. Volumenreduktion durch nichtinvasive Beatmung. Pneumologie 2010. [DOI: 10.1055/s-0030-1251201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siemon K, Reissig K, Ay M, Haidl P, Köhler D. Nocardiose unter langjähriger oraler Steroideinnahme bei schwer einstellbarem allergischen Asthma bronchiale. Pneumologie 2010. [DOI: 10.1055/s-0030-1251328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Heyse D, Dellweg D, Siemon K, Haidl P, Köhler D, Riffelmann F. Exogen allergische Alveolitis versus opportunistische Pneumonie. Pneumologie 2010. [DOI: 10.1055/s-0030-1251155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siemon K, Ay M, Barchfeld T, Dellweg D, Heyse D, Haidl P, Köhler D. Erschwerte Diagnostik eines Wirbelkörperabszeß bei zusätzlich ausgeprägter beinbetonter Critical Illness Polyneuropathie – ein Fallbericht. Pneumologie 2009. [DOI: 10.1055/s-0029-1213876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Schulbert M, Kerl J, Köhler D. Vergleich identischer Beatmungsgeräte desselben Herstellers in Bezug auf abgegebenen Druck und Tidalvolumen an einem Lungenmodell. Pneumologie 2009. [DOI: 10.1055/s-0029-1214124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Westhoff M, Stanzel F, Siemon K, Lang W, Holinka G. Karzinosarkom der Trachea. Pneumologie 2009. [DOI: 10.1055/s-0029-1214038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dellweg D, Heyse D, Siemon K, Barchfeld T, Köhler D. Kontrollierte auto-adaptive nicht-invasive Beatmung – erste Erfahrungswerte aus der Praxis. Pneumologie 2009. [DOI: 10.1055/s-0029-1213822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Körber D, Barchfeld T, Dellweg D, Köhler D, Westhoff M. Beatmungspflichtigkeit – schwieriges Weaning bei unentdecktem trachealem Tumorein – ein Fallbericht. Pneumologie 2009. [DOI: 10.1055/s-0029-1213823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dellweg D, Siemon K, Mahler F, Appelhans P, Klauke M, Köhler D. Spiroergometrische Leistungsdiagnostik vor und nach Blutspende. Pneumologie 2008; 62:372-7. [DOI: 10.1055/s-2008-1038181] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Siemon K, Rüther U, Böckling S, Dellweg D, Wenzel M, Haidl P, Köhler D. Hyperkapnie nach ambulantem Gerätetausch. Pneumologie 2008. [DOI: 10.1055/s-2008-1074387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Kerl J, Rüther U, Ay M, Wenzel M, Dellweg D, Köhler D. Hyperkapnie trotz identischer Beatmungsform. Vergleich zweier Beatmungsgeräte. Pneumologie 2008. [DOI: 10.1055/s-2008-1074388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Haidl P, Clement C, Köhler D. Inhalation unter nichtinvasiver Beatmung ermöglicht kaum pulmonale Deposition. Pneumologie 2008. [DOI: 10.1055/s-2008-1074088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Barchfeld T, Silberg B, Heinz M, Höhn E, Dellweg D, Haidl P, Köhler D. Lässt sich bei Frührehapatienten nach Langzeitbeatmung die 6min Wegstrecke bei Entlassung durch Funktionsuntersuchungen in Ruhe abschätzen? Pneumologie 2007. [DOI: 10.1055/s-2007-973186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Barchfeld T, Appelhans P, Heller D, Dellweg D, Haidl P, Köhler D. Funktionelle Verbesserung einer inoperablen Thoraxinstabilität durch Vakuumfixation; ein Fallbericht. Pneumologie 2007. [DOI: 10.1055/s-2007-973323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Barchfeld T, Cersovsky A, Winterkamp S, Dellweg D, Wenzel M, Köhler D. Frührehabilitation nach Langzeitbeatmung. Evaluation nach 18 Monaten. Pneumologie 2007. [DOI: 10.1055/s-2007-973393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siemon K, Barchfeld T, Haidl P, Stieglitz S, Herling S, Köhler D. Hat die Lokalanästhesie mit Acoin® Einfluss auf das bronchoskopisch gewonnene Keimspektrum? Pneumologie 2006. [DOI: 10.1055/s-2006-933853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siemon K, Gessenhardt F, Haidl P, Köhler D. Hat die Messung der mucociliären Clearance einen Einfluss auf unsere Therapie? Pneumologie 2006. [DOI: 10.1055/s-2006-934050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Siemon K, Barchfeld T, Cersovsky A, Haidl P, Köhler D. Frührehabilitation nach Langzeitbeatmung. Eine sinnvolle Einrichtung nach „erfolgreichem“ Weaning! Pneumologie 2006. [DOI: 10.1055/s-2006-934043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
The aim of the present study was to test the influence of inhaled isotonic Ems salt (brine from the spa of Bad Ems, Germany) compared to isotonic saline on radioaerosol clearance (RC) in patients with chronic cough. Ems salt is an alkaline solution (pH 8.0-9.0) containing largely bicarbonate ions rather than the chloride ions present in isotonic saline (pH 6.4). RC was assessed with a radioaerosol technique using technetium-99m albumin in supine patients. After a 30-min baseline measurement of RC according to a single blind and randomized design, patients inhaled Ems salt (n=22, 20-77 yrs) or isotonic saline (n=21, 34-72 yrs) via a jet nebulizer (Pari Boy) for 10 min and were scanned for an additional 30 min. There was no difference between the two groups before intervention in terms of deposition pattern, lung function and baseline RC rate. After inhalation of Ems salt, the RC rate (1/tau) improved significantly from 0.15+/-0.14 (mean+/-SD) to 0.53+/-0.70 L.h(-1) (p<0.005); no change was found after isotonic saline (0.13+/-0.13 to 0.08+/-0.09 L.h(-1), NS). Voluntary coughs performed after 60 min had no effect on the RC rate. However, in the Ems salt group, significantly more patients reported an inhalation induced cough. Compared to the Ems salt patients, who did not cough during and after inhalation, the RC rate in the cough group was enhanced significantly (0.10+/-0.12 versus 0.73+/-0.83, p=0.017), this effect being seen more frequently in females (p=0.003). It is concluded that Ems salt improves radioaerosol clearance significantly in patients with chronic cough. The underlying mechanism, regarding whether induced cough, increased water content in the mucus or enhanced ciliary beat frequency is the leading cause of Ems salt action, remains unclear.
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Affiliation(s)
- P Haidl
- Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, Schmallenberg, Germany
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Wenzel M, Schönhofer B, Siemon K, Köhler D. [Nasal strips without effect on obstructive sleep apnea and snoring]. Pneumologie 1997; 51:1108-10. [PMID: 9487771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recently a nose plaster (NP, Breathe-Right) has been increasingly used in the treatment of obstructive sleep apnoea (OSA) and snoring. Hence, we examined the use of the NP as a treatment of both OSA and snoring without OSA. The NP has a elastic spine that increases the diameter of the nostril and is thought to reduce the degree of OSA and snoring. According to the polysomnographic data two groups were differentiated: Group A (30 patients with OSA, apnoea index > 10/h, 26 men) and Group B (20 snorers, without OSA, 13 men). After the diagnostic polysomnography the efficacy of the NP was measured with a cardiorespiratory polygraph on the 2 following nights. In the group A the polygraphic data (apnoea index, time of apneas, desaturation index, time of desaturations, mean and nadir SaO2) were studied; in group B the snoring index (snoring events/hour) was measured. A questionnaire scored quality of sleeping, daytime condition and the quality of nose breathing. In neither group were the recorded polygraphic findings different with the NP although with the NP an improved nose breathing was scored in both groups. In group A 90% of the patients scored the daytime sleepiness unchanged and 10 of 30 patients described an improved quality of sleep. In group B there was no change in the frequency of snoring events with the NP. Neither the degree of OSA nor of snoring without OSA were changed by the NP, which can therefore not be considered a treatment of these conditions. However, the majority of the study population were impressed by the symptomatic improvement in nose breathing.
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Affiliation(s)
- M Wenzel
- Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, Schmallenberg-Grafschaft
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Schönhofer B, Wenzel M, Barchfeld T, Siemon K, Rager H, Köhler D. [Value of various intra- and extraoral therapeutic procedures for treatment of obstructive sleep apnea and snoring]. Med Klin (Munich) 1997; 92:167-74. [PMID: 9173209 DOI: 10.1007/bf03043275] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recently intra- and extraoral devices are increasingly used in order to treat obstructive sleep apnea (OSA) and snoring. We examined the value of some devices according to the literature and our own results. PATIENTS AND METHODS The mandibular advancing devices aim at increasing upper airway diameter. The active part of the tongue extending device (SnorEx) is a stamp connected to a piston which exerts pressure at the base of the tongue causing its forward displacement; we studied 23 patients. The principle of an optically stimulating system ("eye-cover", Snore-Stop) consists of a microphone and light diods which are integrated in the eye-cover. After detecting acoustic signals (for example snoring) optical stimuli are generated in front of the eyes, which are thought to induce arousals causing a change of body position and the reduction of the snoring and apneas; we measured 24 patients. The principle of the tongue-retainer (Snore-Master) is the fixation of the tongue in a ventral position, which is thought to enlarge the mesopharyngeal area; we studied 14 patients. The nose plaster (Breathe-Right) contains an elastic spine that pulls the alae nasi cranial. This manipulation is thought to increase the diameter of the nostril and reduce the airway resistance. We measured 30 patients with obstructive sleep apnea and 20 snoring subjects without obstructive sleep apnea. RESULTS Regarding the mandibular advancing due to different appliance designs and study protocols variable success rates have been documented. In patients with mild to moderate obstructive sleep apnea a reduction of the sleep related breathing disorder could be shown. Non compliance (NC) to the tongue extending device was 75% (17/23). Non-compliance-patients were characterized by unacceptable local-side-effects of the prosthesis, lacking improvement of symptoms and of the respiratory disturbance index. Both tongue-retainer and -extensor are characterized by a high incidence of local side effects. Neither the eye-cover nor the nose plaster could improve the severity of obstructive sleep apnoe or snoring. In contrast to another study we could not show a significant effect of the tongue-retainer. CONCLUSIONS Neither the nose plaster nor the optical stimulating device influenced the degree of obstructive sleep apnea and snoring. There are conflicting data regarding the tongue retainer. The high rate of non-compliant subjects and the low efficacy of the tongue extending prosthesis precludes large-scale use of this treatment modality in patients with obstructive sleep apnoe and snoring. In selected individuals suffering from a mild to moderate degree of obstructive sleep apnea with CPAP-inefficiency and -incompliance the mandibular advancing principle may be an therapeutic alternative to CPAP.
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Affiliation(s)
- B Schönhofer
- Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, Schmallenberg-Grafschaft
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Siemon K, Esterlund R, Van Aarle J, Knaack M, Westmeier W, Patzelt P. A new measurement of the gamma-ray intensities of 234mPa accompanying the decay of 238U. ACTA ACUST UNITED AC 1992. [DOI: 10.1016/0883-2889(92)90149-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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