Subscribe to RSS
DOI: 10.1055/a-2238-4253
Task Force Dyspnoe Unit (DU)
Task Force Dyspnoe unit (DU)Zusammenfassung
Die akut aufgetretene Dyspnoe ist eines der häufigsten internistischen Symptome in der Notaufnahme. Sie entsteht bei einer akuten Erkrankung oder aus der Exazerbation einer chronischen Erkrankung heraus. Für die Leitsymptome des akuten Schlaganfalls sowie bei akutem Brustschmerz existieren mit den Stroke und Chest Pain Units bereits symptombezogene Notfallstrukturen und entsprechende Strukturvorgaben. Diese fehlen in Deutschland für das Leitsymptom Dyspnoe, obwohl in anderen Ländern der Nutzen dieser Strukturen bereits bewiesen wurde. Die Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin hat nun zusammen mit dem Verband Pneumologischer Kliniken eine Task Force ins Leben gerufen, deren Aufgabe es ist, sich mit dem Thema auseinanderzusetzten und entsprechende Strukturvorgaben solcher „Dyspnoe Units“ für Deutschland zu erarbeiten. Am Ende des Prozesses steht fakultativ die Zertifizierung derartiger Einheiten an deutschen Krankenhäusern.
Abstract
Acute dyspnoea is one of the most common internal medicine symptoms in the emergency department. It arises from an acute illness or from the exacerbation of a chronic illness. Symptom-related emergency structures and corresponding structural guidelines already exist in the stroke and chest pain units for dealing with the leading symptoms of acute stroke and acute chest pain. These are lacking in Germany for the key symptom of dyspnoea, although the benefits of these structures have already been proven in other countries. The German Society for Pneumology and Respiratory Medicine (DGP) has now set up a task force together with the Association of Pneumology Clinics (VPK), in order to deal with the topic and develop appropriate structural guidelines for such “dyspnoea units” in Germany. At the end of the process, the certification of such units at German hospitals is optional.
Publication History
Received: 10 December 2023
Accepted after revision: 03 January 2024
Article published online:
21 February 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Hartl S, Lopez-Campos JL, Pozo-Rodriguez F. et al. Risk of death and readmission of hospital-admitted COPD exacerbations: European COPD Audit. Eur Respir J 2016; 47: 113-121 DOI: 10.1183/13993003.01391-2014. (PMID: 26493806)
- 2 Jayadev A, Stone R, Steiner MC. et al. Time to NIV and mortality in AECOPD hospital admissions: an observational study into real world insights from National COPD Audits. BMJ Open Resp Res 2019; 6: 444 DOI: 10.1136/bmjresp-2019-000444.
- 3 Scquizzato T, Imbriaco G, Moro F. et al. Non-Invasive Ventilation in the Prehospital Emergency Setting: A Systematic Review and Meta-Analysis. Prehospital Emerg care 2023; 27: 566-574 DOI: 10.1080/10903127.2022.2086331. (PMID: 35695184)
- 4 Ram F, Picot J, Lightowler J. et al. Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane database Syst Rev 2004; 01: CD004104 DOI: 10.1002/14651858.CD004104.PUB2.
- 5 Drummond J, Rowe B, Cheung L. et al. The use of noninvasive mechanical ventilation for the treatment of acute exacerbations of chronic obstructive pulmonary disease in Canada. Can Respir J 2005; 12: 129-133 DOI: 10.1155/2005/714792. (PMID: 15875063)
- 6 Maheshwari V, Paioli D, Rothaar R. et al. Utilization of noninvasive ventilation in acute care hospitals: a regional survey. Chest 2006; 129: 1226-1233 DOI: 10.1378/CHEST.129.5.1226. (PMID: 16685013)
- 7 Kvale PA, Conway WA, Coates EO. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Nocturnal Oxygen Therapy Trial Group. Ann Intern Med 1980; 93: 391-398 DOI: 10.7326/0003-4819-93-3-391.
- 8 Austin MA, Wills KE, Blizzard L. et al. Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: randomised controlled trial. BMJ 2010; 341: 927 DOI: 10.1136/BMJ.C5462. (PMID: 20959284)
- 9 Burkhardt R, Pankow W. The diagnosis of chronic obstructive pulmonary disease. Dtsch Arztebl Int 2014; 111: 834-846 DOI: 10.3238/ARZTEBL.2014.0834. (PMID: 25556602)
- 10 COPD – International Respiratory Coalition (IRC). Accessed October 22, 2023 at: https://international-respiratory-coalition.org/diseases/copd/
- 11 Welte T. Acute exacerbation in COPD: we must do more. Eur Respir J 2016; 47: 14-15 DOI: 10.1183/13993003.01981-2015. (PMID: 26721956)
- 12 Lane ND, Brewin K, Hartley TM. et al. Specialist emergency care and COPD outcomes. BMJ Open Respir Res 2018; 5: e000334 DOI: 10.1136/BMJRESP-2018-000334. (PMID: 30397485)
- 13 Wardlaw JM, Murray V, Berge E. et al. Thrombolysis for acute ischaemic stroke. Cochrane database Syst Rev 2014; 2014: CD000213 DOI: 10.1002/14651858.CD000213.PUB3. (PMID: 25072528)
- 14 Saver JL, Gornbein J, Grotta J. et al. Number needed to treat to benefit and to harm for intravenous tissue plasminogen activator therapy in the 3- to 4.5-hour window Joint outcome table analysis of the ECASS 3 trial. Stroke 2009; 40: 2433-2437 DOI: 10.1161/STROKEAHA.108.543561.
- 15 Langhorne P. Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev 2013; 2013: CD000197 DOI: 10.1002/14651858.CD000197.PUB3. (PMID: 32324916)
- 16 Ringelstein EB, Müller-Jensen A, Nabavi DG. et al. Erweiterte stroke-unit. Nervenarzt 2011; 82: 778-784 DOI: 10.1007/S00115-011-3247-1/METRICS.
- 17 Keller T, Post F, Tzikas S. et al. Improved outcome in acute coronary syndrome by establishing a chest pain unit. Clin Res Cardiol 2010; 99: 149-155 DOI: 10.1007/S00392-009-0099-9/METRICS. (PMID: 20033695)
- 18 Vafaie M, Hochadel M, Münzel T. et al. Guideline-adherence regarding critical time intervals in the German Chest Pain Unit registry. Eur Heart J Acute Cardiovasc Care 2020; 9: 52-61 DOI: 10.1177/2048872618762639.
- 19 Abidov A, Rozanski A, Hachamovitch R. et al. Prognostic Significance of Dyspnea in Patients Referred for Cardiac Stress Testing. N Engl J Med 2005; 353: 1889-1898 DOI: 10.1056/NEJMOA042741. (PMID: 16267320)
- 20 Kowalski C, Ferencz J, Ukena D. et al. Quality of Care in Certified Lung Cancer Centers. Pneumologie 2015; 69: 329-334 DOI: 10.1055/S-0034-1391776. (PMID: 25822008)
- 21 Schönhofer B, Geiseler J, Pfeifer M. et al. WeanNet: a network of weaning units headed by pneumologists. Pneumologie 2014; 68: 737-742 DOI: 10.1055/S-0034-1377956. (PMID: 25295778)
- 22 Schönhofer B, Geiseler J, Herth F. et al. WeanNet: The network of weaning units of the DGP (Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin) – results to epidemiology an outcome in patients with prolonged weaning. Dtsch Med Wochenschr 2016; 141: e166-e172 DOI: 10.1055/S-0042-112345.