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2.
Pneumologie ; 74(6): 358-365, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32294763

RESUMO

The enormous increase in patients with severe respiratory distress due to the COVID-19 pandemic outbreak requires a systematic approach to optimize ventilated patient at risk flow. A standardised algorithm called "SAVE" was developed to distribute patients with COVID-19 respiratory distress syndrome requiring invasive ventilation. This program is established by now in Berlin. An instrumental bottleneck of this approach is the vacant slot assignment in the intensive care unit to guarantee constant patient flow. The transfer of the patients after acute care treatment is needed urgently to facilitate the weaning process. In a next step we developed a triage algorithm to identify patients at SAVE intensive care units with potential to wean and transfer to weaning institutions - we called POST SAVE. This manuscript highlights the algorithms including the use of a standardised digital evaluation tool, the use of trained navigators to facilitate the communication between SAVE intensive care units and weaning institutions and the establishment of a prospective data registry for patient assignment and reevaluation of the weaning potential in the future.


Assuntos
Unidades de Terapia Intensiva/organização & administração , Guias de Prática Clínica como Assunto , Desmame do Respirador , Berlim , Betacoronavirus , COVID-19 , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Surtos de Doenças/prevenção & controle , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estudos Prospectivos , SARS-CoV-2
3.
Pneumologie ; 70(5): 314-9, 2016 May.
Artigo em Alemão | MEDLINE | ID: mdl-26956576

RESUMO

BACKGROUND: In the process of medical rehabilitation muscular endurance training is the main focus. Unfortunately, outpatient rehabilitation opportunities are limited and specialized pulmonary exercise groups ("lung sport groups") rarely available. Therefore we developed an outpatient endurance sports program for patients with respiratory diseases and evaluated its effectiveness. METHODS: In this feasibility study 31 patients (50 ±â€Š15 years) with diverse respiratory diseases were included. By professional functional exercise testing (incl. CPET and lactate measurement according to the standards of DGP and DGSP) the patients optimal training zone was determined and an individualized 12 week lasting aerobic endurance training with ≥ 3 sessions of 20 - 60 min/week realized. RESULTS: After completion of the exercise training program a significant improvement in dyspnoea (Borg-Scale: 65.7 ±â€Š12.2 vs. 62.2 ±â€Š12.6, p = 0.013), body constitution (BMI: 25.7 ±â€Š3.3 vs. 24.3 ±â€Š3.2 kg/m(2), p = 0.018; portion of body fat: 24.8 ±â€Š5.8 vs. 23.8 ±â€Š6.4 %, p = 0.043) as well as physical capacity (VO2 at 4 mmol/l Laktat: 24.2 ±â€Š6.9 vs. 26.5 ±â€Š7.6 ml/min/kg, p < 0.01; performance at 4 mmol/l Laktat: running/walking (n = 14) + 1.1 km/h, p = 0.018 and biking/bicycle ergometer (n = 17) + 8.7 Watt, p = 0.019) was recorded. These positive developments were also observed in mental and physical quality of life (quality of life questionnaire SF-36: physical score + 9.7 points, mental score + 4.5 points). CONCLUSION: The evaluated exercise program can easily be trained by the patient in a self-dependent setting and was seen to be an effective sports medical treatment in patients with diverse pulmonary diseases.


Assuntos
Assistência Ambulatorial/métodos , Terapia por Exercício/métodos , Treinamento Intervalado de Alta Intensidade/métodos , Resistência Física , Transtornos Respiratórios/reabilitação , Esportes , Estudos de Viabilidade , Feminino , Humanos , Ácido Láctico/sangue , Masculino , Pessoa de Meia-Idade , Condicionamento Físico Humano/métodos , Pneumologia/métodos , Transtornos Respiratórios/sangue , Transtornos Respiratórios/diagnóstico , Testes de Função Respiratória , Autocuidado/métodos , Medicina Esportiva/métodos , Resultado do Tratamento
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