{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T01:49:14Z","timestamp":1764812954976},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"19","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Hintergrund\u2002Die Zahl der Patienten, die im Verlauf einer intensivmedizinischen Behandlung von einer invasiven Beatmung entw\u00f6hnt werden m\u00fcssen, hat in den vergangenen Jahren stetig zugenommen. Ein Teil hiervon bleibt dauerhaft beatmet und muss im ambulanten Bereich betreut werden. Das Gros dieser Patienten ist allerdings nicht in einem erfahrenen Weaningzentrum behandelt worden. Es ist daher wahrscheinlich, dass noch \u201eWeaningpotenzial\u201c bei einem Teil der Patienten besteht.<\/jats:p><jats:p>Methoden\u2002Die AOK Hessen hat nach umfangreicher Analyse Ansatzpunkte zur Verbesserung dieser Situation entwickelt, die hier erstmalig vorgestellt werden. Als wesentlich wurden die fachliche Expertise der das Potenzial einsch\u00e4tzenden \u00c4rzte (Weanigerfahrung bzw. Weaningzentrum), die Option der tempor\u00e4ren Unterbringung der Patienten in den neu zu schaffenden Therapiezentren f\u00fcr au\u00dferklinische Beatmung (TAB) und die strukturierte ambulante Nachsorge erkannt.<\/jats:p><jats:p>Ergebnisse\u2002Bei den TAB handelt es sich um extrastation\u00e4re Einheiten, welche einem Weaningzentrum angeschlossen sind. Hier sollen Patienten in wohnlicher Atmosph\u00e4re betreut werden, bei denen es bisher nicht gelang, sie von der Invasivbeatmung zu entw\u00f6hnen. Der Fokus liegt dabei auf der t\u00e4glichen physiotherapeutischen und logop\u00e4dischen Arbeit. Hierf\u00fcr wird ein Zeitraum von bis zu 6 Monaten erm\u00f6glicht, in dem sich die muskul\u00e4re und kognitive Situation verbessern soll. Im Anschluss wird dann je nach Verlauf ein erneuter Weaningversuch im Weaningzentrum unternommen.<\/jats:p><jats:p>Diskussion\u2002Das Konzept wird im folgenden Artikel ausf\u00fchrlich beschrieben. Erste Erfahrungen zeigen den relevanten Stellenwert der TAB in der Entw\u00f6hnung von der Beatmung.<\/jats:p>","DOI":"10.1055\/a-1207-7731","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T22:47:35Z","timestamp":1599691655000},"page":"e108-e115","source":"Crossref","is-referenced-by-count":5,"title":["Vertrag zur prolongierten Beatmungsentw\u00f6hnung der AOK Hessen-Methodik und erste Erfahrungen"],"prefix":"10.1055","volume":"145","author":[{"given":"Dagmar","family":"Giese","sequence":"additional","affiliation":[{"name":"AOK Hessen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Blau","sequence":"additional","affiliation":[{"name":"Kliniken des Main-Taunus-Kreises, 65719 Hofheim"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Kn\u00fcppel","sequence":"additional","affiliation":[{"name":"Krankenhaus Bad Arolsen, 34454 Bad Arolsen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aggi","family":"Neumann-Schiebener","sequence":"additional","affiliation":[{"name":"Asklepios Stadtklinik Bad Wildungen, 34537\u00a0Bad\u00a0Wildungen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"G\u00fcnther","sequence":"additional","affiliation":[{"name":"Agaplesion pneumologische Klinik, 35753 Greifenstein"},{"name":"Bereich Pneumologie, Universit\u00e4tsmedizin G\u00f6ttingen, Deutsches Zentrum Lungenforschung (DZL)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Reinhardt","sequence":"additional","affiliation":[{"name":"Lungenfachklinik Immenhausen, 34376 Immenhausen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfram","family":"Windisch","sequence":"additional","affiliation":[{"name":"Kliniken der Stadt K\u00f6ln. Lehrstuhl f\u00fcr Pneumologie, Universit\u00e4t Witten\/Herdecke, 58448 Witten"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Andreas","sequence":"additional","affiliation":[{"name":"Lungenfachklinik Immenhausen, 34376 Immenhausen"},{"name":"Bereich Pneumologie, Universit\u00e4tsmedizin G\u00f6ttingen, Deutsches Zentrum Lungenforschung (DZL)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.1055\/a-0758-4512","article-title":"Epidemiologische Entwicklung der ausserklinischen Beatmung: Eine rasant zunehmende Herausforderung f\u00fcr die ambulante und station\u00e4re Patientenversorgung","volume":"144","author":"C Karagiannidis","year":"2019","journal-title":"Dtsch Med Wochenschr"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1055\/a-0828-9710","article-title":"WeanNet: Das Netzwerk pneumologischer Weaningzentren","volume":"73","author":"B Sch\u00f6nhofer","year":"2019","journal-title":"Pneumologie"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1055\/a-1010-8764","article-title":"Prolongiertes Weaning \u2013 S2k-Leitlinie herausgegeben von der deutschen Gesellschaft f\u00fcr Pneumologie und Beatmungsmedizin e.V","volume":"73","author":"B Sch\u00f6nhofer","year":"2019","journal-title":"Pneumologie"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1055\/a-0805-5284","article-title":"Explosive Zunahme der h\u00e4uslichen Krankenpflege bei Beatmeten und Tracheotomierten","volume":"144","author":"D K\u00f6hler","year":"2019","journal-title":"Dtsch Med Wochenschr"},{"key":"ref7","first-page":"A-2283","article-title":"Deutsches Gesundheitssystem: Hohe Kosten, durchschnittliche Ergebnisse","volume":"116","author":"H Korzilius","year":"2019","journal-title":"Dtsch Arztebl Int"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1164\/rccm.201806-1131OC","article-title":"Long-Term Outcome after Prolonged Mechanical Ventilation. 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