{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:32:42Z","timestamp":1740126762109,"version":"3.37.3"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"07","funder":[{"name":"VitalAire"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n            Hintergrund Unser Zentrum verfolgte bei der nicht-pharmakologischen Behandlung des Atemversagens bei COVID-19 in \u00dcbereinstimmung mit den deutschen nationalen Leitlinien einen schrittweisen Ansatz, bei dem die nicht-invasiven Ma\u00dfnahmen vor der invasiven mechanischen Beatmung (IMV) oder der extrakorporalen Membranoxygenierung (ECMO) eskaliert wurden. Das Ziel dieser Studie war, diesen individualisierten Ansatz der nicht-pharmakologischen Therapie im Hinblick auf die Patientencharakteristika und klinische Merkmale zu analysieren, die bei der Vorhersage einer schwereren Erkrankung \u2013 insbesondere einer erforderlichen intensivmedizinischen Behandlung \u2013 helfen k\u00f6nnen.\n    <\/jats:p><jats:p>\n            Methodik Diese retrospektive, monozentrische Studie an station\u00e4ren COVID-19-Patienten zwischen M\u00e4rz 2020 und Dezember 2021 analysierte anthropometrische Daten, nicht-pharmakologische Maximaltherapie und \u00dcberlebensstatus auf Basis der in den Patientenakten dokumentierten Daten.\n    <\/jats:p><jats:p>\n            Ergebnisse Von 1052 COVID-19-bedingten Einweisungen wurden 835 Patienten in die Analysekohorte aufgenommen (54% m\u00e4nnlich, Median 58 Jahre). 34% (n=284) erhielten keine Therapie, 40% (n=337) konventionelle Sauerstofftherapie (COT), 3% (n=22) High-Flow-Nasenkan\u00fcle (HFNC), 9% (n=73) kontinuierlichen Atemwegspositivdruck (CPAP), 7% (n=56) nicht-invasive Beatmung (NIV), 4% (n=34) invasive mechanische Ventilation (IMV) und 3% (n=29) extrakorporale Membranoxygenierung (ECMO) als maximale Therapie. Von 551 Patienten, die mindestens mit COT behandelt wurden, mussten 12,3% intubiert werden. Insgesamt mussten 183 Patienten auf der Intensivstation behandelt werden und 106 (13%) starben. 25 (74%) IMV-Patienten und 23 (79%) ECMO-Patienten verstarben. Verstorbene litten h\u00e4ufiger an arterieller Hypertonie, Demenz, Diabetes und Dyslipid\u00e4mie. Die logistische Regression zeigte folgende Risikofaktoren f\u00fcr die Sterblichkeit: eine Sauerstoffbedarf von \u22652 L\/min bei Studienbeginn (OR 6,96 [4,01\u201312,08]), Alter (OR 1,09 [1,05\u20131,14]) und m\u00e4nnliches Geschlecht (OR 2,23 [0,79\u20136,31]).\n    <\/jats:p><jats:p>\n            Schlussfolgerung Die unmittelbare klinische Entscheidung des Arztes f\u00fcr eine Sauerstofftherapie spielt neben anderen anerkannten Risikofaktoren eine wichtige Rolle bei der Vorhersage des Schweregrads des Krankheitsverlaufs und damit bei der Behandlung von COVID-19.\n    <\/jats:p>","DOI":"10.1055\/a-2235-6357","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T22:04:48Z","timestamp":1708553088000},"page":"515-525","source":"Crossref","is-referenced-by-count":0,"title":["Prognostische Faktoren bei einem schrittweisen Ansatz zur nicht-pharmakologischen Therapie von Sauerstoff und mechanischer Beatmung bis hin zur extrakorporalen Membranoxygenierung bei COVID-19"],"prefix":"10.1055","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5227-0112","authenticated-orcid":false,"given":"Sandhya","family":"Matthes","sequence":"first","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"},{"name":"Institut f\u00fcr Pneumologie an der Universit\u00e4t zu K\u00f6ln, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Holl","sequence":"first","affiliation":[{"name":"Institut f\u00fcr Pneumologie an der Universit\u00e4t zu K\u00f6ln, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Randerath","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pneumologie an der Universit\u00e4t zu K\u00f6ln, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Treml","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pneumologie an der Universit\u00e4t zu K\u00f6ln, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Sofianos","sequence":"additional","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Bockover","sequence":"additional","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Oesterlee","sequence":"additional","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Herkenrath","sequence":"additional","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Knoch","sequence":"additional","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Hagmeyer","sequence":"additional","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"},{"name":"Institut f\u00fcr Pneumologie an der Universit\u00e4t zu K\u00f6ln, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winfried","family":"Randerath","sequence":"additional","affiliation":[{"name":"Krankenhaus Bethanien gGmbH, Klinik f\u00fcr Pneumologie und Allergologie, Zentrum f\u00fcr Schlaf- und Beatmungsmedizin, Solingen, Deutschland"},{"name":"Institut f\u00fcr Pneumologie an der Universit\u00e4t zu K\u00f6ln, Solingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"F Zhou","year":"2020","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China","volume":"180","author":"C Wu","year":"2020","journal-title":"JAMA Intern Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1007\/s12016-022-08921-5","article-title":"Risk and Protective Factors for COVID-19 Morbidity, Severity, and Mortality","volume":"64","author":"J Zhang","year":"2022","journal-title":"Clinic Rev Allerg Immunol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/rmv.2146","article-title":"Predictors of COVID-19 severity: A literature review","volume":"31","author":"B Gallo Marin","year":"2021","journal-title":"Rev Med Virol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"100426","DOI":"10.1016\/j.eclinm.2020.100426","article-title":"Scoring systems for predicting mortality for severe patients with COVID-19","volume":"24","author":"Y Shang","year":"2020","journal-title":"eClinicalMedicine"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1186\/s12931-020-01429-6","article-title":"Impact of coronavirus disease 2019 on pulmonary function in early convalescence phase","volume":"21","author":"Y Huang","year":"2020","journal-title":"Respir Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2000524","DOI":"10.1183\/13993003.00524-2020","article-title":"Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study","volume":"55","author":"R-H Du","year":"2020","journal-title":"Eur Respir J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1016\/j.jiph.2023.05.027","article-title":"Risk factors for intensive care admission in patients with COVID-19 pneumonia: A retrospective study","volume":"16","author":"A Mobeireek","year":"2023","journal-title":"J Infect Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e28264","DOI":"10.1002\/jmv.28264","article-title":"A phenome-wide investigation of risk factors for severe COVID-19","volume":"95","author":"A Baranova","year":"2023","journal-title":"J Med Virol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1093\/ije\/dyad012","article-title":"Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19","volume":"52","author":"C Kartsonaki","year":"2023","journal-title":"Int J Epidemiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1007\/s10654-021-00722-y","article-title":"COVID-19 mortality in the UK Biobank cohort: revisiting and evaluating risk factors","volume":"36","author":"J Elliott","year":"2021","journal-title":"Eur J Epidemiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1055\/a-1157-9976","article-title":"Positionspapier zur praktischen Umsetzung der apparativen Differenzialtherapie der\n          akuten respiratorischen Insuffizienz bei COVID-19: Deutsche Gesellschaft f\u00fcr Pneumologie\n          und Beatmungsmedizin e.V. (DGP)","volume":"74","author":"M Pfeifer","year":"2020","journal-title":"Pneumologie"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.21037\/jtd-21-1713","article-title":"Clinical characteristics and determinants of mortality in coronavirus disease 2019 (COVID-19) patients on an intensive care unit \u2013 a retrospective explorative 1-year all-comers study","volume":"14","author":"W Br\u00fccker","year":"2022","journal-title":"J Thorac Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1159\/000533522","article-title":"Analysis of an Individualised Stepwise Approach to Non-Pharmacological Therapy in COVID-19","volume":"102","author":"S Matthes","year":"2023","journal-title":"Respiration"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"119","DOI":"10.7196\/AJTCCM.2022.v28i3.241","article-title":"The optimal management of the patient with COVID-19 pneumonia: HFNC, NIV\/CPAP or mechanical ventilation?","volume":"28","author":"AGB Broadhurst","year":"2022","journal-title":"Afr J Thoracic Crit Care Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.arbres.2023.01.009","article-title":"Effect of the Early Combination of Continuous Positive Airway Pressure and High-Flow Nasal Cannula on Mortality and Intubation Rates in Patients With COVID-19 and Acute Respiratory Distress Syndrome. The DUOCOVID Study","volume":"59","author":"JR Teran-Tinedo","year":"2023","journal-title":"Archivos de Bronconeumolog\u00eda"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1056\/NEJMoa2004500","article-title":"Covid-19 in Critically Ill Patients in the Seattle Region \u2014 Case Series","volume":"382","author":"PK Bhatraju","year":"2020","journal-title":"N Engl J Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1007\/s00103-013-1670-0","article-title":"Verbreitung von Fettstoffwechselst\u00f6rungen bei Erwachsenen in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)","volume":"56","author":"C Scheidt-Nave","year":"2013","journal-title":"Bundesgesundheitsbl"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s13054-021-03634-1","article-title":"Extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis","volume":"25","author":"K Ramanathan","year":"2021","journal-title":"Crit Care"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1164\/rccm.202105-1145LE","article-title":"High In-Hospital Mortality Rate in Patients with COVID-19 Receiving Extracorporeal Membrane Oxygenation in Germany: A Critical Analysis","volume":"204","author":"C Karagiannidis","year":"2021","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Pneumologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2235-6357.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:20:56Z","timestamp":1730802056000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2235-6357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,29]]},"references-count":20,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2024,7,19]]},"published-print":{"date-parts":[[2024,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2235-6357","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0934-8387","1438-8790"],"issn-type":[{"type":"print","value":"0934-8387"},{"type":"electronic","value":"1438-8790"}],"subject":[],"published":{"date-parts":[[2024,1,29]]}}}