6 results on '"Lenka Krabbe"'
Search Results
2. Non-invasive ventilation with pursed lips breathing mode for patients with COPD and hypercapnic respiratory failure: A retrospective analysis.
- Author
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Christoph Jünger, Maja Reimann, Lenka Krabbe, Karoline I Gaede, Christoph Lange, Christian Herzmann, and Stephan Rüller
- Subjects
Medicine ,Science - Abstract
PurposeLong-term non-invasive ventilation (NIV) is recommended for patients with stable chronic obstructive lung disease (COPD) and chronic hypercapnia. High inspiratory pressure NIV (hiNIV) and a significant reduction of arterial pCO2 have been shown to prolong survival. Often, patients on hiNIV describe severe respiratory distress, known as "deventilation syndrome", after removal of the NIV mask in the morning. Mechanical pursed lips breathing ventilation (PLBV) is a new non-invasive ventilation mode that mimics the pressure-curve of pursed lips breathing during expiration. The clinical impact of switching patients from standard NIV to PLBV has not been studied so far.Patients and methodsIn this hypothesis generating study, we retrospectively analysed the effects of switching COPD patients (stage GOLD III-IV) from conventional NIV to PLBV. Medical records of all patients who had an established NIV and were switched to PLBV between March 2016 and October 2017 were screened. Patients were included if they complained of shortness of breath on mask removal, used their conventional NIV regularly, and had a documented complete diagnostic workup including lung function testing, blood gas analysis and 6-minute walk test (6MWT) before and after 3-7 days of PLBV.ResultsSix male and 10 female patients (median age 65.4 years; IQR 64.0-71.3) with a previous NIV treatment duration of 38 months (median; IQR 20-42) were analysed. After PLVB initiation, the median inspiratory ventilation pressure needed to maintain the capillary pre-switch pCO2 level was reduced from 19.5 mbar (IQR 16.0-26.0) to 13.8 mbar (IQR 12.5-14.9; pConclusionBased on this small retrospective analysis, we hypothesise that switching patients with COPD GOLD III-IV and chronic hypercapnia from conventional NIV to PLBV may increase exercise tolerance and FVC in the short term.
- Published
- 2020
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3. Relationship between clinical and radiological signs of bronchiectasis in COPD patients: Results from COSYCONET
- Author
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Kirsten Anne-Marie, Anne Wirz, Erich Traugott, Ficker Joachim H, Bertram J. Jobst, Vivien Janke, Stubbe Beate, Johanna I. Lutter, Barbara Ziss, Franziska C. Trudzinski, Patricia Berger, Henrik Watz, Gogol Manfred, Thomas Bahmer, Beate Polte, Kronsbein Juliane, Campus Kiel, Lange Christoph, Martina Seibert, Rudolf A. Jörres, Pfeifer Michael, Timmermann Hartmut, Grohé Christian, Tobias Welte, Studnicka Michael, Petra Hundack-Winter, Jana Graf, Jürgen Behr, Diana Schottel, Buhl Roland, Virchow J. Christian, Bewig Burkhard, Ruhrlandklinik gGmbH. Essen, Wirtz Hubert, Rosalie Untsch, Birte Struck, Peter Alter, Kathrin Kahnert, Gudrun Hübner, Vogelmeier Claus, Sabine Michalewski, Kropf-Sanchen Cornelia, Kenn Klaus, Pontus Mertsch, Sonja Rohweder, Hauck Rainer, Andreas Stefan, Ilona Kietzmann, Zabel Peter, Michaela Schrade-Illmann, Höffken Gerd, Julia Tobias, Frank Biertz, Seeger Werner, Manuel Klöser, Kahnert Kathrin, Teschler Helmut, Anita Reichel, Gina Spangel, Ulrike Rieber, Randerath Winfried J, Julia Teng, Tanja Lucke, Herth Felix, Jeanette Pieper, Lenka Krabbe, Taube Christian, Jürgen Biederer, Wagner Ulrich, Doris Lehnert, Claus Vogelmeier, Katrin Schwedler, Henke Markus, Jany Berthold, Katus Hugo A, Bals Robert, Zaklina Hinz, Cornelia Böckmann, Ellen Burmann, Margret Gleiniger, Behr Jürgen, Britta Markworth, Ewert Ralf, Gertraud Weiß, Katrin Wons, Barbara Arikan, Watz Henrik, Beate Schaufler, Lena Sterk, Robert Bals, Hans-Ulrich Kauczor, Koczulla Rembert, Held Matthias, and Welte Tobias
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Copd patients ,Medizin ,Comorbidity ,Severity of Illness Index ,Pulmonary Disease, Chronic Obstructive ,Medicine ,Humans ,In patient ,Lung ,Aged ,Aged, 80 and over ,COPD ,Bronchiectasis ,business.industry ,Phlegm ,Middle Aged ,medicine.disease ,Radiological weapon ,Clinical diagnosis ,Cohort ,Female ,Radiography, Thoracic ,Radiology ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
Bronchiectasis (BE) might be frequently present in COPD but masked by COPD symptoms. We studied the relationship of clinical signs of bronchiectasis to the presence and extent of its radiological signs in patients of different COPD severity. Visit 4 data (GOLD grades 1-4) of the COSYCONET cohort was used. Chest CT scans were evaluated for bronchiectasis in 6 lobes using a 3-point scale (0: absence, 1: ≤50%, 2: >50% BE-involvement for each lobe). 1176 patients were included (61%male, age 67.3y), among them 38 (3.2%) with reported physicians' diagnosis of bronchiectasis and 76 (6.5%) with alpha1-antitrypsin deficiency (AA1D). CT scans were obtained in 429 patients. Within this group, any signs of bronchiectasis were found in 46.6% of patients, whereby ≤50% BE occurred in 18.6% in ≤2 lobes, in 10.0% in 3-4 lobes, in 15.9% in 5-6 lobes; >50% bronchiectasis in at least 1 lobe was observed in 2.1%. Scores ≥4 correlated with an elevated ratio FRC/RV. The clinical diagnosis of bronchiectasis correlated with phlegm and cough and with radiological scores of at least 3, optimally ≥5. In COPD patients, clinical diagnosis and radiological signs of BE showed only weak correlations. Correlations became significant with increasing BE-severity implying radiological alterations in several lobes. This indicates the importance of reporting both presence and extent of bronchiectasis on CT. Further research is warranted to refine the criteria for CT scoring of bronchiectasis and to determine the relevance of radiologically but not clinically detectible bronchiectasis and their possible implications for therapy in COPD patients.
- Published
- 2020
4. CAT score single item analysis in patients with COPD: results from COSYCONET
- Author
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J. Randerath Winfried, Pfeifer Michael, Kenn Klaus, Joachim H. Ficker, Gogol Manfred, Grohé Christian, Höffken Gerd, Zaklina Hinz, Julia Tobias, Henke Markus, Teschler Helmut, Welte Tobias, Benjamin Waschki, Buhl Roland, Paul W. Jones, Kirsten Anne-Marie, A. Katus Hugo, Taube Christian, Bewig Burkhard, Beate Polte, Kronsbein Juliane, Stubbe Beate, Bals Robert, Johanna I. Lutter, Sarah Marietta von Siemens, Lange Christoph, Vogelmeier Claus, Ellen Burmann, Wirtz Hubert, Kathrin Kahnert, Erich Traugott, Behr Jürgen, Birte Struck, Vivien Janke, Lenka Krabbe, Timmermann Hartmut, Wagner Ulrich, Anita Reichel, Sabine Michalewski, Gudrun Hübner, Seeger Werner, Doris Lehnert, Jany Berthold, Kropf-Sanchen Cornelia, Sandra Söhler, Jeanette Pieper, Ulrike Rieber, Peter Alter, Herth Felix, Zabel Peter, Andreas Stefan, Koczulla Rembert, Held Matthias, Tobias Welte, Franziska C. Trudzinski, Patricia Berger, Kahnert Kathrin, Jana Graf, Jürgen Behr, Rosalie Untsch, Rudolf A. Jörres, Kornelia Speth, Britta Markworth, Ewert Ralf, Gertraud Weiß, Hans-Ulrich Kauczor, Claus Vogelmeier, Katrin Schwedler, Katrin Wons, Bertram J. Jobst, Barbara Arikan, Margret Gleiniger, Henrik Watz, Watz Henrik, Studnicka Michael, Beate Schaufler, Diana Schottel, Sonja Rohweder, Robert Bals, Ilona Kietzmann, Virchow J. Christian, Burkhard Bewig, Hauck Rainer, and Michaela Schrade-Illmann
- Subjects
Pulmonary and Respiratory Medicine ,Percentile ,medicine.medical_specialty ,Medizin ,Diagnostic Techniques, Respiratory System ,Single item ,CAT score ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Internal medicine ,medicine ,COPD ,In patient ,030212 general & internal medicine ,Lung function ,Emphysema ,business.industry ,Regression analysis ,Cat Score ,Copd ,medicine.disease ,Exploratory factor analysis ,respiratory tract diseases ,030228 respiratory system ,Cohort ,business - Abstract
The COPD Assessment Test (CAT) is in widespread use for the evaluation of patients with chronic obstructive pulmonary disease (COPD). We assessed whether the CAT items carry additional information beyond the sum score regarding COPD characteristics including emphysema. Patients of GOLD grades 1 to 4 from the COPD cohort COSYCONET (German COPD and Systemic Consequences - Comorbidities Network) with complete CAT data were included (n = 2270), of whom 493 had chest CT evaluated for the presence of emphysema. Comorbidities and lung function were assessed following standardised procedures. Cross-sectional data analysis was based on multiple regression analysis of the single CAT items against a panel of comorbidities, lung function, or CT characteristics (qualitative score, 15th percentile of mean lung density), with age, BMI and gender as covariates. This was supported by exploratory factor analysis. Regarding the relationship to comorbidities and emphysema, there were marked differences between CAT items, especially items 1 and 2 versus 3 to 8. This grouping was basically confirmed by factor analysis. Items 4 and 5, and to a lower degree 1, 2 and 6, appeared to be informative regarding the presence of emphysema, whereas the total score was not or less informative. Regarding comorbidities, similar findings as for the total CAT score were obtained for the modified Medical Research Council scale (mMRC) which was also informative regarding emphysema. Our findings suggest that the usefulness of the CAT can be increased if evaluated on the basis of single items which may be indicating the presence of comorbidities and emphysema.
- Published
- 2020
5. Mechanical non-invasive pursed-lip breathing ventilation for hypercapnic patients with COPD
- Author
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Christian Herzmann, Maja Reimann, Christoph Lange, Karoline I. Gaede, Christoph Jünger, Lenka Krabbe, and Stephan Rüller
- Subjects
COPD ,Respiratory distress ,business.industry ,Non invasive ,Pursed lip breathing ,medicine.disease ,pCO2 ,respiratory tract diseases ,FEV1/FVC ratio ,Anesthesia ,Breathing ,Medicine ,Expiration ,business - Abstract
Background: Long-term non-invasive ventilation (NIV) is recommended for patients with COPD and chronic hypercapnia. High inspiratory pressure NIV (hiNIV) and a maximum reduction of arterial pCO2 has been shown to prolong survival in patients with chronic hypercapnia. Often patients on hiNIV describe severe respiratory distress, known as “deventilation syndrome”, after removal of the NIV mask in the morning. With the “VIGARO” mechanical pursed-lip breathing ventilation (PLBV; FLO Medical, Melle, Germany), a new non-invasive ventilation mode is available that mimics the pressure-curve of pursed-lip breathing in the expiration phase. The clinical impact of switching patients from NIV to PLBV has not been studied so far. Methods: We retrospectively analysed the effect of switching from conventional NIV to PLBV in patients with COPD GOLD stage III and IV. Patients were investigated by lung function testing, blood gas analysis and 6 minute walk test before and 3-7 days after conversion from conventional NIV to PBLV. Results: In 16 patients who switched from conventional NIV to PLBV, the mean inspiratory ventilation pressure needed to achieve a constant pCO2 was reduced from 19.1 mbar to 14.1 mbar (p Conclusion: Switching patients with COPD GOLD III and IV and chronic hypercapnic respiratory failure from conventional NIV to PLBV may substantially increased exercise tolerance and FVC in the short term.
- Published
- 2019
6. Correction: Non-invasive ventilation with pursed lips breathing mode for patients with COPD and hypercapnic respiratory failure: A retrospective analysis
- Author
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Lenka Krabbe, Christoph Jünger, Maja Reimann, Christian Herzmann, Christoph Lange, Karoline I. Gaede, and Stephan Rüller
- Subjects
Vital capacity ,COPD ,Multidisciplinary ,Respiratory distress ,business.industry ,Science ,medicine.disease ,Obstructive lung disease ,Pulmonary function testing ,03 medical and health sciences ,FEV1/FVC ratio ,0302 clinical medicine ,030228 respiratory system ,Anesthesia ,Breathing ,Medicine ,030212 general & internal medicine ,medicine.symptom ,business ,Hypercapnia - Abstract
Purpose Long-term non-invasive ventilation (NIV) is recommended for patients with stable chronic obstructive lung disease (COPD) and chronic hypercapnia. High inspiratory pressure NIV (hiNIV) and a significant reduction of arterial pCO2 have been shown to prolong survival. Often, patients on hiNIV describe severe respiratory distress, known as “deventilation syndrome”, after removal of the NIV mask in the morning. Mechanical pursed lips breathing ventilation (PLBV) is a new non-invasive ventilation mode that mimics the pressure-curve of pursed lips breathing during expiration. The clinical impact of switching patients from standard NIV to PLBV has not been studied so far. Patients and methods In this hypothesis generating study, we retrospectively analysed the effects of switching COPD patients (stage GOLD III-IV) from conventional NIV to PLBV. Medical records of all patients who had an established NIV and were switched to PLBV between March 2016 and October 2017 were screened. Patients were included if they complained of shortness of breath on mask removal, used their conventional NIV regularly, and had a documented complete diagnostic workup including lung function testing, blood gas analysis and 6-minute walk test (6MWT) before and after 3–7 days of PLBV. Results Six male and 10 female patients (median age 65.4 years; IQR 64.0–71.3) with a previous NIV treatment duration of 38 months (median; IQR 20–42) were analysed. After PLVB initiation, the median inspiratory ventilation pressure needed to maintain the capillary pre-switch pCO2 level was reduced from 19.5 mbar (IQR 16.0–26.0) to 13.8 mbar (IQR 12.5–14.9; p
- Published
- 2021
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