Leitlinie zur Langzeit-Sauerstofftherapie

P. Haidl; B. Jany; J. Geiseler; S. Andreas; M. Arzt; M. Dreher; M. Frey; R. W. Hauck; F. Herth; N. Hämäläinen; T. Jehser; K. Kenn; B. Lamprecht; F. Magnet; O. Oldenburg; P. Schenk; B. Schucher; M. Studnicka; T. Voshaar; W. Windisch; H. Woehrle; H. Worth; Weitere beteiligte wissenschaftliche Fachgesellschaften und Institutionen: Deutsche Atemwegsliga e. V.; Deutsche Gesellschaft für Innere Medizin e. V. (DGIM); Deutsche Gesellschaft für Kardiologie − Herz- und Kreislaufforschung e. V. (DGK); Deutsche Gesellschaft für Palliativmedizin e. V. (DGP); Deutsche Interdisziplinäre Gesellschaft für Außerklinische Beatmung (DIGAB); Bundesverband der Pneumologen, Schlaf- und Beatmungsmediziner (BdP); Schweizerische Gesellschaft für Pneumologie (SGP); Österreichische Gesellschaft für Pneumologie (ÖGP); Deutsche Sauerstoff- und BeatmungsLiga LOT e. V.

doi:10.1055/a-1252-1492

Pneumologie 2020; 74(12): 813-841
DOI: 10.1055/a-1252-1492

Leitlinie

Leitlinie zur Langzeit-Sauerstofftherapie^[*]

S2k-Leitlinie herausgegeben von der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e. V. (DGP)Guideline for Long-Term Oxygen TherapyS2k-Guideline Published by the German Respiratory Society

P. Haidl

¹Fachkrankenhaus Kloster Grafschaft GmbH, Abteilung Pneumologie II, Schmallenberg

,

B. Jany

²Klinikum Würzburg Mitte (KWM), Klinik für Innere Medizin, Pneumologie und Beatmungsmedizin, Standort MissioKlinik, Würzburg

,

J. Geiseler

³Klinikum Vest, Medizinische Klinik IV: Pneumologie, Beatmungs- und Schlafmedizin, Marl

,

S. Andreas

⁴Lungenfachklinik Immenhausen, Universitätsmedizin Göttingen, Immenhausen

,

M. Arzt

⁵Universitätsklinikum Regensburg, Klinik und Poliklinik für Innere Medizin II, Regensburg

,

M. Dreher

⁶Universitätsklinikum Aachen, Klinik für Pneumologie und Internistische Intensivmedizin, Aachen

,

M. Frey

⁷Klinik Barmelweid, Rombach, Schweiz

,

R. W. Hauck

⁸Klinikum Altötting, Klinik für Pneumologie, Beatmungs- und Schlafmedizin, Altötting

,

F. Herth

⁹Thoraxklinik, Abteilung für Pneumologie und Beatmungsmedizin, Universität Heidelberg, Heidelberg

,

N. Hämäläinen

¹⁰Institut für Lungenforschung, Berlin

,

T. Jehser

¹¹Gemeinschaftskrankenhaus Havelhöhe, Palliativstation, Berlin

,

K. Kenn

¹²Philips Universität Marburg, Lehrstuhl für pneumologische Rehabilitation, Marburg

,

B. Lamprecht

¹³Kepler Universitätsklinikum, Med Campus III, Linz, Österreich

,

F. Magnet

¹⁴Lungenklinik, Kliniken der Stadt Köln gGmbH, Universität Witten-Herdecke, Fakultät für Gesundheit – Department für Humanmedizin, Köln

,

O. Oldenburg

¹⁵Clemenshospital, Klinik für Kardiologie, Münster

,

P. Schenk

¹⁶Landesklinikum Hochegg, Abteilung für Pulmologie, Grimmenstein, Österreich

,

B. Schucher

¹⁷LungenClinic Grosshansdorf, Großhansdorf

,

M. Studnicka

¹⁸Landeskrankenhaus Salzburg, Universitätsklinikum der PMU, Universitätsklinik für Pneumologie, Salzburg, Österreich

,

T. Voshaar

¹⁹Krankenhaus Bethanien Lungenzentrum, Medizinische Klinik III, Moers

,

W. Windisch

¹⁴Lungenklinik, Kliniken der Stadt Köln gGmbH, Universität Witten-Herdecke, Fakultät für Gesundheit – Department für Humanmedizin, Köln

,

H. Woehrle

²⁰Lungenzentrum Ulm, Ulm

,

H. Worth

²¹Facharztzentrum Fürth, Fürth

,

Weitere beteiligte wissenschaftliche Fachgesellschaften und Institutionen: Deutsche Atemwegsliga e. V., Deutsche Gesellschaft für Innere Medizin e. V. (DGIM), Deutsche Gesellschaft für Kardiologie − Herz- und Kreislaufforschung e. V. (DGK), Deutsche Gesellschaft für Palliativmedizin e. V. (DGP), Deutsche Interdisziplinäre Gesellschaft für Außerklinische Beatmung (DIGAB), Bundesverband der Pneumologen, Schlaf- und Beatmungsmediziner (BdP), Schweizerische Gesellschaft für Pneumologie (SGP), Österreichische Gesellschaft für Pneumologie (ÖGP), Deutsche Sauerstoff- und BeatmungsLiga LOT e. V. › Author Affiliations

Abstract

Zusammenfassung

Die Langzeit-Sauerstofftherapie hat einen hohen Stellenwert sowohl zur Verminderung der Letalität als auch zur Verbesserung der Leistungsfähigkeit bei Patienten mit chronischen Lungenerkrankungen.

Die Grundvoraussetzung für die Langzeit-Sauerstofftherapie ist die adäquate Diagnostik und Indikationsstellung. Sinnvoll ist eine kausale Unterscheidung in eine chronische hypoxämische oder hyperkapnische respiratorische Insuffizienz, aus der sich die Differentialindikation zur nichtinvasiven Beatmung ergibt.

Die revidierte Leitlinie behandelt u. a. die Diagnostik und die Indikation bei chronischen Lungen- und Herzerkrankungen sowie den Einsatz in der Palliativmedizin und gibt eine detaillierte Beschreibung der verfügbaren Sauerstoffsysteme. Die Leitlinie soll dazu beitragen, die teilweise bestehende Unter-, Fehl- und Überversorgung zu vermeiden. Zudem wird im Kapitel „Postakute Sauerstofftherapie“ die im Alltag relevante, bisher nicht definierte Vorgehensweise für die Verschreibung einer Sauerstofftherapie am Ende eines stationären Aufenthaltes für den häuslichen Bereich diskutiert. Ein weiterer wichtiger Punkt, die korrekte Verordnung mobiler Sauerstoffsysteme, wird auch in der Leitlinie dargestellt. Die vorliegende aktualisierte Leitlinie zur Langzeit-Sauerstofftherapie löst die alte im Jahr 2008 publizierte Version ab.

Abstract

Long-term oxygen therapy is of great importance both for reducing mortality and for improving performance in patients with chronic lung diseases. The prerequisites for Long-term oxygen therapy are adequate diagnostics and clearly defined indication. A causal distinction into chronic hypoxaemic and hypercapnic respiratory failure is reasonable, from which the differential indication for non-invasive ventilation results.

The revised guideline covers the diagnostics and indication of chronic lung and heart diseases, the role of oxygen in terminal illness and gives a detailed description of available oxygen devices. The guideline is intended to help avoid undersupply, oversupply and false prescriptions. Furthermore, the chapter “Postacute Oxygen Therapy” discusses the procedure, relevant in everyday life, but not yet clearly defined, for prescribing oxygen therapy for the home at the end of an inpatient stay. Another important point, the correct prescription of mobile oxygen systems, is also presented in the guideline. This document is a revised version of the guideline for longterm oxygen therapy and replaces the version of 2008.

Full Text

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Leitlinie zur Langzeit-Sauerstofftherapie[*]

Leitlinie zur Langzeit-Sauerstofftherapie^[*]