Rollnik, J. D., Adolphsen, J., Bauer, J., Bertram, M., Brocke, J., Dohmen, C., Donauer, E., Hartwich, M., Heidler, M. D., Huge, V., Klarmann, S., Lorenzl, S., Lueck, M., Mertl-Roetzer, M., Mokrusch, T., Nowak, D. A., Platz, T., Riechmann, L., Schlachetzki, F., von Helden, A., Wallesch, C. W., Zergiebel, D. and Pohl, M. (2017). Prolonged weaning during early neurological and neurosurgical rehabilitation. S2k guideline published by the Weaning Committee of the German Neurorehabilitation Society (DGNR). Nervenarzt, 88 (6). S. 652 - 675. NEW YORK: SPRINGER. ISSN 1433-0407

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Abstract

Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e.g., cerebral stem lesions), swallowing disturbances (neurogenic dysphagia), neuromuscular problems (e.g., critical illness polyneuropathy, Guillain-Barre syndrome, paraplegia, Myasthenia gravis) and/or cognitive disturbances (e.g., disturbed consciousness and vigilance disorders, severe communication disorders), whose care during the weaning of ventilation requires, in addition to intensive medical competence, neurological or neurosurgical and neurorehabilitation expertise. In Germany, this competence is present in centers of early neurological and neurosurgery rehabilitation, as a hospital treatment. The guideline is based on a systematic search of guideline databases and MEDLINE. Consensus was established by means of a nominal group process and Delphi procedure moderated by the Association of the Scientific Medical Societies in Germany (AWMF). In the present guideline of the DGNR, the special structural and substantive characteristics of early neurological and neurosurgery rehabilitation and existing studies on weaning in early rehabilitation facilities are examined. Addressees of the guideline are neurologists, neurosurgeons, anesthesiologists, palliative physicians, speech therapists, intensive care staff, ergotherapists, physiotherapists, and neuropsychologists. In addition, this guideline is intended to provide information to specialists for physical medicine and rehabilitation (PMR), pneumologists, internists, respiratory therapists, the German Medical Service of Health Insurance Funds (MDK) and the German Association of Health Insurance Funds (MDS). The main goal of this guideline is to convey the current knowledge on the subject of Prolonged weaning in early neurological and neurosurgery rehabilitation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Rollnik, J. D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Adolphsen, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauer, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bertram, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brocke, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dohmen, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Donauer, E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartwich, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heidler, M. D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huge, V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klarmann, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lorenzl, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lueck, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mertl-Roetzer, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mokrusch, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nowak, D. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Platz, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riechmann, L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlachetzki, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Helden, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wallesch, C. W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zergiebel, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pohl, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-228828
DOI: 10.1007/s00115-017-0332-0
Journal or Publication Title: Nervenarzt
Volume: 88
Number: 6
Page Range: S. 652 - 675
Date: 2017
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1433-0407
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTENSIVE-CARE-UNIT; ICU MECHANICAL VENTILATION; TRACHEOSTOMY SPEAKING VALVE; NONINVASIVE VENTILATION; ENDOTRACHEAL INTUBATION; PATIENT COMMUNICATION; SWALLOWING DISORDERS; CRITICAL ILLNESS; CONTROLLED-TRIAL; ILL PATIENTSMultiple languages
Clinical Neurology; PsychiatryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/22882

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