Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Cologne, Germany.
Faculty of Health/School of Medicine, Witten/Herdecke University, Witten, Germany.
Respiration. 2018;96(1):66-97. doi: 10.1159/000488001. Epub 2018 Jun 26.
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010, the German Respiratory Society (Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin, DGP) has leadingly published the Guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure." However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the Guidelines. For this reason, the updated Guidelines are now published. Thereby, the existing chapters, namely technical issues, organizational structures in Germany, qualification criteria, disease-specific recommendations including special features in pediatrics as well as ethical aspects and palliative care, have been updated according to the current literature and the health care developments in Germany. New chapters added to the Guidelines include the topics of home mechanical ventilation in paraplegic patients and in those with failure of prolonged weaning. In the current Guidelines, different societies as well as professional and expert associations have been involved when compared to the 2010 Guidelines. Importantly, disease-specific aspects are now covered by the German Interdisciplinary Society of Home Mechanical Ventilation (DIGAB). In addition, societies and associations directly involved in the care of patients receiving home mechanical ventilation have been included in the current process. Importantly, associations responsible for decisions on costs in the health care system and patient organizations have now been involved.
如今，有创和无创家庭机械通气已成为一种成熟的治疗选择。因此，2010 年德国呼吸学会（Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin，DGP）牵头发布了《慢性呼吸衰竭家庭机械通气治疗指南》。然而，不断发展的技术、新的科学见解以及医疗保健的发展，需要对指南进行广泛修订。出于这个原因，现在发布了更新后的指南。因此，根据现有文献和德国医疗保健的发展情况，对现有的章节，即技术问题、德国的组织结构、资格标准、特定疾病的建议，包括儿科的特殊特征以及伦理方面和姑息治疗进行了更新。新增章节包括截瘫患者和长期撤机失败患者的家庭机械通气主题。与 2010 年指南相比，当前指南涉及到更多的协会以及专业和专家协会。重要的是，特定疾病的方面现在由德国家庭机械通气多学科学会（DIGAB）涵盖。此外，直接参与家庭机械通气患者护理的协会也被纳入当前的流程。重要的是，现在已经涉及负责医疗保健系统成本决策和患者组织的协会。
