Büchner N, Woehrle H, Dellweg D, Wiater A, Young P, Hein H, Randerath W
Medizinischen Klinik I (Pneumologie, Schlaf- und Beatmungsmedizin), Helios Klinikum Duisburg GmbH, An der Abtei 7-11, 47166 Duisburg, Deutschland.
Lungenzentrum Ulm, Ulm, Deutschland.
Somnologie (Berl). 2020;24(4):274-284. doi: 10.1007/s11818-020-00253-w. Epub 2020 Jun 22.
When providing sleep medical services special aspects must be taken into account in the context of the coronavirus pandemic. Despite all prevention, due to the high number of unrecognized cases, SARS-CoV2 contacts in the sleep laboratory must be expected and appropriate precautions are necessary. Nevertheless, the continuation or resumption of sleep medical services under the appropriate hygiene measures is strongly recommended to avoid medical and psychosocial complications. There is no evidence for a deterioration of COVID-19 through CPAP therapy. In principle, the application of positive pressure therapy via various mask systems can be accompanied by the formation of infectious aerosols. In the case of confirmed infection with SARS-CoV2, a pre-existing PAP therapy should be continued in an outpatient setting in accordance with the local guidelines for home isolation, since discontinuation of PAP therapy is associated with additional cardiopulmonary complications due to the untreated sleep-related breathing disorder. According to the current state of knowledge inhalation therapy, nasal high-flow (NHF), and PAP therapy can be carried out without increased risk of infection for health care workers (HCW) as long as appropriate personal protective equipment (eye protection, FFP2 or FFP-3 mask, gown) is being used.This position paper of the German Society for Pneumology and Respiratory Medicine (DGP) and the German Society for Sleep Medicine (DGSM) offers detailed recommendations for the implementation of sleep medicine diagnostics and therapy in the context of the coronavirus pandemic.
在新冠疫情背景下提供睡眠医学服务时,必须考虑特殊情况。尽管采取了所有预防措施,但由于未被识别的病例数量众多,睡眠实验室中接触严重急性呼吸综合征冠状病毒2(SARS-CoV2)的情况仍有可能发生,因此需要采取适当的预防措施。尽管如此,强烈建议在采取适当的卫生措施的情况下继续或恢复睡眠医学服务,以避免医疗和心理社会并发症。没有证据表明持续气道正压通气(CPAP)治疗会使2019冠状病毒病(COVID-19)病情恶化。原则上,通过各种面罩系统应用正压治疗可能会形成感染性气溶胶。对于确诊感染SARS-CoV2的患者,应根据当地家庭隔离指南,在门诊环境中继续先前的持续气道正压通气(PAP)治疗,因为中断PAP治疗会因未治疗的睡眠相关呼吸障碍而导致额外的心肺并发症。根据目前的知识水平,只要使用适当的个人防护设备(眼部防护、FFP2或FFP-3口罩、防护服),吸入治疗、经鼻高流量氧疗(NHF)和PAP治疗对医护人员(HCW)而言感染风险不会增加。德国肺病和呼吸医学学会(DGP)和德国睡眠医学学会(DGSM)的这份立场文件为在新冠疫情背景下实施睡眠医学诊断和治疗提供了详细建议。