Giese Dagmar, Blau Jörg, Knüppel Walter, Neumann-Schiebener Aggi, Günther Andreas, Reinhardt Christian, Windisch Wolfram, Andreas Stefan
AOK Hessen.
Kliniken des Main-Taunus-Kreises, 65719 Hofheim.
Dtsch Med Wochenschr. 2020 Sep;145(19):e108-e115. doi: 10.1055/a-1207-7731. Epub 2020 Sep 9.
In recent years, the number of patients requiring mechanical ventilation has increased steadily. In some cases, weaning is not successful. These patients depend on home mechanical ventilation and intensive outpatient care. Surprisingly, most of these patients were never treated in a weaning center. Thus, weaning might still be possible in at least some of them. Health insurance companies have recognized this problem.
AOK Hessen, a major health insurance company in the German federal state of Hesse, identified some starting points for improvement after having surveyed their patients in ambulant intensive care. Principal points for future measures are expertise of the treating medical center (weaning experience, weaning center), establishment of new centers for homecare ventilation for long term therapy of these patients and a coordinated follow up.
Centers for homecare ventilation are wards with a non-hospital atmosphere affiliated to a weaning center. The main focus here is not weaning itself but daily physical and speech therapy. Patients in home care ventilation centers have time (up to 6 months) to improve their physical and mental strength. Afterwards, depending to their development, they can be transferred to the weaning center again.
In this paper, we introduce the concept of the home care ventilation centers. Initial data suggests that home care ventilation centers can contribute to successful weaning.
近年来，需要机械通气的患者数量稳步增加。在某些情况下，撤机并不成功。这些患者依赖家庭机械通气和强化门诊护理。令人惊讶的是，这些患者中的大多数从未在撤机中心接受过治疗。因此，至少其中一些患者仍有可能实现撤机。健康保险公司已经认识到了这个问题。
德国黑森州的主要健康保险公司AOK Hessen在对其门诊重症监护患者进行调查后，确定了一些改进的切入点。未来措施的主要要点包括治疗医疗中心的专业知识（撤机经验、撤机中心）、为这些患者的长期治疗建立新的家庭护理通气中心以及协调的随访。
家庭护理通气中心是隶属于撤机中心的具有非医院氛围的病房。这里的主要重点不是撤机本身，而是日常的物理治疗和言语治疗。家庭护理通气中心的患者有时间（长达6个月）来增强他们的身心力量。之后，根据他们的进展情况，他们可以再次被转至撤机中心。
在本文中，我们介绍了家庭护理通气中心的概念。初步数据表明，家庭护理通气中心有助于成功撤机。
