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Der Pneumologe

, Volume 13, Issue 3, pp 191–197 | Cite as

Langzeitsauerstofftherapie und Beatmung

Traumata für die Seele?
  • M. TempelEmail author
Leitthema
  • 501 Downloads

Zusammenfassung

Hintergrund

Langzeitsauerstofftherapie (LTOT), nichtinvasive Beatmung (NIV) und invasive Langzeitbeatmung (LZB) sind anerkannte Therapieverfahren bei Versagen des respiratorischen Systems. Die rasante Zunahme der Verordnungen wird u. a. begründet mit positiven Effekten auf Lebensqualität und mentale Gesundheit.

Fragestellung

Der Beitrag beschäftigt sich mit der Frage, inwieweit LTOT, NIV und LZB ungünstige neuropsychologische Nebenwirkungen zeigen und so möglicherweise Risikofaktoren für psychische Störungen darstellen.

Material und Methode

Auswertung von quantitativen und qualitativen Studien. Vergleich mit klinischen Beobachtungen.

Ergebnisse

Neben positiven Auswirkungen von LTOT, NIV und LZB auf Lebensqualität und mentale Gesundheit ergeben sich Hinweise auf unerwünschte psychomentale Effekte bei Patienten und ihren Betreuern.

Schlussfolgerung

Ein differenziertes Vorgehen bei Diagnostik und Indikationsstellung für LTOT und Beatmungstherapie unter Einbeziehung neuropsychologischer und psychosozialer Faktoren erscheint sinnvoll. Ebenso sind eine kommunikative Begleitung im Krankheitsverlauf und ein geschärfter Blick auf die emotionale Belastung der Betreuer notwendig.

Schlüsselwörter

Respiratorisches Versagen Langzeit-Sauerstofftherapie Beatmung Lebensqualität Psychosoziale Aspekte Betreuer 

Abkürzungen

ALS

Amyotrophe Lateralsklerose

ARI

Akute respiratorische Insuffizienz

COPD

Chronic Obstructive Pulmonary Disease

CRI

Chronische respiratorische Insuffizienz

HMV

Home Mechanical Ventilation

HRQL

Health Related Quality of Life

ICU

Intensive Care Unit

IV

Invasive Ventilation

LTOT

Long-Term Oxygen Therapy

NIV

Non-invasive Ventilation

NMD

Neuro Muscular Disease

ProWean

Prolongiertes Weaning

PTBS

Posttraumatische Belastungsstörung

Long-term oxygen therapy and ventilation

Traumatic psychological experiences?

Abstract

Background

Long-term oxygen therapy (LTOT), non-invasive ventilation (NIV) and long-term mechanical ventilation (LTMV) are well-established for treatment of respiratory failure. The rapid increase of prescription is justified among other things by positive effects on the quality of life and mental health.

Objective

This study investigated to what extent LTOT, NIV and LTMV show adverse neuropsychological side effects and thus represent possible risk factors for mental diseases.

Material and methods

Analysis of quantitative and qualitative studies. Comparison with clinical observations.

Results

In addition to the positive effects of LTOT, NIV and LTMV on the quality of life and mental health there are indications of undesirable psychomental effects on patients and their carers.

Conclusion

A differentiated approach to the diagnostics and indications for LTOT and mechanical ventilation taking neuropsychological and psychological factors into account seems to make sense. In addition, communication and caring during the disease progress are required as well as a critical look at the emotional burden of the carers.

Keywords

Respiratory failure Long-term oxygen therapy Mechanical ventilation Quality of life Psychosocial aspects Carer 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Tempel erhielt Honorar für einen Vortrag von Novartis.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Albrecht JS et al (2015) New episodes of depression among Medicare beneficiaries with chronic obstructive pulmonary disease. Int J Geriartr Psychiatry. doi:10.1002/gps.4348Google Scholar
  2. 2.
    Ando H et al (2015) Why don’t they accept non-invasive ventilation? Insight into the interpersonal perspectives of patients with motor neurone disease. Br J Health Psychol 20:341–359CrossRefPubMedGoogle Scholar
  3. 3.
    Berger BE et al (2011) The experience of stigma in chronic obstructive pulmonary disease. West J Nurs Res 33:916–932CrossRefPubMedGoogle Scholar
  4. 4.
    Cedano S et al (2013) Quality of life and burden in carers for persons with chronic obstructive pulmonary disease receiving oxygen therapy. Rev Lat Am Enfermagem 21:860–867CrossRefPubMedGoogle Scholar
  5. 5.
    Cousins R et al (2013) Determinants of accepting non-invasive ventilation treatment in motor neurone disease: a quantitative analysis at point of need. Health Psychol Behav Med 1:47–58CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Cullen DL (2006) Long term oxygen therapy adherence and COPD: what we don’t know. Chron Respir Dis 3:217–222CrossRefPubMedGoogle Scholar
  7. 7.
    Doi Y (2003) Psychosocial impact of the progress of chronic respiratory disease and long-term domiciliary oxygen therapy. Disabil Rehabil 25:992–999CrossRefPubMedGoogle Scholar
  8. 8.
    Earnest MA (2002) Explaining adherence to supplemental oxygen therapy: the patient´s perspective. J Gen Intern Med 17:749–755CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Figueiredo D et al (2014) Caring for people with early and advanced chronic obstructive pulmonary disease: how do family carers cope? J Clin Nurs 23:211–220CrossRefPubMedGoogle Scholar
  10. 10.
    Gauthier A et al (2007) A longitudinal study on quality of life and depression in ALS patient-caregiver couples. Neurology 68:923–926CrossRefPubMedGoogle Scholar
  11. 11.
    Goldstein LH et al (2006) Predictors of psychological distress in carers of people with amyotrophic lateral sclerosis: a longitudinal study. Psychol Med 36:865–875CrossRefPubMedGoogle Scholar
  12. 12.
    Huttmann SE et al (2015) Invasive home mechanical ventilation: living conditions and health-related quality of life. Respiration 89:312–321CrossRefPubMedGoogle Scholar
  13. 13.
    Jubran A et al (2010) Post-traumatic stress disorder after weaning from prolonged mechanical ventilation. Intensive Care Med 36:2030–2037CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Jubran A et al (2010) Depressive disorders during weaning from prolonged mechanical ventilation. Intensive Care Med 36:828–835CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Kanervisto M et al (2007) Family dynamics in families of severe COPD patients. J Clin Nurs 16:1498–1505CrossRefPubMedGoogle Scholar
  16. 16.
    Katsenos S, Constantopoulos SH (2011) Long-Term Oxygen Therapy in COPD: Factors Affecting and Ways of Improving Patient Compliance. Pulm Med 2011:325362CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kaub-Wittemer D et al (2003) Quality of life and psychosocial issues in ventilated patients with amyotrophic lateral sclerosis and their caregivers. J Pain Symptom Manage 26:890–896CrossRefPubMedGoogle Scholar
  18. 18.
    Koehler U et al (2014) Die Langzeit-Sauerstoff-Therapie (LTOT) – Was sollten Arzt, Versorger und Krankenkasse wissen? Pneumologie 68:193–198Google Scholar
  19. 19.
    Kühl K et al (2012) Ist das peinlich!? Die Rolle von Scham bei COPD. Atemwegs Lungenkrankh 38:333–341CrossRefGoogle Scholar
  20. 20.
    Kühl K et al (2011) Der COPD-Angst-Fragebogen (CAF): Ein neues Instrument zur Erfassung krankheitsspezifischer Ängste bei COPD-Patienten. Psychother Psychosom Med Psychol 61:e1–e9CrossRefPubMedGoogle Scholar
  21. 21.
    Lewis KE et al (2007) Prevalence of anxiety and depression in patients with severe COPD: similar high levels with and without LTOT. COPD 4:305–312CrossRefPubMedGoogle Scholar
  22. 22.
    Lulé D et al (2008) Depression and quality of life in patients with amyotrophic lateral sclerosis. Dtsch Arztebl Int 105:397–403PubMedPubMedCentralGoogle Scholar
  23. 23.
    Magnussen H et al (2014) Position zur Langzeit-Sauerstofftherapie. Pneumologie 68:591–593Google Scholar
  24. 24.
    Marchese S et al (2008) Outcome and attitudes toward home tracheostomy ventilation of consecutive patients: a 10-year experience. Respir Med 102:430–436CrossRefPubMedGoogle Scholar
  25. 25.
    Murphy V et al (2009) Problem solving skills predict quality of life and psychological morbidity in ALS caregivers. Amyotroph Lateral Scle 10:147–153CrossRefGoogle Scholar
  26. 26.
    Neri M et al (2006) Long-term oxygen therapy in chronic respiratory failure: a Multicenter Italian Study on Oxygen Therapy Adherence (MISOTA). Respir Med 100:795–806Google Scholar
  27. 27.
    Parker AM et al (2015) Posttraumatic stress disorder in critical illness survivors: a metaanalysis. Crit Care Med 43:1121–1129CrossRefPubMedGoogle Scholar
  28. 28.
    Rabkin JG et al (2000) Resilience and distress among amyotrophic lateral sclerosis patients and caregivers. Psychosom Med 62:271–279CrossRefPubMedGoogle Scholar
  29. 29.
    Rattray JE et al (2005) Predictors of emotional outcomes of intensive care. Anaesthesia 60:1085–1092CrossRefPubMedGoogle Scholar
  30. 30.
    Read J et al (2010) Sleep and well-being in young men with neuromuscular disorders receiving non-invasive ventilation and their carers. Neuromuscul Disord 20:458–463CrossRefPubMedGoogle Scholar
  31. 31.
    Rose L et al (2014) Weaning from mechanical ventilation: a scoping review of qualitative studies. Am J Crit Care 23:e54–70CrossRefPubMedGoogle Scholar
  32. 32.
    Rousseau MC et al (2011) Quality of life of ALS and LIS patients with and without invasive mechanical ventilation. J Neurol 258:1801–1804CrossRefPubMedGoogle Scholar
  33. 33.
    Schneider C et al (2010) COPD and the risk of depression. Chest 137:341–347CrossRefPubMedGoogle Scholar
  34. 34.
    Torheim H, Gjengedal E (2010) How to cope with the mask? Experiences of mask treatment in patients with acute chronic obstructive pulmonary disease-exacerbations. Scand J Caring Sci 24:499–506CrossRefPubMedGoogle Scholar
  35. 35.
    Tsay SF et al (2013) The experiences of adult ventilator-dependent patients: a meta-synthesis review. Nurs Health Sci 15:525–533CrossRefPubMedGoogle Scholar
  36. 36.
    Wada H et al (2014) Social isolation in individuals with chronic respiratory failure undergoing long-term oxygen therapy. J Am Geriatr Soc 62:1807–1808CrossRefPubMedGoogle Scholar
  37. 37.
    Wrench C (2012) How well do COPD patients with chronic respiratory failure and their carers adapt to using long-term oxygen at home? Prim Care Respir J 21:109–110CrossRefPubMedGoogle Scholar
  38. 38.
    Wunsch H et al (2014) Psychiatric diagnoses and psychoactive medication use among nonsurgical critically ill patients receiving mechanical ventilation. JAMA 311:1133–1142CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Klinik DonaustaufZentrum für Pneumologie, Psychosomatische Medizin, Psychotherapie und zertifiziertes Weaning-ZentrumDonaustaufDeutschland

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