Pneumologie
-
Randomized Controlled Trial
[Patient education in COPD during inpatient rehabilitation improves quality of life and morbidity].
Pulmonary rehabilitation is recommended for the treatment of COPD in international guidelines. However, patient education as an important part of pulmonary rehabilitation has not been addressed sufficiently to show its benefit. The aim of this study was to find out whether education improves the effectiveness of rehabilitation with regard to quality of life (QoL) and morbidity in the year following rehabilitation. ⋯ Patient education for COPD has been shown to improve the effectiveness of an inpatient rehabilitation programme regarding quality of life. It also reduces morbidity and supports a change of lifestyle. Therefore, education should be an essential component of rehabilitation in COPD.
-
Randomized Controlled Trial Comparative Study
[Efficacy of tiotropium bromide (Spiriva) in patients with chronic-obstructive pulmonary disease (COPD) of different severities].
Aim of this study was to evaluate the efficacy of inhaled Tiotropium bromide in COPD patients of different severities in pneumological practices during a three months clinical trial. ⋯ Tiotropium bromide 18 microg once daily led to a persistent improvement of lung function and a reduction of exacerbations in patients with COPD of different severities.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
[Multicenter study on "non-invasive ventilation in patients with severe chronic obstructive pulmonary disease and emphysema(COPD)"].
Non-invasive ventilation is applied with increasing frequency in patients with chronic hypercapnic COPD and insufficiency of the ventilatory pump. In the few existing clinical trials on long-term use of NIV, no significant improvement on survival could be proven, mainly due to methodical reasons. The "National Task Force for Non-invasive ventilation and weaning" plans to study patients with severe COPD and hypercapnic ventilatory pump insufficiency in a prospective, randomised, multicentre clinical trial over one year. ⋯ The main outcome parameter is all-cause mortality, secondary outcome parameters are course of the disease, exercise capacity, quality of life and consumption of medical resources. The sample size is estimated on 300 patients (150 control group, 150 intervention group). The whole study will take approximately three years.
-
Randomized Controlled Trial Clinical Trial
[Inhaled prostacyclin and iloprost in severe pulmonary hypertension secondary to pulmonary fibrosis].
Pulmonary hypertension is a life-threatening complication of lung fibrosis. Vasodilator therapy is difficult owing to systemic side effects and pulmonary ventilation-perfusion mismatch. We compared the effects of intravenous prostacyclin and inhaled NO and aerosolized prostacyclin in randomized order and, in addition, tested for effects of oxygen and systemic calcium antagonists (CAAs) in eight patients with lung fibrosis and pulmonary hypertension. ⋯ Long-term therapy with aerosolized iloprost (long-acting PGI2 analog) resulted in unequivocal clinical improvement from a state of immobilization and severe resting dyspnea in a patient with decompensated right heart failure. We concluded that, in pulmonary hypertension secondary to lung fibrosis, aerosolization of PGI2 or iloprost causes marked pulmonary vasodilatation with maintenance of gas exchange and systemic arterial pressure. Long-term therapy with inhaled iloprost may be life saving in decompensated right heart failure from pulmonary hypertension secondary to lung fibrosis.