@article{RollnikAdolphsenBaueretal.2017,
  author    = {Rollnik, Jens D. and Adolphsen, Jens and Bauer, J. and Bertram, Maja and Brocke, Jan and Dohmen, Christian and Donauer, E. and Hartwich, Mathias and Heidler, Maria Dorothea and Huge, Volker and Klarmann, Silke and Lorenzl, Stefan and L{\"u}ck, Michelle and Mertl-R{\"o}tzer, Marion and Mokrusch, Thomas and Nowak, D. A. and Platz, Tanja and Riechmann, Lutz and Schlachetzki, Felix and von Helden, Alvin and Wallesch, C. W. and Zergiebel, D. and Pohl, M.},
  title     = {Prolongiertes Weaning in der neurologisch-neurochirurgischen Fr{\"u}hrehabilitation},
  series = {Der Nervenarzt: Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie},
  volume    = {88},
  journal   = {Der Nervenarzt: Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie},
  publisher = {Springer},
  address   = {New York},
  issn      = {0028-2804},
  doi       = {10.1007/s00115-017-0332-0},
  pages     = {652 -- 674},
  year      = {2017},
  abstract  = {Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e.g., cerebral stem lesions), swallowing disturbances (neurogenic dysphagia), neuromuscular problems (e.g., critical illness polyneuropathy, Guillain-Barre syndrome, paraplegia, Myasthenia gravis) and/or cognitive disturbances (e.g., disturbed consciousness and vigilance disorders, severe communication disorders), whose care during the weaning of ventilation requires, in addition to intensive medical competence, neurological or neurosurgical and neurorehabilitation expertise. In Germany, this competence is present in centers of early neurological and neurosurgery rehabilitation, as a hospital treatment. The guideline is based on a systematic search of guideline databases and MEDLINE. Consensus was established by means of a nominal group process and Delphi procedure moderated by the Association of the Scientific Medical Societies in Germany (AWMF). In the present guideline of the DGNR, the special structural and substantive characteristics of early neurological and neurosurgery rehabilitation and existing studies on weaning in early rehabilitation facilities are examined. Addressees of the guideline are neurologists, neurosurgeons, anesthesiologists, palliative physicians, speech therapists, intensive care staff, ergotherapists, physiotherapists, and neuropsychologists. In addition, this guideline is intended to provide information to specialists for physical medicine and rehabilitation (PMR), pneumologists, internists, respiratory therapists, the German Medical Service of Health Insurance Funds (MDK) and the German Association of Health Insurance Funds (MDS). The main goal of this guideline is to convey the current knowledge on the subject of "Prolonged weaning in early neurological and neurosurgery rehabilitation".},
  language  = {de}
}
@article{HeidlerSalzwedelJoebgesetal.2018,
  author    = {Heidler, Maria-Dorothea and Salzwedel, Annett and J{\"o}bges, Michael and L{\"u}ck, Olaf and Dohle, Christian and Seifert, Michael and von Helden, Andrea and Hollweg, Wibke and V{\"o}ller, Heinz},
  title     = {Decannulation of tracheotomized patients after long-term mechanical ventilation - results of a prospective multicentric study in German neurological early rehabilitation hospitals},
  series = {BMC Anesthesiology},
  volume    = {18},
  journal   = {BMC Anesthesiology},
  publisher = {BMC},
  address   = {London},
  issn      = {1471-2253},
  doi       = {10.1186/s12871-018-0527-3},
  pages     = {7},
  year      = {2018},
  abstract  = {Background: In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. Methods: From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65.4 +/- 12.9 years, 68\% male) were included consecutively in a prospective multicentric observation study. At admission, sociodemographic and clinical data (e.g. relevant neurological and internistic diseases, duration of mechanical ventilation, tracheotomy technique, and nutrition) as well as functional assessments (Coma Recovery Scale-Revised (CRS-R), Early Rehabilitation Barthel Index, Bogenhausener Dysphagia Score) were collected. Complications and the success of the decannulation procedure were documented at discharge. Results: Four hundred seventy patients (57\%) were decannulated. The probability of decannulation was significantly negatively associated with increasing age (OR 0.68 per SD = 12.9 years, p < 0.001), prolonged duration of mechanical ventilation (OR 0.57 per 33.2 days, p < 0.001) and complications. An oral diet (OR 3.80; p < 0.001) and a higher alertness at admission (OR 3.07 per 7.18 CRS-R points; p < 0.001) were positively associated. Conclusions: This study identified practically measurable predictors of decannulation, which in the future can be used for a decannulation prognosis and supply optimization at admission in the neurological early rehabilitation clinic.},
  language  = {en}
}