Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation von Patienten mit einem Herzunterstützungssystem (VAD – ventricular assist device)

Willemsen, Detlev; Cordes, Carsten; Bjarnason-Wehrens, Birna; Knoglinger, Ernst; Langheim, Eike; Marx, R.; Reiss, Nils; Schmidt, Thomas A.; Workowski, Anke; Bartsch, Petra; Baumbach, Christian; Bongarth, Christa; Phillips, Heather; Radke, Rebecca; Riedel, Matthias; Schmidt, Stefan; Skobel, Erik; Toussaint, C; Glatz, Johannes

doi:10.1007/s11789-015-0077-x

Cited by 22 publications

(35 citation statements)

References 161 publications

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“…Die Herztransplantation gilt nach wie vor als Goldstandard der refraktären Herzinsuffizienztherapie [1]. Sie ist zumeist die letzte und einzige Alternative für Patienten, die an einer fortschreitenden terminalen Herzinsuffizienz leiden.…”

Section: Faktor Organmangelunclassified

“…Um der großen Problematik der sinkenden Transplantationsbereitschaft zu begegnen, sind mechanische Herzunterstützungssysteme eine immer notwendiger werdende Intervention [1].…”

Section: Faktor Organmangelunclassified

“…B. Berlin Heart EXCOR ® , MEDOS-VAD ® ▪ Intrakorporale Lage der Blutpumpe, z. B. TCI HeartMate ® , Jarvic 2000 LVAD ® [1] Parakorporale Pumpeinheiten können sowohl als Linksoder auch als Rechtsherzunterstützungssysteme Anwendung finden.…”

Section: Einteilung Lage Und Pumpfunktion Von Kardialen Unterstützununclassified

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Neue Kraft für ein krankes Herz

Schweitzer¹

2020

intensiv

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Mechanische Herzkreislaufunterstützungssysteme trotzen dem vorhandenen Organmangel, indem sie Menschen mit terminaler Herzinsuffizienz eine geeignete Alternative zur etablierten Herztransplantation bieten. Durch die steigende Inzidenz der refraktären Herzinsuffizienz gewinnen sogenannte „Ventricular Assist Device“-Systeme in der intensivmedizinischen Praxis zunehmend an Bedeutung. Der folgende Beitrag beleuchtet die Grundlagen zu den aktuellen mechanischen Kreislaufunterstützungssystemen hinsichtlich der Pathophysiologie, Therapie und allgemeinen Fakten. Im Mittelpunkt steht das biventrikuläre Herzunterstützungssystem Berlin Heart EXCOR®.

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Section: Faktor Organmangelunclassified

“…Um der großen Problematik der sinkenden Transplantationsbereitschaft zu begegnen, sind mechanische Herzunterstützungssysteme eine immer notwendiger werdende Intervention [1].…”

Section: Faktor Organmangelunclassified

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Neue Kraft für ein krankes Herz

Schweitzer¹

2020

intensiv

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“…Diese Patienten und ihre Angehörigen benötigen eine intensive psychosoziale Betreuung, damit sie in der häuslichen Umgebung mit der neuen Situation und ihren Ängsten zurechtkommen. Eine ausführliche Beschreibung der kardiologischen Rehabilitation bei dieser sehr speziellen Patientengruppe ist in einem aktuellen Positionspapier enthalten [33].…”

Section: Patienten Mit Herzunterstützungssystem (Vad)unclassified

Kardiologische Rehabilitation

Schwaab

2017

Rehabilitation

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Physical training, psychosocial intervention, nutrition counselling and optimisation of secondary preventive medication to reduce morbidity and mortality of the disease as well as the reintegration into social life and return to work are equivalent goals of cardiac rehabilitation. This requires multifactorial intervention by a multidisciplinary team. In Germany, cardiac rehabilitation starting early after an index event could demonstrate a significant reduction of total mortality, myocardial infarction and hospitalisation during a follow-up of 1-2 years in 5 controlled cohort studies including 12 556 patients after myocardial infarction and CABG surgery. The reduction of clinical events was obtained in addition to rapid revascularisation therapy during the acute coronary event and on top of evidence based medication. In national and international guidelines, cardiac rehabilitation is recommended as well after valve surgery or intervention, in patients with heart failure and after ICD-, CRT- and VAD-implantation. Cardiac rehabilitation in Germany should be evaluated in a randomised controlled trial as well. In addition, multifactorial interventions should be tailored individually to specific patient subgroups, medical conditions and comorbidities. Return to work should be emphasized as a major topic of cardiac rehabilitation.

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“…For hemodynamically stable VAD-patients, the participation in medically supervised and individually adapted ET is suggested [107][108][109][110] All exercises for the abdominal and back muscles are not recommended [108,110]. (↓↓ 100%)…”

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confidence: 99%

Cardiac Rehabilitation in German Speaking Countries of Europe—Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH—Part 2

Schwaab

Bjarnason-Wehrens

Meng

et al. 2021

JCM

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Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients’ groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for “distress management” and “lifestyle changes”. PE is able to increase patients’ knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients’ groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively.

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Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation von Patienten mit einem Herzunterstützungssystem (VAD – ventricular assist device)

Cited by 22 publications

References 161 publications

Neue Kraft für ein krankes Herz

Neue Kraft für ein krankes Herz

Kardiologische Rehabilitation

Cardiac Rehabilitation in German Speaking Countries of Europe—Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH—Part 2

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