Pneumologie
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Spirometry is a highly standardized method which allows to measure the forced vital capacity (FVC) with high precision and reproducibility. In patients with IPF FVC is directly linked to the disease process which is characterized by scaring of alveoli and shrinkage of the lungs. ⋯ Based on these studies FVC decline is a validated surrogate of mortality in IPF. It is concluded that FVC decline is not only accepted as an endpoint of clinical treatment trials in IPF but is also valid as a patient related outcome parameter which should be considered for the assessment of the efficacy of an IPF drug.
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Riociguat is the first clinically available soluble Guanylate-cyclase stimulator (sGC) and representative of a completely new class of drugs. Riociguat is approved for pulmonary arterial hypertension (PAH) and non-operable or recurrent/persistent chronic thromboembolic pulmonary hypertension (CTEPH). ⋯ This article focusses on its mode of action and clinical trial data. Finally, based on these data, the status of approval, as well as the costs a proposal is given how Riociguat can be integrated in the current treatment of PAH and CTEPH.
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There is an increase of both prolonged mechanical ventilation (MV) and prolonged weaning from the respirator in the last decade in Germany. Prolonged MV is associated with an increase of morbidity, mortality and costs. ⋯ Based on growing experience the criteria and procedures of the certification process were adjusted in the last years, leading to a higher transparency and acceleration of the process. On this background WeanNet is necessary to improve the communication about prolonged weaning in public health, with insurance companies and associated scientific societies.