Zusammenfassung Nächtliche und frühmorgendliche respiratorische Beschwerden sind bei Patienten m... more Zusammenfassung Nächtliche und frühmorgendliche respiratorische Beschwerden sind bei Patienten mit Asthma bronchiale sehr häufig zu finden. Es erscheint einleuchtend, wenngleich auch nicht ausreichend bewiesen, dass ein nächtliches Asthma mit Atemwegsobstruktion und Husten zu einer Störung der Schlafqualität führen kann. Um einen kausalen Zusammenhang zwischen nächtlichem Asthma bronchiale und Schlaf herstellen zu können, müssen objektive Methoden herangezogen werden. Die nächtliche akustische Langzeitregistrierung
Within the last years there has been significant progress in the field of chronic cough. So far, ... more Within the last years there has been significant progress in the field of chronic cough. So far, the analysis and evaluation of chronic cough was done mainly on the basis of subjective methods such as manual counts of cough events, questionnaires and diaries. Testing cough hypersensitivity and monitoring 24 h cough represent objective criteria. Validated questionnaires on cough frequency and quality of life represent the impact of chronic cough. Cough frequency monitoring, the preferred tool to objectively assess cough, should be used as primary end-point in clinical trials. It will also be possible to discriminate between productive and non-productive cough. The relationship with subjective measures of cough is weak. In the future, cough and its therapy should therefore be assessed with a combination of subjective and objective tools.
Long-term oxygen treatment (LTOT) has been demonstrated to improve prognosis in patients with chr... more Long-term oxygen treatment (LTOT) has been demonstrated to improve prognosis in patients with chronic respiratory insufficiency. In terms of pathogenesis, improved oxygenation, reduction of pulmonary artery pressure as well as reduction of respiratory work are important. Since there are considerable differences between the LTOT systems, individually tailored therapy is needed. In particular, the mobility aspects of the patients must be taken into consideration. It is important to distinguish between stationary/mobile devices with a liquid oxygen system and stationary/mobile devices with oxygen concentrator. Oxygen titration should be performed in relation to rest and activity phases (e. g. 6 minute walk test) as well as in relation to the sleep phase. Employing devices with demand-controlled valves should be critically examined. This can be undertaken only under physician orders and requires continuous monitoring.
Auscultation is an important, non-invasive and simple measure in the diagnosis of lung diseases t... more Auscultation is an important, non-invasive and simple measure in the diagnosis of lung diseases that can detect sometimes pathological processes prior to radiography. Attempts have already been made to automatically detect characteristic pathological sounds, but a knowledge of potential influencing factors is a must for correct interpretation. In this study we have investigated the effect of the subcutaneous fat layer on normal lung sounds. This is of importance to determine corrective factors for the automatic detection of bronchial breathing in pneumonia. The lung sounds of 125 healthy people (55f, 70m) were digitally recorded at four different positions of the thorax (3. ICR paravertebral, 7. ICR medioscapular, all left and right). Evaluation was done separately for gender. The subcutaneous fat layer was measured with a Holtain Skinfold Caliper at the identical four recording positions. For a quantitative evaluation of the sounds we calculated the relative power of frequency band...
A review of the literature shows that more than 50% of examined patients suffering from coronary ... more A review of the literature shows that more than 50% of examined patients suffering from coronary heart disease were also suffering from sleep-related apnea. We were able to diagnose a pathological sleep apnea in 9 out of 25 patients (36%) suffering from an angiographically confirmed coronary 2-vessel and 3-vessel disorder. Patients with this combination--this is the hypothesis derived from our study--are at risk due to nocturnal apnea-induced myocardial ischaemia and rhythmic disorders. In 15 patients with sleep apnea and coronary heart disease or small vessel disease, nocturnal polysomnography was conducted, in parallel a 6-channel ECG was recorded. The apnea index (second night) was on the average 33 phases/h, the maximal duration of an apnea phases being 120 seconds. The minimal blood gas saturation recorded during sleep was between 46 and 89% (median 76.0%). In 4 of the 15 patients it was possible to confirm myocardial ischaemia (correlated via REM and also via NREM) with a maxi...
Zusammenfassung Bei einem 58-jährigen Patienten kam es seit 6 Wochen zum Auftreten von nächtlich... more Zusammenfassung Bei einem 58-jährigen Patienten kam es seit 6 Wochen zum Auftreten von nächtlichen Hustenattacken und Erstickungsgefühl. Die am Tage ambulant durchgeführten klinischen Untersuchungen sowie die Lungenfunktion waren ohne pathologische Befunde geblieben. Erst durch eine nächtliche Langzeitregistierung der Atemgeräusche konnte ein richtungsweisender Befund erhoben werden: Während der gesamten Schlafzeit fand sich in- und exspiratorisches Giemen als Zeichen rezidivierender Bronchialobstruktionen. Als ursächlich für
Aliment Pharmacol Ther 2011; 33: 592–600SummaryBackground Increased prevalence of respiratory sy... more Aliment Pharmacol Ther 2011; 33: 592–600SummaryBackground Increased prevalence of respiratory symptoms has been commonly reported in patients with gastro‐oesophageal reflux disease (GERD).Aim To introduce a novel Lung‐Sound‐Monitoring device that allows simultaneous measurement of both nocturnal respiratory symptoms and episodes of acidic and biliary refluxes.Methods Nocturnal respiratory symptoms (coughing and wheezing) were continuously recorded in 20 healthy subjects and 30 reflux patients with respiratory symptoms in parallel to combined pH‐monitoring and Bilitec measurement.Results Analysis could be completed in 20 healthy subjects and in 25 patients with reflux. A clear temporal correlation to reflux phases was detected in 49% of coughing and 41% of wheezing events, respectively. Moreover, 89% of the coughing and 100% of the wheezing events succeeded reflux episodes. Finally, the technique was capable of assessing a statistically significant difference between patients and...
Zusammenfassung Nächtliche und frühmorgendliche respiratorische Beschwerden sind bei Patienten m... more Zusammenfassung Nächtliche und frühmorgendliche respiratorische Beschwerden sind bei Patienten mit Asthma bronchiale sehr häufig zu finden. Es erscheint einleuchtend, wenngleich auch nicht ausreichend bewiesen, dass ein nächtliches Asthma mit Atemwegsobstruktion und Husten zu einer Störung der Schlafqualität führen kann. Um einen kausalen Zusammenhang zwischen nächtlichem Asthma bronchiale und Schlaf herstellen zu können, müssen objektive Methoden herangezogen werden. Die nächtliche akustische Langzeitregistrierung
Within the last years there has been significant progress in the field of chronic cough. So far, ... more Within the last years there has been significant progress in the field of chronic cough. So far, the analysis and evaluation of chronic cough was done mainly on the basis of subjective methods such as manual counts of cough events, questionnaires and diaries. Testing cough hypersensitivity and monitoring 24 h cough represent objective criteria. Validated questionnaires on cough frequency and quality of life represent the impact of chronic cough. Cough frequency monitoring, the preferred tool to objectively assess cough, should be used as primary end-point in clinical trials. It will also be possible to discriminate between productive and non-productive cough. The relationship with subjective measures of cough is weak. In the future, cough and its therapy should therefore be assessed with a combination of subjective and objective tools.
Long-term oxygen treatment (LTOT) has been demonstrated to improve prognosis in patients with chr... more Long-term oxygen treatment (LTOT) has been demonstrated to improve prognosis in patients with chronic respiratory insufficiency. In terms of pathogenesis, improved oxygenation, reduction of pulmonary artery pressure as well as reduction of respiratory work are important. Since there are considerable differences between the LTOT systems, individually tailored therapy is needed. In particular, the mobility aspects of the patients must be taken into consideration. It is important to distinguish between stationary/mobile devices with a liquid oxygen system and stationary/mobile devices with oxygen concentrator. Oxygen titration should be performed in relation to rest and activity phases (e. g. 6 minute walk test) as well as in relation to the sleep phase. Employing devices with demand-controlled valves should be critically examined. This can be undertaken only under physician orders and requires continuous monitoring.
Auscultation is an important, non-invasive and simple measure in the diagnosis of lung diseases t... more Auscultation is an important, non-invasive and simple measure in the diagnosis of lung diseases that can detect sometimes pathological processes prior to radiography. Attempts have already been made to automatically detect characteristic pathological sounds, but a knowledge of potential influencing factors is a must for correct interpretation. In this study we have investigated the effect of the subcutaneous fat layer on normal lung sounds. This is of importance to determine corrective factors for the automatic detection of bronchial breathing in pneumonia. The lung sounds of 125 healthy people (55f, 70m) were digitally recorded at four different positions of the thorax (3. ICR paravertebral, 7. ICR medioscapular, all left and right). Evaluation was done separately for gender. The subcutaneous fat layer was measured with a Holtain Skinfold Caliper at the identical four recording positions. For a quantitative evaluation of the sounds we calculated the relative power of frequency band...
A review of the literature shows that more than 50% of examined patients suffering from coronary ... more A review of the literature shows that more than 50% of examined patients suffering from coronary heart disease were also suffering from sleep-related apnea. We were able to diagnose a pathological sleep apnea in 9 out of 25 patients (36%) suffering from an angiographically confirmed coronary 2-vessel and 3-vessel disorder. Patients with this combination--this is the hypothesis derived from our study--are at risk due to nocturnal apnea-induced myocardial ischaemia and rhythmic disorders. In 15 patients with sleep apnea and coronary heart disease or small vessel disease, nocturnal polysomnography was conducted, in parallel a 6-channel ECG was recorded. The apnea index (second night) was on the average 33 phases/h, the maximal duration of an apnea phases being 120 seconds. The minimal blood gas saturation recorded during sleep was between 46 and 89% (median 76.0%). In 4 of the 15 patients it was possible to confirm myocardial ischaemia (correlated via REM and also via NREM) with a maxi...
Zusammenfassung Bei einem 58-jährigen Patienten kam es seit 6 Wochen zum Auftreten von nächtlich... more Zusammenfassung Bei einem 58-jährigen Patienten kam es seit 6 Wochen zum Auftreten von nächtlichen Hustenattacken und Erstickungsgefühl. Die am Tage ambulant durchgeführten klinischen Untersuchungen sowie die Lungenfunktion waren ohne pathologische Befunde geblieben. Erst durch eine nächtliche Langzeitregistierung der Atemgeräusche konnte ein richtungsweisender Befund erhoben werden: Während der gesamten Schlafzeit fand sich in- und exspiratorisches Giemen als Zeichen rezidivierender Bronchialobstruktionen. Als ursächlich für
Aliment Pharmacol Ther 2011; 33: 592–600SummaryBackground Increased prevalence of respiratory sy... more Aliment Pharmacol Ther 2011; 33: 592–600SummaryBackground Increased prevalence of respiratory symptoms has been commonly reported in patients with gastro‐oesophageal reflux disease (GERD).Aim To introduce a novel Lung‐Sound‐Monitoring device that allows simultaneous measurement of both nocturnal respiratory symptoms and episodes of acidic and biliary refluxes.Methods Nocturnal respiratory symptoms (coughing and wheezing) were continuously recorded in 20 healthy subjects and 30 reflux patients with respiratory symptoms in parallel to combined pH‐monitoring and Bilitec measurement.Results Analysis could be completed in 20 healthy subjects and in 25 patients with reflux. A clear temporal correlation to reflux phases was detected in 49% of coughing and 41% of wheezing events, respectively. Moreover, 89% of the coughing and 100% of the wheezing events succeeded reflux episodes. Finally, the technique was capable of assessing a statistically significant difference between patients and...
Uploads
Papers by U. Koehler