Diagnosis and conservative treatment of fibrosing alveolitis in Asklepios Hospital Barmbek Hamburg

About the department

The Department of Pulmonology at the Asklepios Hospital Barmbek Hamburg provides the full range of diagnostics and treatment for diseases of the respiratory system. The long clinical experience of doctors allows them to treat patients with diseases of any severity, ranging from bronchial asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and pneumonia to lung and pleural tumors. Of particular interest to the department's specialists are interventional endoscopic procedures, both diagnostic and therapeutic. The department also has all the necessary resources for mechanical ventilation and intensive care for patients with lung diseases and other pathologies of the internal organs. The department houses a specialized Weaning Center. The medical team of the center is proud of its outstanding results: complete weaning occurs in approximately 80% of patients, and only 15% of patients require respiratory support at home after their hospital stay. The health of patients is in the safe hands of a highly qualified team consisting of pulmonologists, intensive care specialists, and pulmonary rehabilitation specialists. Doctors strictly adhere to current clinical protocols and give priority to the most sparing treatment. Hence, they primarily consider options such as drug therapy, oxygen therapy, respiratory exercises, etc. Endoscopic procedures on the organs of the respiratory system are performed in compliance with hygiene and safety standards. Pain management can also be provided if required. The department is headed by Prof. Dr. med. Ralf Eberhardt.

The department's pulmonologists have vast experience in the treatment of chronic obstructive pulmonary disease (COPD). This pathology limits the airflow into the respiratory tract, and the patient develops shortness of breath. Chronic obstructive pulmonary disease is often impossible to cure completely, so the initial goal of therapy is to slow its progression, alleviate symptoms, and improve the patient's quality of life. This is achieved through drug therapy. In addition, patients should change their lifestyles by quitting smoking, adhering to a proper diet, performing physiotherapeutic breathing exercises, etc. As the disease progresses, treatment commonly involves long-acting sprays and, in some cases, anti-inflammatory drugs. In cases of severe COPD, doctors prescribe long-term oxygen therapy and non-invasive ventilation. COPD also often causes pulmonary emphysema, a persistent expansion of the alveolar walls with their subsequent destruction. In such cases, the department's pulmonologists successfully perform endoscopic lung volume reduction (ELVR).

The department also offers various therapeutic options for the treatment of acute and chronic respiratory failure. Acute respiratory failure causes severe shortness of breath, cyanosis (blue skin), and confusion. In cases of lung dysfunction, the body does not receive enough oxygen, so acute respiratory failure always threatens the patient's life. The causes of acute respiratory failure include bronchial asthma or COPD exacerbation, pneumonia, pulmonary embolism, or acute coronary syndrome. Chronic respiratory failure usually occurs due to advanced COPD, pulmonary emphysema, and pulmonary fibrosis. Spinal curvature or morbid obesity may also cause this pathological condition. Eliminating the cause of the pathological condition plays a decisive role in providing care to patients with respiratory failure. During the first critical days, the patient breathes through a mask, and then, depending on the symptoms, effective drugs are prescribed. In more severe cases, long-term oxygen therapy may be required.

Special attention in the department's clinical practice is paid to the treatment of malignant lung tumors. Lung cancer is among the most common and life-threatening types of oncology worldwide. In cooperation with the Department of Thoracic Surgery, patients are offered a variety of surgical interventions, which are often combined with chemotherapy and radiation therapy (before and after surgery). In cases where the tumor spreads metastases, the chances of recovery decrease, so the goal of treatment is to curb the disease and improve the quality of life for patients. In this case, therapy helps relieve pain and other symptoms such as general weakness, shortness of breath, or loss of appetite. Psychological counseling is an integral part of the therapy, which helps patients cope with emotional distress.

The department has state-of-the-art endoscopy rooms where bronchoscopy is performed every day. Endoscopic procedures can be performed for both diagnostic and treatment purposes. Bronchoscopy is the only diagnostic method that allows doctors to visually assess the inner surface of the trachea and bronchi. In some cases, bronchoscopy can also be performed to arrest pulmonary hemorrhage, remove foreign bodies from the respiratory tract, or remove tumors in the early stages using argon plasma coagulation. Endoscopic techniques are also used here for lung volume reduction interventions. Bronchoscopy is usually performed under sedation or local anesthesia for patients to feel as comfortable as possible.

The department's range of medical services includes:

• Diagnostics and treatment of chronic obstructive pulmonary disease (COPD)
• Diagnostics and treatment of emphysema
• Diagnostics and treatment of acute and chronic respiratory failure
• Diagnostics and treatment of pneumonia
• Diagnostics and treatment of interstitial lung disease: sarcoidosis, exogenous allergic alveolitis, and idiopathic pulmonary fibrosis
• Diagnostics and treatment of benign and malignant lung tumors
• Diagnostics and treatment of sleep-related breathing disorders (the main focus on obstructive sleep apnea)
• Diagnostics and treatment of other pulmonary diseases

The department's therapeutic options include:

• Drug therapy: pills, injections, and infusions
• Oxygen therapy, including mechanical ventilation and weaning from mechanical ventilation
• Breathing exercises
• Endoscopic therapeutic procedures (bronchoscopy)
  • Arrest of pulmonary hemorrhage
  • Foreign body removal from the respiratory tract
  • Removal of small tumors in the early stages using argon plasma coagulation
  • Endoscopic lung volume reduction
• Other treatment methods