Far Removed From Patients
Pointing out that measuring the respiratory rate in severely ill patients—which includes patients with pneumonia—is a useful approach to treatment does undoubtedly have its merits. The fact that this parameter is also of prognostic significance would be more obvious to readers, however, if any mention at all had been made of the pathophysiology of this phenomenon. It is concerning that this article may have been written only to point out a self evident clinical diagnosis.
Changes in the respiratory rate may have different causes even in pneumonia, a fact that doctors have been familiar with for some 120 years (1, 2). It is scientifically correct to present a biological parameter in a statistical manner only, but it is clinically pointless, because this does not really get to the bottom of the problem. The estimated prognosis is of little help for patients. What is important is that a doctor draws diagnostic or therapeutic conclusions from what he or she sees. The article does not make any mention of this. It is an example of a way of thinking that is removed from patients and merely focused on organizational economic principles.
Prof. Dr. med. Peter von Wichert, Dir. emer
Zentrum Innere Medizin
Philipps Universität Marburg
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Leube W: Diagnose der inneren Krankheiten. Leipzig: F.C.W. Vogel 1895: 127.|
|2.||Wyngaarden JB, Smith LH: Textbook of medicine. Philadelphia: W. B. Saunders 1985: 1501.|
|3.||Strauß R, Ewig S, Richter K, König T, Heller G, Bauer TT: The prognostic significance of respiratory rate in patients with pneumonia—a retrospective analysis of data from 705 928 hospitalized patients in Germany from 2010–2012. Dtsch Arztebl Int 2014; 111: 503–8. VOLLTEXT|