A5085190374- Viral Infections and Immunology Research
- Sepsis Diagnosis and Treatment
- Hemodynamic Monitoring and Therapy
- Mechanical Circulatory Support Devices
- Acute Kidney Injury Research
- Abdominal Surgery and Complications
- Anesthesia and Neurotoxicity Research
- Congenital Heart Disease Studies
- Ultrasound in Clinical Applications
- Cardiac Structural Anomalies and Repair
- Neonatal Respiratory Health Research
- Cardiac, Anesthesia and Surgical Outcomes
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Intensive Care Unit Cognitive Disorders
- Cardiovascular Effects of Exercise
- Respiratory Support and Mechanisms
- Blood transfusion and management
- Cardiac Arrest and Resuscitation
- Surgical Simulation and Training
- Infective Endocarditis Diagnosis and Management
- CAR-T cell therapy research
- Anesthesia and Sedative Agents
- Appendicitis Diagnosis and Management
- Cytomegalovirus and herpesvirus research
- Renal Diseases and Glomerulopathies
Medizinische Hochschule Hannover
2015-2024
Summary Background In pediatric anesthesia, preoperative fasting guidelines are still often exceeded. Objective The objective of this noninterventional clinical observational cohort study was to evaluate the effect an optimized management ( OPT ) on glucose concentration, ketone bodies, acid–base balance, and change in mean arterial blood pressure MAP during induction anesthesia children. Methods Children aged 0–36 months scheduled for elective surgery with n = 50) were compared peers...
Activation of protein kinase C (PKC) isoforms has been implicated in the pathogenesis diabetic nephropathy. We showed earlier that PKC-α is activated kidneys hyperglycemic animals. now used PKC-α−/− mice to test hypothesis this PKC isoform mediates streptozotocin-induced observed renal and glomerular hypertrophy was similar wild-type mice. However, development albuminuria almost absent The hyperglycemia-induced downregulation negatively charged basement membrane heparan sulfate proteoglycan...
Particulate contamination due to infusion therapy carries a potential health risk for intensive care patients.
BACKGROUND Systemic inflammatory response syndrome (SIRS) is frequent after cardiac surgery, but data on its incidence and perioperative risk factors are scarce for children with congenital heart disease. METHODS SIRS within 72 hours following surgery was evaluated in a secondary analysis of enrolled to treatment-free control group randomized controlled trial. Intraoperative parameters were investigated their association using multivariable fractional polynomial logistic regression models....
Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation sepsis critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support). This secondary analysis randomized controlled trial conducted at German...
Abstract In patients awaiting L u T x, MV and ECMO are often the last ways to create a bridge x. Both interventions associated with poor posttransplant outcome survival rate. To improve results of these patients, new “bridging‐strategies” necessary. Recent reports demonstrate promising for concept “awake ” in adult patients. date, no data on this approach pediatric have been available. We therefore describe use VV ‐ as treatment strategy RF awake It presents our experiences first three...
Abstract Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy myocarditis. The role mechanical circulatory support (MCS) in children severe failure myocarditis is unclear. aim this study was determine characteristics outcome requiring MCS and/or transplantation. MYKKE cohort between September 2013 2016 analyzed. A total 195 were...
Albuminuria in diabetic nephropathy is due to endothelial dysfunction, a loss of negative charges the basement membrane, and changes slit-membrane diaphragm composition. We have recently shown that protein kinase C alpha (PKCalpha)-deficient mice are protected against development albuminuria under conditions. here tested hypothesis PKCalpha mediates hyperglycemia-induced downregulation slit-diaphragm nephrin. After 8 weeks streptozotocin (STZ)-induced hyperglycemia expression glomerular...
To examine the physical properties and chemical composition of particles captured by in-line microfilters in critically ill children, to investigate inflammatory cytotoxic effects on endothelial cells (HUVEC) macrophages vitro. Prospective, observational study following their use pediatric intensive care unit. In vitro model utilizing cytokine assays human murine macrophages. Twenty filter membranes from nine patients five controls were examined electron microscopy (EM) energy dispersion...
Infused particles induce thrombogenesis, impair microcirculation and modulate immune response. We have previously shown in critically ill children, that particle-retentive in-line filtration reduced the overall complication rate of severe events, length stay duration mechanical ventilation. now evaluated influence on different organ function thereby elucidated potential underlying pathophysiological effects particle infusion.In this single-centre, prospective, randomized controlled trial 807...
Cardiac surgery with cardiopulmonary bypass (CPB) frequently leads to systemic inflammatory response syndrome (SIRS) concomitant organ malfunction. Infused particles may exacerbate syndromes since they activate the coagulation cascade and alter or microvascular perfusion. In a randomized, controlled, prospective trial, we have previously shown that particle-retentive in-line filtration prevented major complications in critically ill children. Now, investigated effect of on subgroup cardiac...
Background/Objectives: Risk assessment in pediatric myocarditis is challenging, particularly when left ventricular ejection fraction (LVEF) preserved. This study aimed to evaluate LV myocardial deformation using speckle-tracking echocardiography (STE)-derived longitudinal +strain (LS) and assessed its diagnostic prognostic value children with myocarditis. Methods: Retrospective STE-derived layer-specific LS analysis was performed on echocardiograms from patients within the multicenter,...
Summary Objectives: Artificial colloids, frequently used to prevent hemorrhagic shock in children, impair blood coagulation. To determine the impact of acute isovolaemic hemodilution with artificial colloids on clot formation, we conducted an experimental study a pediatric animal model. Methods: Fifteen piglets underwent hemorrhage by withdrawing 40 ml·kg −1 volume steps 10 each within 1 hour. After withdrawal, loss was randomly compensated administering 4% gelatin (GEL) or hydroxylethyl...
Summary Background Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with recovery agitation, nausea, vomiting total ( TIVA ). Combination two different anesthetics may lead unwanted burst suppression in electroencephalogram EEG ) during transition phase. Objective The objective this prospective clinical observational study was identify optimal initial propofol...
Abstract Background In critically ill children, detection of intra-abdominal hypertension (IAH > 10 mmHg) and abdominal compartment syndrome (ACS = IAH + organ dysfunction) is paramount usually monitored through intra-vesical pressures (IVP) as current standard. IVP, however, carries important disadvantages, being time-consuming, discontinuous, with infection risk observer-dependent manipulation, ill-defined for catheter sizes. Therefore, we sought to validate air-capsule-based...
Abstract Background Constantly elevated intra-abdominal pressure (IAH) can lead to abdominal compartment syndrome (ACS), which is associated with organ dysfunction and even multiorgan failure. Our 2010 survey revealed an inconsistent acceptance of definitions guidelines among pediatric intensivists regarding the diagnosis treatment IAH ACS in Germany. This first assess impact updated on neonatal/pediatric intensive care units (NICU/PICU) German-speaking countries after WSACS published those...
Dose adjustment of unfractionated heparin (UFH) anticoagulation is an important factor to reduce hemorrhagic events. High doses can be monitored by Activated Clotting Time (ACT). Because limited information about the monitoring low-dose we assessed ACT, aPTT and anti-Xa. Blood samples from healthy volunteers (n = 54) were treated ex vivo with increasing UFH (0-0.4 IU/ml). Samples ICU-patients 60), drawn during continuous infusion. Simultaneous ACT measurements performed using iSTAT...
Abstract Background The amplitude-integrated EEG (aEEG) is a widely used monitoring tool in neonatology / pediatric intensive care. It takes into account the amplitudes, but not frequency composition, of EEG. Advantages aEEG are clear criteria for interpretation and time compression. During first year life, electroencephalogram (EEG) during sedation anesthesia changes from low-differentiated to differentiated EEG; higher-frequency waves develop increasingly. There few studies on use...
Since the onset of widespread COVID-19 vaccination, increased incidence vaccine-associated myocarditis (VA-myocarditis) has been noted, particularly in male adolescents.