A5074596227- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Blood transfusion and management
- Venous Thromboembolism Diagnosis and Management
- Atrial Fibrillation Management and Outcomes
- Trauma and Emergency Care Studies
- Blood donation and transfusion practices
- Hemodynamic Monitoring and Therapy
- Cardiac, Anesthesia and Surgical Outcomes
- Sepsis Diagnosis and Treatment
- Liver Disease and Transplantation
- Hemostasis and retained surgical items
- Antiplatelet Therapy and Cardiovascular Diseases
- Acute Myocardial Infarction Research
- Liver Disease Diagnosis and Treatment
- Platelet Disorders and Treatments
- Receptor Mechanisms and Signaling
- Blood properties and coagulation
- Cardiac Arrest and Resuscitation
- Mechanical Circulatory Support Devices
- Anesthesia and Pain Management
- Cardiac electrophysiology and arrhythmias
- Hip and Femur Fractures
- Clinical Reasoning and Diagnostic Skills
- Cardiac Valve Diseases and Treatments
- Biomedical and Chemical Research
University of Duisburg-Essen
2012-2023
Alfried Krupp Hospital
2021-2023
Essen University Hospital
2012-2021
Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin
2019-2021
German Society of Medical Intensive Care and Emergency Medicine
2019
West German Heart and Vascular Center Essen
2019
Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin
2007-2012
Primary Source
2011
Kliniken Essen-Mitte
2008
Heinrich Heine University Düsseldorf
2008
Blood transfusion is associated with increased morbidity and mortality. We developed implemented an algorithm for coagulation management in cardiovascular surgery based on first-line administration of factor concentrates combined point-of-care thromboelastometry/impedance aggregometry.In a retrospective cohort study including 3,865 patients, we analyzed the incidence intraoperative allogeneic blood transfusions (primary endpoints) before after implementation.Following implementation, any...
BACKGROUND: Massive bleeding and transfusion of packed red blood cells (PRBC), fresh frozen plasma (FFP) platelets are associated with increased morbidity, mortality costs. PATIENTS AND METHODS: We analysed the requirements after implementation point-of-care (POC) coagulation management algorithms based on early, calculated, goal-directed therapy fibrinogen concentrate prothrombin complex (PCC) in different perioperative settings (trauma surgery, visceral transplant surgery (VTS),...
Hypothermia and acidosis were reported to influence coagulopathy in different clinical settings. We evaluated whole blood coagulation determine the effects of hypothermia and/or on hemostasis.Whole samples (3.000 microL) from 10 healthy volunteers (2 female, 8 male) acidified by adding 40 microL hydrochloric acid increasing molarity achieve a pH (alpha-stat) between 7.0 7.37, was analyzed rotational thromboelastometry after an incubation period 30 min using both intrinsically (InTEM)...
Background Allogeneic blood products transfusion during liver transplantation ( LT ) can be associated with increased morbidity and mortality. Data on thromboelastometry ROTEM )‐guided coagulation management factor concentrates CFC s)—fibrinogen concentrate and/or prothrombin complex PCC )—are sparse. We aimed to retrospectively evaluate the safety events observed this approach in our clinic. Study Design Methods patients from J anuary 2009 D ecember 2010 (n = 266) were identified by chart...
Impaired platelet function is a major risk factor for peri-operative bleeding and transfusion. This prospective, observational study enrolled 101 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass. Platelet was assessed by two whole blood impedance aggregometers (ROTEM® Multiplate®), using three different activators (arachidonic acid, adenosine diphosphate thrombin receptor-activating peptide-6), at time points (before anaesthesia, after aortic declamping...
About one third of all blood components transfused intraoperatively is used in cardiac surgery, whereas mortality cardiosurgical patients correlates nearly linear with the number units packed red cells. Acquired platelet function disorders play a major role perioperative bleeding surgery. Therefore, use point-of-care-suitable analyzers seems to be reasonable this field. Methods: Platelet analyzer PFA-100®, rotational thrombelastometry (ROTEM®), and multiple (Multiplate®) are principle...
Hyperfibrinolysis is a pathological state that often results in depletion of coagulation factors and platelets can contribute to bleeding. Factor XIII (FXIII) thrombin activatable fibrinolysis inhibitor have key roles protecting clots against fibrinolysis. We tested the hypotheses FXIII concentrate, prothrombin complex concentrate (PCC), recombinant factor VIIa (rFVIIa), tranexamic acid (TA) inhibit different degrees, antifibrinolysis.Hyperfibrinolysis was induced by addition tissue...
Background While much effort has been spent on guiding coagulation and transfusion therapy in patients undergoing cardiopulmonary bypass ( CPB ) surgery, the use of conventional laboratory‐based tests is hampered by long turnaround times interference with heparin protamine. To allow faster assessment maximum clot firmness MCF point‐of‐care thromboelastometry ROTEM ®, TEM International GmbH, Munich, Germany), we tested whether clotting time CT ), formation CFT or early values CF predict ....
The purpose of this study is to evaluate the effects a tailor-made, non-technical skills seminar on medical student's behaviour, attitudes, and performance during simulated patient treatment.Seventy-seven students were randomized either (NTS group, n=43) or (control n=34). human simulation was used as an evaluation tool. Before seminars, all performed same emergency scenario provide baseline measurements. After exposed second scenario, behavioural markers for evaluating their rated....
Most centres use fresh frozen plasma (FFP) based protocols to prevent or treat haemostatic disturbances during liver transplantation. In the present study, we used a rotational thrombelastometry (ROTEM™, TEM, Munich, Germany) guided haemostasis management with fibrinogen concentrates, prothrombin complex concentrates (PCC), platelet and tranexamic acid without FFP usage determined effect on 30 day mortality. Retrospective data analysis 372 consecutive adult transplant patients performed...
Görlinger, Klaus; Dirkmann, Daniel; Hanke, Alexander A.; Kamler, Markus; Kottenberg, Eva; Thielmann, Matthias; Jakob, Heinz; Peters, Jürgen Author Information
Although thromboelastometry (ROTEM®) and thrombelastography can be used for bedside diagnosis of fibrinolysis, the time needed detection is often prolonged. Since untreated fibrinolysis result in consumption coagulation factors bleeding, early decision making are desirable. Accordingly, we assessed ROTEM variables from extrinsically activated assays with (APTEM) without (EXTEM) addition aprotinin their ability to rapidly identify fibrinolysis. Specifically, tested hypotheses that prolonged...
Background: In aortic surgery bleeding complications can be fatal. Therefore, rotational thromboelastometry(ROTEMTM)based coagulation management was introduced. Methods: After 5 cases of acute type A dissection and arch replacement had been treated based on ROTEM findings (ROTEM group; RG), without were matched as control group (CG). CG treatment conventional tests clinical findings. Blood component factor requirements, ventilation time, duration stay at intensive care unit (ICU),...
Abstract Background Sugammadex prolongs activated partial thromboplastin time (aPTT) and prothrombin (PT) suggestive of anticoagulant effects. To pinpoint its presumed site action, the authors assessed Sugammadex’s impact on a panel coagulation assays. Methods Sugammadex, Rocuronium, Rocuronium combined, or saline were added to blood samples from healthy volunteers analyzed using plasmatic (i.e., aPTT, thrombin time, fibrinogen concentration) (n = 8 each), PT (quick), activities factors,...