A5102751594- Sepsis Diagnosis and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiac Arrest and Resuscitation
- Hemodynamic Monitoring and Therapy
- Nausea and vomiting management
- Travel-related health issues
- Nosocomial Infections in ICU
- Airway Management and Intubation Techniques
- Intensive Care Unit Cognitive Disorders
- Antibiotics Pharmacokinetics and Efficacy
- Clinical Nutrition and Gastroenterology
- Anesthesia and Pain Management
- Cardiac and Coronary Surgery Techniques
- Trauma Management and Diagnosis
- Esophageal Cancer Research and Treatment
- Disaster Response and Management
- Aortic aneurysm repair treatments
- Esophageal and GI Pathology
- Metabolomics and Mass Spectrometry Studies
- Cancer, Hypoxia, and Metabolism
- Abdominal Surgery and Complications
- Antibiotic Use and Resistance
- Respiratory Support and Mechanisms
- German Literature and Culture Studies
- Gastric Cancer Management and Outcomes
University Hospital Cologne
2015-2025
University of Cologne
2016-2025
Kliniken Maria Hilf
2021-2025
Poliklinik für Endokrinologie, Diabetologie und Präventivmedizin
2015-2018
German Society for Aeronautics and Astronautics
2018
Lufthansa (Germany)
2018
LWL-Universitätsklinikum Bochum
2013
University Hospitals of the Ruhr-University of Bochum
2013
Ruhr University Bochum
2013
BG University Hospital Bergmannsheil Bochum
2013
Insufficient antimicrobial exposure is associated with worse outcomes in sepsis. We evaluated whether therapeutic drug monitoring (TDM)-guided antibiotic therapy improves outcomes. Randomized, multicenter, controlled trial from January 2017 to December 2019. Adult patients (n = 254) sepsis or septic shock were randomly assigned 1:1 receive continuous infusion of piperacillin/tazobactam dosing guided by daily TDM piperacillin a fixed dose (13.5 g/24 h if eGFR ≥ 20 mL/min). Target plasma...
Acute kidney disease (AKD) is a significant health care burden worldwide. However, little known about this complication after major surgery.
1. Mn and Cu intake retention in twenty full-term infants six preterm were studied on the basis of 72 h balances. The age was 2–16 weeks gestational (triplets) 34 36 weeks. Three nutrition schemes pursued: breast-fed, formula-fed with unsupplemented adapted formula trace element supplementation. 2. mean concentration all breast-milk samples ( n 2339) 6·2 μg/1. two formulas had similar concentrations (77 99 μg/1) but different Fe, (121 619 μg/1), Zn I contents. mother's milk 833 3. following...
Procalcitonin (PCT)-protocols to guide antibiotic treatment in severe infections are known be effective. But less is about the long-term effects of such protocols on consumption under real life conditions. This retrospective study analyses use patients with sepsis and septic shock after implementation a PCT-protocol.We conducted ICU-database search for adult between 2005 2009 organ dysfunction who where treated accordingly PCT-guided algorithm as follows: Daily measurements PCT (BRAHMS...
Intraoperative handovers of anesthesia care are common. Handovers might improve by reducing physician fatigue, but there is also an inherent risk losing critical information. Large observational analyses report associations between handover and adverse events, including higher mortality.To determine the effect on postoperative morbidity mortality.This was a parallel-group, randomized clinical trial conducted in 12 German centers with patients enrolled June 2019 2021 (final follow-up, July...
BACKGROUND Education of schoolchildren in cardiopulmonary resuscitation (CPR) is a strategic goal for improvement bystander CPR society. OBJECTIVE(S) The primary objective was to analyse the impact training on knowledge and self-confidence secondary schoolchildren. In addition, independent predictors improved were investigated. DESIGN Randomised-interventional controlled study. SETTING Four schools Germany. PARTICIPANTS hundred twenty-four aged from 14 18 years included into Fifty-one...
Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infection with hospital mortality in excess of 40%. Along insufficient and delayed empirical antimicrobial therapy, inappropriate exposure has been identified negatively affect patient outcomes. Receipt prolonged infusion (i.e. extended or continuous infusion) piperacillin/tazobactam (TZP) improves associated reduced patients sepsis. Using therapeutic drug monitoring (TDM) dosing tailored the altered...
Cardiopulmonary bypass (CPB) triggers marked cytokine release often followed by a systemic inflammatory response syndrome, associated with adverse postoperative outcomes. This trial investigates the intraoperative use of haemoadsorption (HA) during cardiac surgery CPB to assess its impact on response. In this prospective randomised controlled (ethics approval no. 5094-14DRKS00007928), patients (> 65 years) undergoing elective on-pump were HA (CytoSorb) or standard care without HA. Primary...
Background: Anastomotic leaks after esophagectomy cause significant morbidity and mortality. In addition to their early detection prompt endoscopic or surgical management, providing adequate antimicrobial agents is a fundamental aspect of therapy. this study, different types microbiological samples were analyzed provide insight into the microbial pathogen spectrum anastomotic esophagectomy. Methods: We retrospectively reviewed patients who developed leak Ivor-Lewis at German high-volume...
Hypobaric hypoxia (HH) during airline travel induces several (patho-) physiological reactions in the human body. Whereas severe is investigated thoroughly, very little known about effects of moderate or short-term hypoxia, e.g. flights. The aim present study was to analyse changes serum protein expression and activation signalling cascades volunteers staying for 30 min a simulated altitude equivalent travel. After approval local ethics committee, 10 participants were exposed (simulation 2400...
On-pump cardiac surgery triggers a significant postoperative systemic inflammatory response, sometimes resulting in multiple-organ dysfunction associated with poor clinical outcome. Extracorporeal cytokine elimination novel haemoadsorption (HA) device (CytoSorb®) promises to attenuate response. This study primarily assesses the efficacy of intraoperative HA during cardiopulmonary bypass (CPB) reduce proinflammatory burden and after on-pump surgery, secondarily, we aim evaluate effects on...
Peri-operative critical events are still a major problem in paediatric anaesthesia care. Access to more experienced healthcare teams might reduce the adverse event rate and improve outcomes.The current study analysed incidences of peri-operative cardiac arrest before after implementation specialised team training programme.Retrospective cohort with before-and-after analysis.Department Anaesthesiology Intensive Care Medicine, University Hospital Cologne, Germany.A total 36 243 anaesthetics (0...
BACKGROUND: The vascular endothelial glycocalyx is susceptible to ischemia and hypoxia. Released soluble components of the (EG) have been identified as potential damage associated molecular patterns (DAMPs) able enhance an ongoing inflammatory response. Shedding EG has with released atrial-natriuretic peptide (ANP) during cardiac surgery procedures. A novel hemoadsorption technique (CytoSorb®) shown effectively remove molecules up 55 kDa unspecifically from circulation. It not known whether...
In randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of therapy in intensive care unit (ICU) patients. However, concern was raised on low protocol adherence and high rates overruling, thus the value PCT-guided real clinical life outside study conditions remains unclear. this study, a PCT guide patients with severe sepsis septic shock analysed.From 2012 2014, surgical ICU or were retrospectively screened for...
Key Clinical Message Individual airway management is mandatory in patients with large goiters undergoing thyroid surgery. Preoperative endoscopic evaluation and imaging studies can support clinical decision making. Awake tracheotomy be an effective reasonable strategy such patients.
Administration of oxygen is one the most common interventions in medicine. Previous research showed that differential regulated proteins could be linked to hyperoxia-associated signaling cascades different tissues. However, it still remains unclear which pathways are activated by hyperoxia. The present study analyses hyperoxia-induced protein alterations lung, brain, and kidney tissue using a proteomic bioinformatic approach. Pooled data 36 Wistar rats exposed hyperoxia were used. To...
During the last years, proteomic studies have revealed several interesting findings in experimental sepsis models and septic patients. However, most investigated protein alterations only single organs or whole blood. To identify possible biomarkers to evaluate relationship between alteration affected blood, proteomics data from heart, brain, liver, kidney, serum were analysed. Using functional network analyses combination with hierarchical cluster analysis, we found that regulation patterns...