A5045900761- Respiratory Support and Mechanisms
- Mechanical Circulatory Support Devices
- Sepsis Diagnosis and Treatment
- Neonatal Respiratory Health Research
- Intensive Care Unit Cognitive Disorders
- Glass properties and applications
- Luminescence Properties of Advanced Materials
- Traumatic Brain Injury and Neurovascular Disturbances
- Hemodynamic Monitoring and Therapy
- Cardiac Arrest and Resuscitation
- Electron and X-Ray Spectroscopy Techniques
- Solid State Laser Technologies
- Inhalation and Respiratory Drug Delivery
- Thermal Regulation in Medicine
- Intracranial Aneurysms: Treatment and Complications
- Semiconductor materials and devices
- Spectroscopy and Laser Applications
- Ion channel regulation and function
- Photonic and Optical Devices
- Abdominal Surgery and Complications
- Quantum Dots Synthesis And Properties
- Cardiac and Coronary Surgery Techniques
- Photorefractive and Nonlinear Optics
- Bone Tissue Engineering Materials
- Pneumothorax, Barotrauma, Emphysema
University Medical Centre Mannheim
2015-2025
Heidelberg University
2015-2025
University Hospital Heidelberg
2015-2025
Franklin & Marshall College
2005-2024
Universidade Federal do Rio de Janeiro
2023
University of Mannheim
2018-2022
The vasoactive inotropic score (VIS) is calculated as a weighted sum of all administered vasopressor and medications quantifies the amount pharmacological cardiovascular support in patients with most severe combined cardiopulmonary failure supported extracorporeal membrane oxygenation (ECMO). This study evaluated (1) whether VIS prior to initiation ECMO an independent predictor survival these (2) might guide selection appropriate cannulation modality (Veno-Venous 'V-V' or Veno-VenoArterial...
Superobesity and laparoscopic surgery promote negative end-expiratory transpulmonary pressure that causes atelectasis formation impaired respiratory mechanics. The authors hypothesized differs between fixed individualized positive (PEEP) strategies mediates their effects on mechanics, lung volume, gas exchange, hemodynamic parameters in superobese patients.In this prospective, nonrandomized crossover study including 40 patients (body mass index 57.3 ± 6.4 kg/m2) undergoing bariatric surgery,...
Abstract Background Prone positioning (PP) homogenizes ventilation distribution and may limit ventilator-induced lung injury (VILI) in patients with moderate to severe acute respiratory distress syndrome (ARDS). The static dynamic components of that cause VILI have been aggregated mechanical power, considered a unifying driver VILI. PP affect power differently due changes mechanics; however, the effects on are unclear. This study aimed compare following parameters during supine (SP) PP:...
Prone positioning in combination with the application of low tidal volume and adequate positive end-expiratory pressure (PEEP) improves survival patients moderate to severe acute respiratory distress syndrome (ARDS). However, effects PEEP on transpulmonary (Ptpexp) during prone require clarification. For this purpose, three different titration strategies Ptpexp, mechanics, mechanical power, gas exchange, hemodynamics were evaluated comparing supine positioning.In forty consecutive ARDS...
To investigate the effects of positive end-expiratory pressure (PEEP) on respiratory function and hemodynamics in patients with acute lung injury (ALI) or distress syndrome (ARDS) normal intra-abdominal (IAP < 12 mmHg) hypertension (IAH, defined as IAP ≥ during protective ventilation a decremental PEEP, prospective, observational clinical pilot study was performed. Twenty ALI/ARDS IAH treated surgical intensive care unit university hospital were studied. The mean 16 ± 3 mmHg 8 mmHg,...
BACKGROUNDResults of many randomized trials on COVID-19 convalescent plasma (CCP) have been reported, but information long-term outcome after CCP treatment is limited. The objectives this extended observation the CAPSID trial are to assess and disease burden in patients initially treated with or without CCP.METHODSOf 105 patients, 50 participated observation. Quality life (QoL) was assessed by questionnaires a structured interview. donors (n = 113) asymptomatic moderate were included as...
In critically ill patients, compromised microcirculation causes tissue hypoxia, organ failure, and death. These pathophysiological processes occur particularly in patients with high illness severity, so reliable hypoxia biomarkers should reflect this their occurrence. This secondary analysis of a prospective study categorized by burden dysfunction (BOD) using the cohort's median initial sequential failure assessment (SOFA) score 8 as cutoff. The kinetic parameters markers lactate...
Abstract Background Invasive mechanical ventilation (IMV) is a standard therapy for intensive care patients with respiratory failure. With increasing population age and multimorbidity, the number of who cannot be weaned from IMV increases, resulting in impaired quality life high costs. In addition, human resources are tied up these patients. Methods The PRiVENT intervention prospective, mixed-methods interventional, multicentre study parallel comparison group selected insurance claims data...
A common final pathway of pathogenetic mechanisms in septic organ dysfunction and death is a lack or non-utilization oxygen. Plasma concentrations lactate serve as surrogates for the oxygen-deficiency-induced imbalance between energy supply demand. As S-adenosylhomocysteine (SAH) was shown to reflect tissue hypoxia, we compared ability SAH versus predict progression inflammatory disease death. Using univariate multiple logistic regression, found that but not lactate, taken upon patients'...
Abstract Introduction The ideal ventilation strategy for patients with massive brain damage requires better elucidation. We hypothesized that in the presence of injury, a using low (6 milliliters per kilogram body weight) tidal volume (V T ) open lung positive end-expiratory pressure (LV /OLPEEP) set according to minimal static elastance respiratory system, attenuates impact on gas-exchange, mechanics, histology and whole genome alterations compared high (12 V (HV /LPEEP). Methods In total,...
Abstract Background Even an ultraprotective ventilation strategy in severe acute respiratory distress syndrome (ARDS) patients treated with extracorporeal membrane oxygenation (ECMO) might induce ventilator-induced lung injury and apneic the sole application of positive end-expiratory pressure may, therefore, be alternative strategy. We, compared effects on oxygenation, oxygen delivery, system mechanics, hemodynamics, strain, air distribution recruitment parenchyma ARDS ECMO. Methods In a...
Long-term invasive mechanical ventilation (IMV) is a major burden for those affected and causes high costs the health care system. Early risk assessment prerequisite best possible support of high-risk patients during weaning process. We aimed to identify factors long-term IMV within 96 h (h) after onset IMV. The analysis was based on data from one Germany's largest statutory insurance funds; who received ≥ were admitted in January 2015 at earliest discharged December 2017 latest analysed....
Abstract Introduction To test the hypothesis that open lung (OL) ventilatory strategies using high-frequency oscillatory ventilation (HFOV) or controlled mechanical (CMV) compared to CMV with lower positive end-expiratory pressure (PEEP) improve respiratory function while minimizing injury as well systemic inflammation, a prospective randomized study was performed at university animal laboratory three different conditions. Methods Seventy-eight adult male Wistar rats were randomly assigned...
Abstract Background We tested the effect of different blood flow levels in extracorporeal circuit on measurements cardiac stroke volume (SV), global end-diastolic index (GEDVI) and extravascular lung water derived from transpulmonary thermodilution (TPTD) 20 patients with severe acute respiratory distress syndrome (ARDS) treated veno-venous membrane oxygenation (ECMO). Methods Comparative SV transesophageal echocardiography TPTD were performed at least 5 times during treatment patients. The...
The Trendelenburg position with pneumoperitoneum during surgery promotes dorsobasal atelectasis formation, which impairs respiratory mechanics and increases lung stress strain. Positive end-expiratory pressure (PEEP) can reduce pulmonary inhomogeneities preserve volume (EELV), resulting in decreased inspiratory strain improved gas-exchange. optimal intraoperative PEEP strategy is unclear.To compare the effects of individualised titration strategies on set levels transpulmonary pressures,...
Abstract Background Sepsis is the leading cause of death in intensive care unit (ICU). Expediting its diagnosis, largely determined by clinical assessment, improves survival. Predictive and explanatory modelling sepsis critically ill commonly bases both outcome definition predictions on criteria for consensus definitions sepsis, to circularity. As a remedy, we collected ground truth labels sepsis. Methods In Ground Truth Questionnaire (GTSQ), senior attending physicians ICU documented daily...
Background The acute respiratory distress syndrome (ARDS) is characterized by pulmonary epithelial and endothelial barrier dysfunction injury. In severe forms of ARDS, extracorporeal membrane oxygenation (ECMO) often the last option for life support. Endothelial progenitor (EPC) mesenchymal stem cells (MSC) can regenerate damaged endothelium thereby improve dysfunction. However, we still lack sufficient knowledge about how ECMO might affect EPC- MSC-mediated regenerative pathways in ARDS....
Objective Although sepsis and delayed cerebral ischemia (DCI) are severe complications in patients with aneurysmal subarachnoid hemorrhage (aSAH) share pathophysiological features, their interrelation additive effect on functional outcome is uncertain. We investigated the association between DCI cumulative aSAH using current sepsis-3 definition. Methods Patients admitted to our hospital 11/2014 11/2018 for were retrospectively analyzed. The main explanatory variable was sepsis, diagnosed...
Tissue hypoxia is associated with the development of organ dysfunction and death in critically ill patients commonly captured using blood lactate. The kinetic parameters serial lactate evaluations are superior at predicting mortality compared single values. S-adenosylhomocysteine (SAH), which also hypoxia, was recently established as a useful predictor septic death. We evaluated performance SAH for prediction cohort patients. For SAH, maxima means well normalized area scores were calculated...