A5047226324- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Mechanical Circulatory Support Devices
- Intensive Care Unit Cognitive Disorders
- Neonatal Respiratory Health Research
- Burn Injury Management and Outcomes
- Non-Invasive Vital Sign Monitoring
- Venous Thromboembolism Diagnosis and Management
- Antifungal resistance and susceptibility
- Atrial Fibrillation Management and Outcomes
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Trauma and Emergency Care Studies
- Wound Healing and Treatments
- Traumatic Brain Injury and Neurovascular Disturbances
- Airway Management and Intubation Techniques
- Antibiotics Pharmacokinetics and Efficacy
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Sepsis Diagnosis and Treatment
- Hemostasis and retained surgical items
- COVID-19 Impact on Reproduction
- Anesthesia and Neurotoxicity Research
- Cardiovascular and exercise physiology
- Complement system in diseases
- Maternal and Perinatal Health Interventions
- Homicide, Infanticide, and Child Abuse
University Hospital Bonn
2007-2024
American Thoracic Society
2020
United States Army Institute of Surgical Research
2013-2019
National Research Council
2016
National Academies of Sciences, Engineering, and Medicine
2016
May Institute
2015
Textron Systems (United Kingdom)
2015
Innovative Research (United States)
2015
United States Army Medical Research and Development Command
2015
CytoSorbents (United States)
2015
Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting patients.673 ARDS patients treated in 26 centers between January 1st 2020 March 22nd 2021 were included. Data on clinical characteristics,...
Host inflammatory response to any form of tissue injury, including burn, trauma, or shock, has been well documented. After significant burns, cytokines can increase substantially within the first 24 h after injury and may contribute subsequent organ failure. Hemoadsorption by cytokine-adsorbing columns attenuate this maladaptive response, thereby improving outcomes. The aim study was investigate feasibility, technical safety, efficacy cytokine myoglobin removal early use a absorbing column...
Background: Despite being still invasive and challenging, technical improvement has resulted in broader more frequent application of extracorporeal membrane oxygenation (ECMO), to prevent hypoxemia reduce invasiveness mechanical ventilation (MV). Heparin-coated ECMO-circuits are currently standard care, addition heparin based anticoagulation (AC) regimen guided by activated clotting time (ACT) or partial thromboplastin (aPTT). these advances, a reliable prediction hemorrhage is difficult the...
In critical illness, the gut is susceptible to hypoperfusion and hypoxia. Positive-pressure ventilation can affect systemic hemodynamics regional blood flow distribution, with potentially deleterious effects on intestinal circulation. The authors hypothesized that spontaneous breathing (SB) airway pressure release (APRV) provides better than APRV without SB.Twelve pigs oleic acid-induced lung injury received SB. When SB was abolished, either tidal volume or ventilator rate increased maintain...
AbstractAbstract In a study of six spontaneously breathing conscious sheep connected to minimally invasive circuit, extracorporeal blood acidification with lactic acid (acid load carbon dioxide removal) increased removal by 50% compared standard removal. Although infusion overall energy expenditure, feasibility safety and efficiency were proved. Supplemental Digital Content is available in the text. Background The authors studied effects on membrane lung extraction (VCO 2 ML), spontaneous...
Systemic-blood flow, cerebral-blood and spinal cord blood flow can be affected by mechanical ventilation. We investigated the effect of spontaneous breathing on cerebral during airway pressure release ventilation (APRV) with without breathing.Twelve pigs oleic-acid-induced lung injury were ventilated APRV or in random order. Without breathing, either upper limit ventilator rate was increased to maintain pH PaCO2 constant. Systemic hemodynamic parameters determined double indicator dilution...
Extra Corporeal Membrane Oxygenation (ECMO) has become an accepted treatment option for severely ill patients. Due to a limited availability of ECMO support therapy, patients must often be transported specialised centre before or after cannulation. According the ELSO guidelines, specialist should present such interventions. Here we describe safety and efficacy reduced team approach involving one anaesthesiologist, experienced in intensive care medicine, critical nurse. This study is 10 years...
(1) Background: With the rise of multi-/pan-drug resistant (MDR/PDR) pathogens, less utilized antibiotic Colistin has made a comeback. fell out favor due to its small therapeutic range and high potential for toxicity. Today, it is used again as last resort substance in treating MDR/PDR pathogens. Although new guidelines with detailed recommendations dosing are available, finding right dose critically ill patients renal failure remains difficult. Here, we evaluate efficiency current...
(1) Background: This retrospective study focused on severe acute respiratory distress syndrome (ARDS) patients treated with veno-venous (VV) extracorporeal membrane oxygenation (ECMO) and who inhaled nitric oxide (NO) for pulmonary arterial hypertension (PAH) and/or right ventricular failure (RV failure). (2) Methods: Out of 662 ECMO-supported patients, 366 received VV ECMO, including 48 NO. We examined the NO's indications, dosing, duration, ability to lower PAH. compared without NO in...
Thermodilution methods to determine cardiac output (CO) may be affected by veno-venous extracorporeal membrane oxygenation (ECMO). We compared CO estimations pulmonary arterial thermodilution using a catheter (CO PAC ), transpulmonary TPTD and three-dimensional echocardiography (3DEcho) 3DEcho ) in 18 patients under ECMO. Comparisons between , were performed correlation statistics Bland–Altman analysis. Blood flow on ECMO support ranged from 4.3 5.8 L/min (median 4.9 L/min). Cardiac measured...
Acidification of blood entering a membrane lung (ML) with lactic acid enhances CO2 removal (VCO2ML). We compared the effects infusion acetic, citric, and acids on VCO2ML. Three sheep were connected to custom-made circuit, consisting Hemolung device (Alung Technologies, Pittsburgh, PA), hemofilter (NxStage, NxStage Medical, Lawrence, MA), peristaltic pump recirculating ultrafiltrate before ML. Blood flow was set at 250 ml/min, gas (GF) 10 L/min, 100 ml/min. Acetic (4.4 M), citric (0.4 or M)...
The combination of extracorporeal carbon dioxide removal (ECCO2R) and hemofiltration is a possible therapeutic strategy for patients needing both lung renal support. We tested the effects recirculation ultrafiltrate on membrane (ML) CO2 (VCO2ML). Three conscious, spontaneously breathing sheep were connected to commercially produced ECCO2R device (Hemolung; Alung Technologies, Pittsburgh, PA) with blood flow 250 ml/min gas 10 L/min. A hemofilter (NxStage, NxStage Medical, Lawrence, MA) was...
In thermally injured patients, inhalation injury is often associated with acute respiratory distress syndrome (ARDS), and an independent predictor of increased morbidity mortality. Extracorporeal CO2 removal (ECCO2R) therapy offers new possibilities in protective mechanical ventilation ARDS patients. We performed early application ECCO2R mild-to-moderate sheep ventilated BiPAP mode. Our aim was to investigate its effect on severity the lung injury.Non-pregnant farm-bred ewes (n = 15) were...
Smoke inhalation and burn injury remain a major source of morbidity mortality. There is known dysregulation hemostasis in patients, but either hypercoagulation or hypocoagulation states are reported. Sheep an established animal model for studying pathology provide robust data on hemostatic function at baseline after injury.After IACUC-approved protocol, 15 sheep were anesthetized subjected to 40% full thickness with smoke inhalation. Blood was sampled baseline, 1 day postinjury (early...
Invasive fungal disease (IFD) is associated with the mortality of patients on extracorporeal membrane oxygenation (ECMO). Several risk factors for IFD have been identified in or without ECMO. Here, we assessed relevance coronavirus (COVID-19) occurrence veno-venous (V-V) ECMO respiratory failure. In a retrospective analysis all cases between January 2013 and December 2022 (2020–2022 COVID-19 patients), active type, timing duration were investigated. Demographics, hospital, ICU length stay...
Abstract Background In acute respiratory failure elevated intraabdominal pressure aggravates lung collapse, tidal recruitment, and ventilation inhomogeneity. Low positive end-expiratory (PEEP) may promote collapse intrapulmonary shunting, whereas high PEEP increase dead space by inspiratory overdistension. The authors hypothesized that an electrical impedance tomography–guided approach minimizing recruitment improves regional perfusion matching when compared to a table-based low PEEP/no...
Abstract Impaired skeletal muscle quality is a major risk factor for adverse outcomes in acute respiratory failure. However, conventional methods assessment are inapplicable the critical care setting. This study aimed to determine prognostic value of computed tomography (CT) fatty fraction (FMF) as biomarker patients undergoing extracorporeal membrane oxygenation (ECMO). To calculate FMF, paraspinal area was obtained from clinical CT and separated into areas lean based on densitometric...
Objective: To assess the feasibility of extracorporeal membrane oxygenation (ECMO) or life support (ECLS) as last resort therapy in patients with acute pancreatitis and subsequent secondary respiratory distress syndrome (ARDS). Methods: Retrospective analysis from January 2013, to April 2020, ECMO pancreatitis-induced ARDS at a German University Hospital. Demographics, hospital ICU length stay, duration therapy, days on mechanical ventilation, fluid balance, need for decompressive...
To assess the prevalence and relevance of invasive fungal disease (IFD) during veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO).
(1)
Axial flow pumps are standard treatment in cases of cardiogenic shock and high-risk interventions cardiology cardiac surgery, although the optimal anticoagulation strategy remains unclear. We evaluated whether laboratory findings could predict bleeding complications acquired von Willebrand syndrome (avWS) among patients who were treated using axial pumps. retrospectively 60 consecutive received Impella devices (Impella RP: n = 20, CP/5.0: 40; Abiomed Inc., Danvers, USA) between January 2019...
Background The objective of this study was to investigate cardiac abnormalities in intensive care unit (ICU) survivors critical illness and determine whether temporary acute kidney injury (AKI) is associated with more pronounced findings on cardiovascular magnetic resonance. Methods Results There were 2175 patients treated the ICU (from 2015 until 2021) due who screened for eligibility. Post-ICU without known disease prospectively recruited from March 2021 May 2022. Participants underwent...