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3. Functional dependence following intensive care unit-treated sepsis: three-year follow-up results from the prospective Mid-German Sepsis Cohort (MSC)

Author

Fleischmann-Struzek, Carolin, Born, Sebastian, Kesselmeier, Miriam, Ely, E. Wesley, Töpfer, Kristin, Romeike, Heike, Bauer, Michael, Bercker, Sven, Bodechtel, Ulf, Fiedler, Sandra, Groesdonk, Heinrich V., Petros, Sirak, Platzer, Stefanie, Rüddel, Hendrik, Schreiber, Torsten, Reinhart, Konrad, and Scherag, André

Published
2024
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5. Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on intensive care unit patient prognosis: a causal inference approach using data from the Eurobact2 study

Author

Tabah, Alexis, Lipman, Jeffrey, Pollock, Hamish, Ben Margetts, Udy, Andrew, Young, Meredith, Bhadange, Neeraj, Tyler, Steven, Ledtischke, Anne, Finnis, Mackenzie, Dwivedi, Jyotsna, Saxena, Manoj, Biradar, Vishwanath, Soar, Natalie, Sarode, Vineet, Brewster, David, Regli, Adrian, Weeda, Elizabeth, Ahmed, Samiul, Fourie, Cheryl, Laupland, Kevin, Ramanan, Mahesh, Walsham, James, Meyer, Jason, Litton, Edward, Maria Palermo, Anna, Yap, Timothy, Eroglu, Ege, George Attokaran, Antony, Jaramillo, C'havala, Nafees, Khalid Mk, Nafees, Khalid Mahmood Khan, Aqilah Haji Abd Rashid, Nurhikmahtul, Adi Muhamad Ibnu Walid, Haji, Mon, Tomas, Dhakshina Moorthi, P., Sudhirchandra, Shah, Sridharan, Dhadappa Damodar, Haibo, Qiu, Xie, Jianfeng, Jianfeng, Xie, Wei-Hua, Lu, Zhen, Wang, Qian, Chuanyun, Luo, Jili, Chen, Xiaomei, Wang, Hao, Zhao, Peng, Zhao, Juan, Wusi, Qiu, Mingmin, Chen, Xu, Lei, Yin, Chengfen, Wang, Ruilan, Wang, Jinfeng, Yin, Yongjie, Zhang, Min, Ye, Jilu, Hu, Chungfang, Zhou, Suming, Huang, Min, Yan, Jing, Wang, Yan, Qin, Bingyu, Ye, Ling, Weifeng, Xie, Peije, Li, Geng, Nan, Ling, Lowell, Hayashi, Yoshiro, Karumai, Toshiyuki, Yamasaki, Masaki, Hashimoto, Satoru, Hosokawa, Koji, Makino, Jun, Matsuyoshi, Takeo, Kuriyama, Akira, Shigemitsu, Hidenobu, Mishima, Yuka, Nagashima, Michio, Yoshida, Hideki, Fujitani, Shigeki, Omori, Koichiro, Rinka, Hiroshi, Saito, Hiroki, Atobe, Kaori, Kato, Hideaki, Takaki, Shunsuke, Sulaiman, Helmi, Shahnaz Hasan, M., Fadhil Hadi Jamaluddin, Muhamad, Pheng, Lee See, Visvalingam, Sheshendrasurian, Thing Liew, Mun, Ling Danny Wong, Siong, Khang Fong, Kean, Bt Abdul Rahman, Hamizah, Md Noor, Zuraini, Lee, Kok Tong, Hamid Azman, Abd., Zulfakar Mazlan, Mohd, Ali, Saedah, Hernandez, Aaron Mark, Abello, Anton, Jeon, Kyeongman, Lee, Sang-Min, Park, Sunghoon, Park, Seung Yong, Yoon Lim, Sung, Kwa, Andrea Lay Hoon, Yuan Goh, Qing, Ng, Shin Yi, An Lie, Sui, Junyang Goh, Ken, Yunkai Li, Andrew, Ong, Caroline Yu Ming, Yan Lim, Jia, Lishan Quah, Jessica, Ng, Kangqi, Xiang Long Ng, Louis, Yeh, Tony Yu-Chang, Chang Yeh, Yu, Chou, Nai-Kuan, Cia, Cong-Tat, Hu, Ting-Yu, Kuo, Li-Kuo, Ku, Shih-Chi, Wongsurakiat, Phunsup, Apichatbutr, Yutthana, Chiewroongroj, Supattra, Alsisi, Adel, Nadeem, Rashid, El Houfi, Ashraf, Elhadidy, Amr, Barsoum, Mina, Osman, Nermin, Mostafa, Tarek, Elbahnasawy, Mohamed, Saber, Ahmed, Aldhalia, Amer, Elmandouh, Omar, Elsayed, Ahmed, Elbadawy, Merihan A., Awad, Ahmed K., Hemead, Hanan M., Zand, Farid, Ouhadian, Maryam, Hamid Borsi, Seyed, Mehraban, Zahra, Kashipazha, Davood, Ahmadi, Fatemeh, Savaie, Mohsen, Soltani, Farhad, Rashidi, Mahboobeh, Baghbanian, Reza, Javaherforoosh, Fatemeh, Amiri, Fereshteh, Kiani, Arash, Amin Zargar, Mohammad, Mahmoodpoor, Ata, Aalinezhad, Fatemeh, Dabiri, Gholamreza, Sabetian, Golnar, Sarshad, Hakimeh, Masjedi, Mansoor, Tajvidi, Ramin, Nasirodin (S.M.N.) Tabatabaei, Dr Seyed Mohammad, Ahmed, Abdullah Khudhur, Singer, Pierre, Kagan, Ilya, Rigler, Merav, Belman, Daniel, Levin, Phillip, Harara, Belal, Diab, Adei, Abillama, Fayez, Abilama, Fayez, Ibrahim, Rebecca, Fares, Aya, Elhadi, Muhammed, Buimsaedah, Ahmad, Gamra, Marwa, Aqeelah, Ahmed, Ali Mohammed Ali, Almajdoub, Gaber Sadik Homaidan, Ahmed, Almiqlash, Bushray, Bilkhayr, Hala, Bouhuwaish, Ahmad, Sa Taher, Ahmed, Abdulwahed, Eman, Abousnina, Fathi A., Khaled Hdada, Aisha, Jobran, Rania, Ben Hasan, Hayat, Shaban Ben Hasan, Rabab, Khalid Abidi, Serghini, Issam, Seddiki, Rachid, Boukatta, Brahim, Kanjaa, Nabil, Mouhssine, Doumiri, Ahmed Wajdi, Maazouzi, Dendane, Tarek, Ali Zeggwagh, Amine, Housni, Brahim, Younes, Oujidi, Hachimi, Abdelhamid, Ghannam, A., Belkhadir, Z., Abu Jayyab, Mustafa, Aithssain, Ali, Lance, Marcus, Nissar, Shaikh, Sallam, Hend, Elrabi, Omar, Almekhlafi, Ghaleb A., Awad, Maher, Aljabbary, Ahmed, Karam Chaaban, Mohammad, Abu-Sayf, Natalia, Al-Jadaan, Mohammad, Bakr, Lubna, Mounir Bouaziz, Bouaziz, Mounir, Turki, Olfa, Sellami, Walid, Vidal, Gabriela, Centeno, Pablo, Morvillo, Natalia, Oscar Acevedo, José, Mabel Lopez, Patricia, Fernández, Rubén, Segura, Matías, Aparicio, Marta, Alonzo, Irene, Nuccetelli, Yanina, Montefiore, Pablo, Arias, Mario, Felipe Reyes, Luis, Ñamendys-Silva, Silvio A., Romero-Gonzalez, Juan P., Hermosillo, Mariana, Alejandro Castillo, Roberto, Nicolás Pantoja Leal, Jesús, Garcia Aguilar, Candy, Ocotlan Gonzalez Herrera, Mara, Vladimir Espinoza Villafuerte, Missael, Lomeli-Teran, Manuel, Dominguez-Cherit, Jose G., Davalos-Alvarez, Adrian, Sánchez-Hurtado, Luis, Tejeda-Huezo, Brigitte, Perez-Nieto, Orlando R., Deloya Tomas, Ernesto, De Bus, Liesbet, De Waele, Jan, Francois, Guy, Hollevoet, Isabelle, Denys, Wouter, Bourgeois, Marc, Vanderhaeghen, Sofie F.M., Mesland, Jean-Baptiste, Henin, Pierre, Haentjens, Lionel, Biston, Patrick, Noel, Cindérella, Layos, Nathalie, Misset, Benoît, De Schryver, Nicolas, Serck, Nicolas, Wittebole, Xavier, De Waele, Elisabeth, Opdenacker, Godelive, Kovacevic, Pedja, Zlojutro, Biljana, Ina, Filipovic-Grcic, Custovic, Aida, Filipovic-Grcic, Ina, Radonic, Radovan, Vujaklija Brajkovic, Ana, Persec, Jasminka, Sakan, Sanja, Nikolic, Mario, Lasic, Hrvoje, Leone, Marc, Timsit, Jean-François, Ruppe, Etienne, Ruckly, Stephane, Montravers, Philippe, Arbelot, Charlotte, Patrier, Juliette, Zappela, N., Montravers, P., Dulac, Thierry, Castanera, Jérémy, Auchabie, Johann, Le Meur, Anthony, Marchalot, A., Beuzelin, M., Massri, Alexandre, Guesdon, Charlotte, Escudier, Etienne, Mateu, Philippe, Rosman, Jérémy, Leroy, Olivier, Alfandari, Serge, Nica, Alexandru, Souweine, Bertrand, Coupez, Elisabeth, Duburcq, Thibault, Kipnis, Eric, Bortolotti, Perrine, Le Souhaitier, Mathieu, Mira, Jean-Paul, Garcon, Pierre, Duprey, Matthieu, Thyrault, Martial, Paulet, Rémi, Philippart, François, Tran, Marc, Bruel, Cédric, Weiss, Emmanuel, Janny, Sylvie, Foucrier, Arnaud, Perrigault, Pierre-François, Djanikian, Flora, Barbier, François, Gainnier, Marc, Bourenne, Jérémy, Louis, Guillaume, Smonig, Roland, Argaud, Laurent, Baudry, Thomas, Mekonted Dessap, Armand, Razazi, Keyvan, Kalfon, Pierre, Badre, Gaëtan, Larcher, Romaric, Lefrant, Jean-Yves, Roger, Claire, Sarton, Benjamine, Silva, Stein, Demeret, Sophie, Le Guennec, Loïc, Siami, Shidasp, Aparicio, Christelle, Voiriot, Guillaume, Fartoukh, Muriel, Dahyot-Fizelier, Claire, Imzi, Nadia, Klouche, Kada, Bracht, Hendrik, Hoheisen, Sandra, Bloos, Frank, Thomas-Rueddel, Daniel, Petros, Sirak, Pasieka, Bastian, Dubler, Simon, Schmidt, Karsten, Gottschalk, Antje, Wempe, Carola, Lepper, Philippe, Metz, Carlos, Viderman, Dmitriy, Umbetzhanov, Yerlan, Mugazov, Miras, Bazhykayeva, Yelena, Kaligozhin, Zhannur, Babashev, Baurzhan, Merenkov, Yevgeniy, Temirov, Talgat, Arvaniti, Kostoula, Smyrniotis, Dimitrios, Psallida, Vasiliki, Fildisis, Georgios, Soulountsi, Vasiliki, Kaimakamis, Evangelos, Iasonidou, Cristina, Papoti, Sofia, Renta, Foteini, Vasileiou, Maria, Romanou, Vasiliki, Koutsoukou, Vasiliki, Kristina Matei, Mariana, Moldovan, Leora, Karaiskos, Ilias, Paskalis, Harry, Marmanidou, Kyriaki, Papanikolaou, M., Kampolis, C., Oikonomou, Marina, Kogkopoulos, Evangelos, Nikolaou, Charikleia, Sakkalis, Anastasios, Chatzis, Marinos, Georgopoulou, Maria, Efthymiou, Anna, Chantziara, Vasiliki, Sakagianni, Aikaterini, Athanasa (Athanassa), Zoi (Zoe), Papageorgiou, Eirini, Ali, Fadi, Dimopoulos, Georges, Panagiota Almiroudi, Mariota, Malliotakis, Polychronis, Marouli, Diamantina, Theodorou, Vasiliki, Retselas, Ioannis, Kouroulas, Vasilios, Papathanakos, Georgios, Bassetti, Matteo, Giacobbe, Daniele, Montrucchio, Giorgia, Sales, Gabriele, De Pascale, Gennaro, Maria Montini, Luca, Carelli, Simone, Vargas, Joel, Di Gravio, Valentina, Roberto Giacobbe, Daniele, Gratarola, Angelo, Porcile, Elisa, Mirabella, Michele, Daroui, Ivan, Lodi, Giovanni, Zuccaro, Francesco, Grazia Schlevenin, Maria, Pelosi, Paolo, Battaglini, Denise, Cortegiani, Andrea, Ippolito, Mariachiara, Bellina, Davide, Di Guardo, Andrea, Pelagalli, Lorella, Covotta, Marco, Rocco, Monica, Fiorelli, Silvia, Cotoia, Antonella, Chiara Rizzo, Anna, Adam Mikstacki, Mikstacki, Adam, Tamowicz, Barbara, Kaptur Komorowska, Irmina, Szczesniak, Anna, Bojko, Jozef, Kotkowska, Anna, Walczak-Wieteska, Paulina, Wasowska, Dominika, Nowakowski, Tomasz, Broda, Hanna, Mariusz Peichota, Assoc, Pietraszek-Grzywaczewska, Iwona, Martin-Loeches, Ignacio, Bisanti, Alessandra, Paiva, José Artur, Póvoa, Pedro, Cartoze, Nuno, Pereira, Tiago, Guimarães, Nádia, Alves, Madalena, Josefina Pinheiro Marques, Ana, Rios Pinto, Ana, Krystopchuk, Andriy, Teresa, Ana, Manuel Pereira de Figueiredo, António, Botelho, Isabel, Duarte, Tiago, Costa, Vasco, Pedro Cunha, Rui, Molinos, Elena, Tito da Costa, Ledo, Sara, Queiró, Joana, Pascoalinho, Dulce, Nunes, Cristina, Pedro Moura, José, Pereira, Énio, Carvalho Mendes, António, Valeanu, Liana, Bubenek-Turconi, Serban, Marina Grintescu, Ioana, Cobilinschi, Cristian, Carmen Filipescu, Daniela, Elena Predoi, Cornelia, Tomescu, Dana, Popescu, Mihai, Marcu, Alexandra, Grigoras, Ioana, Lungu, Olguta, Gritsan, Alexey, Anderzhanova, Anastasia, Meleshkina, Yulia, Magomedov, Marat, Zubareva, Nadezhda, Tribulev, Maksim, Gaigolnik, Denis, Eremenko, Aleksandr, Vistovskaya, Natala, Chukina, Maria, Belskiy, Vladislav, Furman, Mikhail, Ferrer Rocca, Ricard, Martinez, Maria, Casares, Vanessa, Mellado Artigas, Ricard, Vera, Paula, Flores, Matias, Amador Amerigo, Joaquin, Gracia Arnillas, Maria Pilar, Munoz Bermudez, Rosana, Armestar, Fernando, Catalan, Beatriz, Roig, Regina, Raguer, Laura, Dolores Quesada, María, Diaz Santos, Emilio, Gomà, Gemma, Ubeda, Alejandro, Salgado, Maria, Forcelledo Espina, Lorena, Garcia Prieto, Emilio, Asensio, Mj, Rodriguez, M., Maseda, Dr Emilio, Suarez De La Rica, Alejandro, Ignacio Ayestaran, J., Novo, Mariana, Blasco-Navalpotro, Miguel Angel, Orejas Gallego, Alberto, Sjovall, Fredrik, Sjövall, Fredrik, Spahic, Dzana, Johan Svensson, Carl, Haney, Michael, Edin, Alicia, Åkerlund, Joyce, De Geer, Lina, Prazak, Josef, Buetti, Niccolò, Jakob, Stephan, Pagani, Jl, Abed-Maillard, S., Akova, Murat, Tarık Aslan, Abdullah, Tarik Aslan, Abdullah, Timuroglu, Arif, Kocagoz, Sesin, Kusoglu, Hulya, Mehtap, Selcuk, Ceyhun, Solakoğlu, Altintas, Dr. Neriman Defne, Talan, Leyla, Kayaaslan, Bircan, Kaya Kalem, Ayşe, Kurt, Dr. Ibrahim, Telli, Murat, Ozturk, Barcin, Erol, Çiğdem, Dindar Demiray, Emine Kubra, Çolak, Sait, Akbas, Türkay, Dr. Kursat Gundogan, Sari, Ali, Agalar, Canan, Çolak, Onur, Baykam, Nurcan (N), Akdogan, Ozlem (O), Yilmaz, Mesut, Tunay, Burcu, Cakmak, Rumeysa, Saltoglu, Nese, Karaali, Ridvan, Iftihar Koksal, Firdevs Aksoy, Eroglu, Ahmet, Tolga Saracoglu, Kemal, Bilir, Yeliz, Guzeldag, Seda, Ersoz, Gulden, Evik, Guliz, Sungurtekin, Hulya, Ozgen, Cansu, Erdoğan, Cem, Gürbüz, Yunus, Altin, Nilgün, Bayindir, Yasar, Ersoy, Yasemin, Goksu, Senay, Akyol, Ahmet, Dr, Kartal, Batirel, Ayse, Cagan Aktas, Sabahat, Morris, Andrew Conway, Conway Morris, Andrew, Routledge, Matthew, Ercole, Ari, Antcliffe, David, Rojo, Roceld, Tizard, Kate, Faulkner, Maria, Cowton, Amanda, Kent, Melanie, Raj, Ashok, Zormpa, Artemis, Tinaslanidis, George, Khade, Reena, Torlinski, Tomasz, Mulhi, Randeep, Goyal, Shraddha, Bajaj, Manan, Soltan, Marina, Yonan, Aimee, Dolan, Rachael, Johnson, Aimee, Macfie, Caroline, Lennard, James, Templeton, Maie, Sousa Arias, Sonia, Franke, Uwe, Hugill, Keith, Angell, Hollie, Benjamin J Parcell, Cobb, Katherine, Cole, Stephen, Smith, Tim, Graham, Clive, Cerman, Jaroslav, Keegan, Allison, Ritzema, Jenny, Sanderson, Amanda, Roshdy, Ashraf, Szakmany, Tamas, Baumer, Tom, Longbottom, Rebecca, Hall, Daniel, Tatham, Kate, Loftus, S., Husain, A., Black, E., Jhanji, S., Rao Baikady, R., Mcguigan, Peter, Mckee, Rachel, Kannan, Santhana, Antrolikar, Supriya, Marsden, Nicholas, Della Torre, Valentina, Banach, Dorota, Zaki, Ahmed, Jackson, Matthew, Chikungwa, Moses, Attwood, Ben, Patel, Jamie, Rebecca E Tilley, Humphreys, Sally K., Jean Renaud, Paul, Sokhan, Anton, Burma, Yaroslava, Sligl, Wendy, Baig, Nadia, McCoshen, Lorena, Kutsogiannis, Demetrios J., Thompson, Patricia, Hewer, Tayne, Rabbani, Raihan, Huq, Shihan Mahmud Redwanul, Hasan, Rajib, Motiul Islam, Mohammad, Gurjar, Mohan, Baronia, Arvind, Kothari, Nikhil, Sharma, Ankur, Karmakar, Saurabh, Sharma, Priya, Nimbolkar, Janardan, Samdani, Pratit, Vaidyanathan, R., Ahmedi Rubina, Noor, Jain, Nikhilesh, Pahuja, Madhumati, Singh, Ritu, Shekhar, Saurav, Syed, Nabeel Muzaffar, Ozair, Ahmad, Sarwar Siddiqui, Suhail, Bose, Payel, Datta, Avijatri, Rathod, Darshana, Patel, Mayur, MK, Renuka, Sailaja, K Baby, Dsilva, Carol, Chandran, Jagadish, Ghosh, Pralay, Mukherjee, Sudipta, Sheshala, Kaladhar, Chandra Misra, Krushna, Adekola, Oyebola O., Yusuf Yakubu, Saidu, Mgbosoro Ugwu, Euphemia, Olatosi, John (O), Desalu, Ibironke, Asiyanbi, Gabriel, Oladimeji, Motunrayo, Idowu, Olusola, Adeola, Fowotade, Mer, Mervyn, Mc Cree, Melanie, El Sanousi, Dr. Bashir, Adil Ali Karar, Ali, Saidahmed, Elfayadh, Hamid, Hytham K.S., Loiodice, Ambre, Bailly, Sébastien, Ruckly, Stéphane, and Staiquly, Quentin

Published
2024
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8. The effect of age and body mass index on energy expenditure of critically ill medical patients

Author

Hölzel, Christin, Weidhase, Lorenz, and Petros, Sirak

Subjects
Age -- Physiological aspects -- Health aspects, Bioenergetics -- Health aspects -- Demographic aspects, Energy metabolism -- Health aspects -- Demographic aspects, Critically ill -- Physiological aspects, Body mass index -- Health aspects -- Physiological aspects, Food/cooking/nutrition, Health
Abstract

Background Data on the influence of age and body mass index (BMI) on energy metabolism of the critically ill are heterogeneous. Due to the increasingly aging critically ill population, investigation on age- and BMI-specific energy metabolism is relevant. Methods A total of 394 indirect calorimetry measurements were conducted on 348 critically ill adult medical patients, including 46 repeat measurements after 3.6 [plus or minus] 4.3 days. Measured resting energy expenditure (MREE) was compared for age groups, BMI, and gender. Predicted energy expenditure (PEE) using the Penn State, Swinamer, and Ireton-Jones equations and the ACCP recommendations was also compared with MREE. Results The patients were 65.6 [plus or minus] 14.5 years old. Their mean Acute Physiology and Chronic Health Evaluation II score was 27.6 [plus or minus] 7.8. Mean BMI was 27.8 [plus or minus] 8.4 kg/m.sup.2, and 25.6% were obese. MREE adjusted for ideal body weight decreased with increasing age, while it increased with increasing BMI. Age, BMI, and gender are independent determinants of MREE after adjusting for clinical factors (R.sup.2 = 0.34). All four prediction equations showed a proportional bias, with the Penn State equation performing acceptably. In 46 patients with repeat indirect calorimetry, there was no significant difference between the first and second MREE (p = 0.62). Conclusions Age, BMI, and gender are independent determinants of resting energy expenditure in critically ill adults. Variations between measured and predicted energy expenditure are considerable. Should prediction equations be used, their performance in the specific population should be taken into consideration. Repeat indirect calorimetry may not always be necessary. However, this may depend on the length of stay and the extent of stress., Author(s): Christin Hölzel [sup.1] , Lorenz Weidhase [sup.1] , Sirak Petros [sup.1] Author Affiliations: (1) Medical ICU, University Hospital Leipzig, Leipzig, Germany Introduction Defining the optimal energy requirement of the [...]

Published
2021
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11. Emicizumab plasma levels after accelerated saturation in acquired haemophilia A.

Author

Kloeter, Tristan, Keller, Maren, Metze, Michael, Petros, Sirak, and Pfrepper, Christian

Subjects
BISPECIFIC antibodies, BLOOD coagulation factors, EMICIZUMAB, LARYNGEAL muscles, BLOOD coagulation factor VIII, RITUXIMAB
Abstract

This article discusses the use of emicizumab, a bispecific antibody, in the treatment of acquired hemophilia A (AHA), a severe bleeding disorder. Traditionally, AHA has been treated with bypassing agents and immunosuppressive therapy. However, emicizumab has shown promise in preventing bleeding in AHA patients. The article presents data from three patients who received emicizumab and achieved measurable plasma levels within 48 hours. The authors conclude that emicizumab can effectively control bleeding in AHA patients, but individual responses may vary and clinical monitoring is necessary. [Extracted from the article]

Published
2024
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14. Measurement of recombinant porcine factor VIII in patients with congenital haemophilia A and inhibitors in the presence of emicizumab.

Author

Pfrepper, Christian, Klamroth, Robert, Ettingshausen, Carmen Escuriola, Petros, Sirak, Siegemund, Annelie, and Siegemund, Thomas

Subjects
BLOOD coagulation factor VIII, EMICIZUMAB, HEMOPHILIACS, THROMBIN
Abstract

Introduction: Recombinant porcine factor VIII (rpFVIII) is a treatment option for break‐through bleeds in patients with congenital haemophilia A with inhibitors (CHAwI) on emicizumab. However, there are limited data about the measurement of rpFVIII in the presence of emicizumab. Aim: To analyse whether rpFVIII can be measured with a chromogenic assay with bovine component (bCSA) in plasma from CHAwI on emicizumab treatment. Methods: In the first part of the study, FVIII deficient plasma was spiked with rpFVIII, in the second part, commercial plasma from CHAwI was spiked with emicizumab and rpFVIII, and in the third part, plasma from CHAwI on emicizumab treatment was spiked with rpFVIII. FVIII was then measured with bCSA and a chromogenic assay with human component (hCSA). Thrombin generation (TG) and clot‐waveform analysis (CWA) were also carried out. Results: The recovery of rpFVIII measured with bCSA is approximately 80% and is further influenced by the presence of an anti‐porcine inhibitor. rpFVIII assessed with hCSA was influenced by emicizumab. CWA and TG showed a weak correlation with baseline emicizumab concentration, but peak thrombin and CWA correlated well with increasing emicizumab concentrations and rpFVIII activities. Conclusion: This study indicates that rpFVIII can be measured in the presence of emicizumab with a bCSA. A calibration curve for the measurement of rpFVIII with bCSA should be established. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Author

Rashidi, Mahboobeh, Hamid, Hytham K S, Saidahmed, Elfayadh, Karar, Ali Adil Ali, Mc Cree, Melanie, Adeola, Fowotade, Idowu, Olusola, Oladimeji, Motunrayo, Asiyanbi, Gabriel, Desalu, Ibironke, Olatosi, John O, Ugwu, Euphemia Mgbosoro, Yakubu, Saidu Yusuf, Misra, Krushna Chandra, Sheshala, Kaladhar, Mukherjee, Sudipta, Ghosh, Pralay, Chandran, Jagadish, Dsilva, Carol, Baby, Sailaja K, Renuka, M K, Patel, Mayur, Rathod, Darshana, Datta, Avijatri, Bose, Payel, Siddiqui, Suhail Sarwar, Ozair, Ahmad, Muzaffar, Syed Nabeel, Shekhar, Saurav, Singh, Ritu, Pahuja, Madhumati, Jain, Nikhilesh, Rubina, Noor Ahmedi, Vaidyanathan, R, Samdani, Pratit, Nimbolkar, Janardan, Sharma, Priya, Karmakar, Saurabh, Sharma, Ankur, Kothari, Nikhil, Baronia, Arvind, Gurjar, Mohan, Islam, Mohammad Motiul, Hasan, Rajib, Huq, Shihan Mahmud Redwanul, Rabbani, Raihan, Hewer, Tayne, Thompson, Patricia, Sligl, Wendy, Kutsogiannis, Demetrios J, McCoshen, Lorena, Baig, Nadia, Burma, Yaroslava, Sokhan, Anton, Renaud, Paul Jean, Humphreys, Miss Sally K, Tilley, Rebecca E, Patel, Jamie, Attwood, Ben, Chikungwa, Moses, Jackson, Matthew, Zaki, Ahmed, Banach, Dorota, Torre, Valentina Della, Marsden, Nicholas, Antrolikar, Supriya, Kannan, Santhana, Mckee, Rachel, Mcguigan, Peter, Baikady, R Rao, Jhanji, S, Black, E, Husain, A, Loftus, S, Tatham, Kate, Hall, Daniel, Longbottom, Rebecca, Baumer, Tom, Szakmany, Tamas, Roshdy, Ashraf, Sanderson, Amanda, Ritzema, Jenny, Keegan, Allison, Cerman, Jaroslav, Graham, Clive, Smith, Tim, Cole, Stephen, Cobb, Katherine, Parcell, Benjamin J, Angell, Hollie, Hugill, Keith, Franke, Uwe, Arias, Sonia Sousa, Templeton, Maie, Lennard, James, Macfie, Caroline, Johnson, Aimee, Dolan, Rachael, Yonan, Aimee, Soltan, Marina, Bajaj, Manan, Goyal, Shraddha, Mulhi, Randeep, Torlinski, Tomasz, Khade, Reena, Tinaslanidis, George, Zormpa, Artemis, Raj, Ashok, Kent, Melanie, Cowton, Amanda, Faulkner, Maria, Tizard, Kate, Rojo, Roceld, Antcliffe, David, Ercole, Ari, Morris, Andrew Conway, Routledge, Matthew, Aktas, Sabahat Cagan, Batirel, Ayse, Akyol, Ahmet, Goksu, Senay, Ersoy, Yasemin, Bayindir, Yasar, Altin, Nilgün, Gürbüz, Yunus, Erdoğan, Cem, Ozgen, Cansu, Sungurtekin, Hulya, Evik, Guliz, Ersoz, Gulden, Guzeldag, Seda, Bilir, Yeliz, Saracoglu, Kemal Tolga, Eroglu, Ahmet, Aksoy, Firdevs, Koksal, Iftihar, Karaali, Ridvan, Saltoglu, Nese, Cakmak, Rumeysa, Tunay, Burcu, Yilmaz, Mesut, Akdogan, Ozlem O, Baykam, Nurcan N, Çolak, Onur, Agalar, Canan, Sari, Ali, Gundogan, KÜRŞAT, Akbas, Türkay, Çolak, Sait, Demiray, Emine Kubra Dindar, Erol, Çiğdem, Ozturk, Barcin, Telli, Murat, Kurt, Ibrahim, Kalem, Ayşe Kaya, Kayaaslan, Bircan, Talan, Leyla, Altintas, Neriman Defne, Ceyhun, Solakoğlu, Mehtap, Selcuk, Kusoglu, Hulya, Kocagoz, Sesin, Timuroglu, Arif, Aslan, Abdullah Tarik, Akova, Murat, Abed-Maillard, S, Pagani, Jl, Jakob, Stephan, Prazak, Josef, De Geer, Lina, Åkerlund, Joyce, Edin, Alicia, Haney, Michael, Svensson, Carl Johan, Spahic, Dzana, Sjövall, Fredrik, Gallego, Alberto Orejas, Blasco-Navalpotro, Miguel Angel, Novo, Mariana, Ayestaran, J Ignacio, De La Rica, Alejandro Suarez, Maseda, Emilio, Rodriguez, Dra M, Asensio, Dra Mj, Prieto, Emilio Garcia, Espina, Lorena Forcelledo, Salgado, Dra Maria, Ubeda, Alejandro, Gomà, Gemma, Santos, Emilio Diaz, Quesada, María Dolores, Raguer, Laura, Roig, Regina, Catalan, Beatriz, Armestar, Fernando, Bermudez, Rosana Munoz, Arnillas, Maria Pilar Gracia, Amerigo, Joaquin Amador, Flores, Matias, Vera, Paula, Casares, Vanessa, Martinez, Maria, Rocca, Ricard Ferrer, Furman, Mikhail, Belskiy, Vladislav, Chukina, Maria, Vistovskaya, Natala, Eremenko, Aleksandr, Gaigolnik, Denis, Tribulev, Maksim, Zubareva, Nadezhda, Magomedov, Marat, Meleshkina, Yulia, Anderzhanova, Anastasia, Gritsan, Alexey, Lungu, Olguta, Grigoras, Ioana, Marcu, Alexandra, Popescu, Mihai, Tomescu, Dana, Predoi, Cornelia Elena, Filipescu, Daniela Carmen, Cobilinschi, Cristian, Grintescu, Ioana Marina, Bubenek-Turconi, Serban, Valeanu, Liana, Mendes, António Carvalho, Pereira, Énio, Moura, José Pedro, Nunes, Cristina, Pascoalinho, Dulce, Queiró, Joana, Ledo, Sara, da Costa, Tito, Molinos, Elena, Cunha, Rui Pedro, Costa, Vasco, Duarte, Tiago, Botelho, Isabel, de Figueiredo, António Manuel Pereira, Teresa, Ana, Krystopchuk, Andriy, Pinto, Ana Rios, Marques, Ana Josefina Pinheiro, Alves, Madalena, Guimarães, Nádia, Pereira, Tiago, Cartoze, Nuno, Bisanti, Alessandra, Martin-Loeches, Ignacio, Pietraszek-Grzywaczewska, Iwona, Peichota, Mariusz, Broda, Hanna, Nowakowski, Tomasz, Wasowska, Dominika, Walczak-Wieteska, Paulina, Kotkowska, Anna, Bojko, Jozef, Szczesniak, Anna, Komorowska, Irmina Kaptur, Tamowicz, Barbara, Mikstacki, Adam, Rizzo, Anna Chiara, Cotoia, Antonella, Fiorelli, Silvia, Rocco, Monica, Covotta, Marco, Pelagalli, Lorella, Di Guardo, Andrea, Bellina, Davide, Ippolito, Mariachiara, Cortegiani, Andrea, Battaglini, Denise, Pelosi, Paolo, Schlevenin, Maria Grazia, Zuccaro, Francesco, Lodi, Giovanni, Daroui, Ivan, Mirabella, Michele, Porcile, Elisa, Gratarola, Angelo, Giacobbe, Daniele Roberto, Di Gravio, Valentina, Vargas, Joel, Carelli, Simone, Montini, Luca Maria, De Pascale, Gennaro, Sales, Gabriele, Montrucchio, Giorgia, Papathanakos, Georgios, Kouroulas, Vasilios, Retselas, Ioannis, Theodorou, Vasiliki, Marouli, Diamantina, Malliotakis, Polychronis, Almiroudi, Mariota Panagiota, Dimopoulos, Georges, Ali, Fadi, Papageorgiou, Eirini, Athanasa, Zoi, Sakagianni, Aikaterini, Chantziara, Vasiliki, Efthymiou, Anna, Georgopoulou, Maria, Chatzis, Marinos, Sakkalis, Anastasios, Nikolaou, Charikleia, Kogkopoulos, Evangelos, Oikonomou, Marina, Kampolis, C, Papanikolaou, M, Marmanidou, Kyriaki, Paskalis, Harry, Karaiskos, Ilias, Moldovan, Leora, Matei, Mariana Kristina, Koutsoukou, Vasiliki, Romanou, Vasiliki, Vasileiou, Maria, Renta, Foteini, Papoti, Sofia, Iasonidou, Cristina, Kaimakamis, Evangelos, Soulountsi, Vasiliki, Fildisis, Georgios, Psallida, Vasiliki, Smyrniotis, Dimitrios, Arvaniti, Kostoula, Temirov, Talgat, Merenkov, Yevgeniy, Babashev, Baurzhan, Kaligozhin, Zhannur, Bazhykayeva, Yelena, Mugazov, Miras, Ymbetzhanov, Yerlan, Viderman, Dmitriy, Metz, Carlos, Lepper, Philippe, Wempe, Carola, Gottschalk, Antje, Schmidt, Karsten, Dubler, Simon, Pasieka, Bastian, Petros, Sirak, Thomas-Rueddel, Daniel, Bloos, Frank, Hoheisen, Sandra, Bracht, Hendrik, Klouche, Kada, Imzi, Nadia, Dahyot-Fizelier, Claire, Fartoukh, Muriel, Voiriot, Guillaume, Aparicio, Christelle, Siami, Shidasp, Le Guennec, Loïc, Demeret, Sophie, Silva, Stein, Sarton, Benjamine, Roger, Claire, Lefrant, Jean-Yves, Larcher, Romaric, Badre, Gaëtan, Kalfon, Pierre, Razazi, Keyvan, Dessap, Armand Mekonted, Baudry, Thomas, Argaud, Laurent, Smonig, Roland, Louis, Guillaume, Bourenne, Jérémy, Gainnier, Marc, Barbier, François, Djanikian, Flora, Perrigault, Pierre-François, Foucrier, Arnaud, Janny, Sylvie, Weiss, Emmanuel, Bruel, Cédric, Tran, Marc, Philippart, François, Paulet, Rémi, Thyrault, Martial, Duprey, Matthieu, Garcon, Pierre, Mira, Jean-Paul, Le Souhaitier, Mathieu, Bortolotti, Perrine, Kipnis, Eric, Duburcq, Thibault, Coupez, Elisabeth, Souweine, Bertrand, Nica, Alexandru, Alfandari, Serge, Leroy, Olivier, Rosman, Jérémy, Mateu, Philippe, Escudier, Etienne, Guesdon, Charlotte, Massri, Alexandre, Beuzelin, M, Marchalot, A, Le Meur, Anthony, Auchabie, Johann, Castanera, Jérémy, Dulac, Thierry, Montravers, P, Zappela, N, Patrier, Juliette, Timsit, Jean-François, Arbelot, Charlotte, Leone, Marc, Lasic, Hrvoje, Nikolic, Mario, Sakan, Sanja, Persec, Jasminka, Brajkovic, Ana Vujaklija, Radonic, Radovan, Filipovic-Grcic, Ina, Custovic, Aida, Zlojutro, Biljana, Kovacevic, Pedja, Opdenacker, Godelive, De Waele, Elisabeth, Wittebole, Xavier, Serck, Nicolas, De Schryver, Nicolas, Misset, Benoît, Layos, Nathalie, Noel, Cindérella, Biston, Patrick, Haentjens, Lionel, Henin, Pierre, Mesland, Jean-Baptiste, Vanderhaeghen, Sofie F M, Bourgeois, Marc, Denys, Wouter, Hollevoet, Isabelle, De Waele, Jan, De Bus, Liesbet, Tomas, Ernesto Deloya, Perez-Nieto, Orlando R, Tejeda-Huezo, Brigitte, Sánchez-Hurtado, Luis, Ñamendys-Silva, Silvio A, Davalos-Alvarez, Adrian, Dominguez-Cherit, Jose G, Lomeli-Teran, Manuel, Villafuerte, Missael Vladimir Espinoza, Herrera, Mara Ocotlan Gonzalez, Aguilar, Candy Garcia, Leal, Jesús Nicolás Pantoja, Castillo, Roberto Alejandro, Hermosillo, Mariana, Romero-Gonzalez, Juan P, Reyes, Luis Felipe, Montefiore, Pablo, Nuccetelli, Yanina, Alonzo, Microbiologa Irene, Aparicio, Dra Marta, Segura, Matías, Fernández, Rubén, Lopez, Patricia Mabel, Acevedo, José Oscar, Morvillo, Lic Natalia, Centeno, Pablo, Sellami, Walid, Turki, Olfa, Bouaziz, Mounir, Bakr, Lubna, Al-Jadaan, Mohammad, Abu-Sayf, Natalia, Chaaban, Mohammad Karam, Aljabbary, Ahmed, Awad, Maher, Almekhlafi, Ghaleb A, Elrabi, Omar, Sallam, Hend, Nissar, Shaikh, Lance, Marcus, Karic, Edin, Elbuzidi, Abdurahaman, Hssain, Ali Ait, Jayyab, Mustafa Abu, Amro, Sarah, Belkhadir, Z, Ghannam, A, Hachimi, Abdelhamid, Younes, Oujidi, Housni, Brahim, Zeggwagh, Amine Ali, Dendane, Tarek, Wajdi, Maazouzi Ahmed, Mouhssine, Doumiri, Kanjaa, Nabil, Boukatta, Brahim, Seddiki, Rachid, Serghini, Issam, Hasan, Rabab Shaban Ben, Hasan, Hayat Ben, Jobran, Rania, Hdada, Aisha Khaled, Abousnina, Fathi A, Abdulwahed, Eman, Taher, Ahmed Sa, Bouhuwaish, Ahmad, Bilkhayr, Hala, Almiqlash, Bushray, Homaidan, Ahmed Gaber Sadik, AliAli, Almajdoub Mohammed, Aqeelah, Ahmed, Gamra, Marwa, Buimsaedah, Ahmad, Fares, Aya, Ibrahim, Rebecca, Abilama, Fayez, Diab, Adei, Harara, Belal, Levin, Phillip, Belman, Daniel, Rigler, Merav, Kagan, Ilya, Singer, Pierre, Ahmed, Abdullah Khudhur, Tabatabaei, Seyed Mohammad Nasirodin, Tajvidi, Ramin, Masjedi, Mansoor, Sarshad, Hakimeh, Sabetian, Golnar, Dabiri, Gholamreza, Aalinezhad, Fatemeh, Mahmoodpoor, Ata, Zargar, Mohammad Amin, Kiani, Arash, Amiri, Fereshteh, Javaherforoosh, Fatemeh, Baghbanian, Reza, Soltani, Farhad, Savaie, Mohsen, Ahmadi, Fatemeh, Kashipazha, Davood, Mehraban, Zahra, Borsi, Seyed Hamid, Ouhadian, Maryam, Zand, Farid, Hemead, Hanan M, Awad, Ahmed K, Elbadawy, Merihan A, Elsayed, Ahmed, Elmandouh, Omar, Aldhalia, Amer, Saber, Ahmed, Elbahnasawy, Mohamed, Mostafa, Tarek, Osman, Nermin, Barsoum, Mina, Elhadidy, Amr, Alsisi, Adel, Houfi, Ashraf El, Nadeem, Rashid, Chiewroongroj, Supattra, Apichatbutr, Yutthana, Wongsurakiat, Phunsup, Ku, Shih-Chi, Kuo, Li-Kuo, Hu, Ting-Yu, Cia, Cong-Tat, Chou, Nai-Kuan, Yeh, Yu Chang, Ng, Louis Xiang Long, Ng, Kangqi, Quah, Jessica Lishan, Lim, Jia Yan, Ong, Caroline Yu Ming, Li, Andrew Yunkai, Goh, Ken Junyang, Kwa, Andrea Lay Hoon, Lie, Sui An, Ng, Shin Yi, Goh, Qing Yuan, Lim, Sung Yoon, Park, Seung Yong, Park, Sunghoon, Lee, Sang-Min, Jeon, Kyeongman, Ali, Saedah, Mazlan, Mohd Zulfakar, Azman, Abd Hamid, Tong, Lee Kok, Noor, Zuraini Md, Rahman, Hamizah Bt Abdul, Fong, Kean Khang, Wong, Siong Ling Danny, Liew, Mun Thing, Visvalingam, Sheshendrasurian, Pheng, Lee See, Jamaluddin, Muhamad Fadhil Hadi, Hasan, M Shahnaz, Takaki, Shunsuke, Kato, Hideaki, Atobe, Kaori, Saito, Hiroki, Rinka, Hiroshi, Omori, Koichiro, Fujitani, Shigeki, Yoshida, Hideki, Nagashima, Michio, Mishima, Yuka, Shigemitsu, Hidenobu, Kuriyama, Akira, Matsuyoshi, Takeo, Makino, Jun, Hosokawa, Koji, Hashimoto, Satoru, Yamasaki, Masaki, Karumai, Toshiyuki, Hayashi, Yoshiro, Geng, Nan, Peije, Li, Weifeng, Xie, Ye, Ling, Qin, Bingyu, Wang, Yan, Yan, Jing, Huang, Min, Zhou, Suming, Hu, Chungfang, Ye, Jilu, Zhang, Min, Yin, Yongjie, Wang, Jinfeng, Wang, Ruilan, Yin, Chengfen, Xu, Lei, Mingmin, Chen, Wusi, Qiu, Zhao, Juan, Zhao, Peng, Wang, Hao, Chen, Xiaomei, Luo, Jili, Qian, Chuanyun, Zhen, Wang, Wei-Hua, Lu, Jianfeng, Xie, Haibo, Qiu, Sridharan, Dhadappa Damodar, Sudhirchandra, Shah, Moorthi, P Dhakshina, Mon, Tomas, Walid, Haji Adi Muhamad Ibnu, Tabah, Alexis, Buetti, Niccolò, Staiquly, Quentin, Ruckly, Stéphane, Conway Morris, Andrew, Bassetti, Matteo, Lipman, Jeffrey, Ferrer, Ricard, Qiu, Haibo, Paiva, José-Artur, Povoa, Pedro, Abidi, Khalid, Elhadi, Muhammed, Pollock, Hamish, Margetts, Ben, Young, Meredith, Bhadange, Neeraj, Tyler, Steven, Ledtischke, Anne, Finnis, Mackenzie, Dwivedi, Jyotsna, Saxena, Manoj, Biradar, Vishwanath, Soar, Natalie, Sarode, Vineet, Brewster, David, Regli, Adrian, Weeda, Elizabeth, Ahmed, Samiul, Fourie, Cheryl, Laupland, Kevin, Ramanan, Mahesh, Walsham, James, Meyer, Jason, Litton, Edward, Palermo, Anna Maria, Yap, Timothy, Eroglu, Ege, Attokaran, Antony George, Jaramillo, C'havala, Nafees, Khalid Mahmood Khan, Rashid, Nurhikmahtul Aqilah Haji Abd, Tabah, Alexi, Buetti, Niccolò, Staiquly, Quentin, Ruckly, Stéphane, Akova, Murat, Aslan, Abdullah Tarik, Leone, Marc, Conway Morris, Andrew, Bassetti, Matteo, Arvaniti, Kostoula, Lipman, Jeffrey, Ferrer, Ricard, Qiu, Haibo, Paiva, José-Artur, Povoa, Pedro, De Bus, Liesbet, De Waele, Jan, Zand, Farid, Gurjar, Mohan, Alsisi, Adel, Abidi, Khalid, Bracht, Hendrik, Hayashi, Yoshiro, Jeon, Kyeongman, Elhadi, Muhammed, Barbier, Françoi, Timsit, Jean-Françoi, EUROBACT-2 Study Group, ESICM, ESCMID ESGCIP and the OUTCOMEREA Network including, Andrea Cortegiani, and Mariachiara Ippolito

Subjects
antibiotic resistance, bloodstream infection, hospital-acquired, bacteremia, Critical Care and Intensive Care Medicine
Abstract

Purpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) waspresent in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alivefrom hospital by day-28. Conclusions: HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.

Published
2023

25. The dose–response of direct oral anticoagulants is non‐linear at plasma levels below 100 ng/ml.

Author

Metze, Michael, Siegemund, Annelie, Siegemund, Thomas, Klöter, Tristan, Stöbe, Stephan, Laufs, Ulrich, Petros, Sirak, and Pfrepper, Christian

Subjects
ANTICOAGULANTS, THROMBOEMBOLISM, DOSE-effect relationship in pharmacology, BLOOD coagulation factors, DATA analysis software, THROMBIN, MICROBIAL sensitivity tests
Abstract

The article focuses on the dose-response relationship of direct oral anticoagulants (DOACs) at plasma levels below 100 nanograms (ng) per milliliter (mL). It describes a study that investigated the thrombin generation (TG) profiles of different DOACs at various plasma drug levels and highlights the non-linear dose-response relationship, with higher inhibition of thrombin generation observed at lower plasma levels.

Published
2023
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28. Bendamustine and prednisone in combination with bortezomib (BPV) in the treatment of patients with relapsed or refractory multiple myeloma and light chain-induced renal failure

Author

Pönisch, Wolfram, Moll, Barbara, Bourgeois, Malvina, Andrea, Marc, Schliwa, Thomas, Heyn, Simone, Schmalfeld, Marion, Edelmann, Thomas, Becker, Cornelia, Hoffmann, Franz Albert, Schwarzer, Andreas, Kreibich, Ute, Egert, Matthias, Stiegler, Runa, Krahl, Rainer, Remane, Yvonne, Bachmann, Anette, Lindner, Tom, Weidhase, Lorenz, Petros, Sirak, Fricke, Stefan, Vucinic, Vladan, Al Ali, Haifa, and Niederwieser, Dietger

Published
2013
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30. Randomized controlled multicentre study of albumin replacement therapy in septic shock (ARISS): protocol for a randomized controlled trial

Author

Sakr, Yasser, Bauer, Michael, Nierhaus, Axel, Kluge, Stefan, Schumacher, Ulricke, Putensen, Christian, Fichtner, Falk, Petros, Sirak, Scheer, Christian, Jaschinski, Ulrich, Tanev, Ivan, Jacob, David, Weiler, Norbert, Schulze, P. Christian, Fiedler, Fritz, Kapfer, Barbara, Brunkhorst, Frank, Lautenschlaeger, Ingmar, Wartenberg, Katja, Utzolino, Stefan, Briegel, Josef, Moerer, Onnen, Bischoff, Petra, Zarbock, Alexander, Quintel, Michael, and Giattoni, Luciano

Subjects
ddc:610
Published
2020

31. Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19:The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial

Author

Angus, Derek C, Derde, Lennie, Al-Beidh, Farah, Annane, Djillali, Arabi, Yaseen, Beane, Abigail, van Bentum-Puijk, Wilma, Berry, Lindsay, Bhimani, Zahra, Bonten, Marc, Bradbury, Charlotte, Brunkhorst, Frank, Buxton, Meredith, Buzgau, Adrian, Cheng, Allen C, de Jong, Menno, Detry, Michelle, Estcourt, Lise, Fitzgerald, Mark, Goossens, Herman, Green, Cameron, Haniffa, Rashan, Higgins, Alisa M, Horvat, Christopher, Hullegie, Sebastiaan J, Kruger, Peter, Lamontagne, Francois, Lawler, Patrick R, Linstrum, Kelsey, Litton, Edward, Lorenzi, Elizabeth, Marshall, John, McAuley, Daniel, McGlothin, Anna, McGuinness, Shay, McVerry, Bryan, Montgomery, Stephanie, Mouncey, Paul, Murthy, Srinivas, Nichol, Alistair, Parke, Rachael, Parker, Jane, Rowan, Kathryn, Sanil, Ashish, Santos, Marlene, Saunders, Christina, Seymour, Christopher, Turner, Anne, van de Veerdonk, Frank, Venkatesh, Balasubramanian, Zarychanski, Ryan, Berry, Scott, Lewis, Roger J, McArthur, Colin, Webb, Steven A, Gordon, Anthony C, Writing Committee for the REMAP-CAP Investigators, Angus, Derek, Cheng, Allen, De Jong, Menno, Gordon, Anthony, Lawler, Patrick, Webb, Steve, Campbell, Lewis, Forbes, Andrew, Gattas, David, Heritier, Stephane, Higgins, Lisa, Peake, Sandra, Presneill, Jeffrey, Seppelt, Ian, Trapani, Tony, Young, Paul, Bagshaw, Sean, Daneman, Nick, Ferguson, Niall, Misak, Cheryl, Hullegie, Sebastiaan, Pletz, Mathias, Rohde, Gernot, Rowan, Kathy, Alexander, Brian, Basile, Kim, Girard, Timothy, Huang, David, Vates, Jennifer, Beasley, Richard, Fowler, Robert, McGloughlin, Steve, Morpeth, Susan, Paterson, David, Venkatesh, Bala, Uyeki, Tim, Baillie, Kenneth, Duffy, Eamon, Fowler, Rob, Hills, Thomas, Orr, Katrina, Patanwala, Asad, Tong, Steve, Netea, Mihai, Bihari, Shilesh, Carrier, Marc, Fergusson, Dean, Goligher, Ewan, Haidar, Ghady, Hunt, Beverley, Kumar, Anand, Laffan, Mike, Lawless, Patrick, Lother, Sylvain, McCallum, Peter, Middeldopr, Saskia, McQuilten, Zoe, Neal, Matthew, Pasi, John, Schutgens, Roger, Stanworth, Simon, Turgeon, Alexis, Weissman, Alexandra, Adhikari, Neill, Anstey, Matthew, Brant, Emily, de Man, Angelique, Lamonagne, Francois, Masse, Marie-Helene, Udy, Andrew, Arnold, Donald, Begin, Phillipe, Charlewood, Richard, Chasse, Michael, Coyne, Mark, Cooper, Jamie, Daly, James, Gosbell, Iain, Harvala-Simmonds, Heli, Hills, Tom, MacLennan, Sheila, Menon, David, McDyer, John, Pridee, Nicole, Roberts, David, Shankar-Hari, Manu, Thomas, Helen, Tinmouth, Alan, Triulzi, Darrell, Walsh, Tim, Wood, Erica, Calfee, Carolyn, O’Kane, Cecilia, Shyamsundar, Murali, Sinha, Pratik, Thompson, Taylor, Young, Ian, Bihari, Shailesh, Hodgson, Carol, Laffey, John, McAuley, Danny, Orford, Neil, Neto, Ary, Lewis, Roger, McGlothlin, Anna, Miller, Eliza, Singh, Vanessa, Zammit, Claire, van Bentum Puijk, Wilma, Bouwman, Wietske, Mangindaan, Yara, Parker, Lorraine, Peters, Svenja, Rietveld, Ilse, Raymakers, Kik, Ganpat, Radhika, Brillinger, Nicole, Markgraf, Rene, Ainscough, Kate, Brickell, Kathy, Anjum, Aisha, Lane, Janis-Best, Richards-Belle, Alvin, Saull, Michelle, Wiley, Daisy, Bion, Julian, Connor, Jason, Gates, Simon, Manax, Victoria, van der Poll, Tom, Reynolds, John, van Beurden, Marloes, Effelaar, Evelien, Schotsman, Joost, Boyd, Craig, Harland, Cain, Shearer, Audrey, Wren, Jess, Clermont, Giles, Garrard, William, Kalchthaler, Kyle, King, Andrew, Ricketts, Daniel, Malakoutis, Salim, Marroquin, Oscar, Music, Edvin, Quinn, Kevin, Cate, Heidi, Pearson, Karen, Collins, Joanne, Hanson, Jane, Williams, Penny, Jackson, Shane, Asghar, Adeeba, Dyas, Sarah, Sutu, Mihaela, Murphy, Sheenagh, Williamson, Dawn, Mguni, Nhlanhla, Potter, Alison, Porter, David, Goodwin, Jayne, Rook, Clare, Harrison, Susie, Williams, Hannah, Campbell, Hilary, Lomme, Kaatje, Williamson, James, Sheffield, Jonathan, van’t Hoff, Willian, McCracken, Phobe, Young, Meredith, Board, Jasmin, Mart, Emma, Knott, Cameron, Smith, Julie, Boschert, Catherine, Affleck, Julia, Ramanan, Mahesh, D’Souza, Ramsy, Pateman, Kelsey, Shakih, Arif, Cheung, Winston, Kol, Mark, Wong, Helen, Shah, Asim, Wagh, Atul, Simpson, Joanne, Duke, Graeme, Chan, Peter, Cartner, Brittney, Hunter, Stephanie, Laver, Russell, Shrestha, Tapaswi, Regli, Adrian, Pellicano, Annamaria, McCullough, James, Tallott, Mandy, Kumar, Nikhil, Panwar, Rakshit, Brinkerhoff, Gail, Koppen, Cassandra, Cazzola, Federica, Brain, Matthew, Mineall, Sarah, Fischer, Roy, Biradar, Vishwanath, Soar, Natalie, White, Hayden, Estensen, Kristen, Morrison, Lynette, Smith, Joanne, Cooper, Melanie, Health, Monash, Shehabi, Yahya, Al-Bassam, Wisam, Hulley, Amanda, Whitehead, Christina, Lowrey, Julie, Gresha, Rebecca, Walsham, James, Meyer, Jason, Harward, Meg, Venz, Ellen, Williams, Patricia, Kurenda, Catherine, Smith, Kirsy, Smith, Margaret, Garcia, Rebecca, Barge, Deborah, Byrne, Deborah, Byrne, Kathleen, Driscoll, Alana, Fortune, Louise, Janin, Pierre, Yarad, Elizabeth, Hammond, Naomi, Bass, Frances, Ashelford, Angela, Waterson, Sharon, Wedd, Steve, McNamara, Robert, Buhr, Heidi, Coles, Jennifer, Schweikert, Sacha, Wibrow, Bradley, Rauniyar, Rashmi, Myers, Erina, Fysh, Ed, Dawda, Ashlish, Mevavala, Bhaumik, Litton, Ed, Ferrier, Janet, Nair, Priya, Buscher, Hergen, Reynolds, Claire, Santamaria, John, Barbazza, Leanne, Homes, Jennifer, Smith, Roger, Murray, Lauren, Brailsford, Jane, Forbes, Loretta, Maguire, Teena, Mariappa, Vasanth, Smith, Judith, Simpson, Scott, Maiden, Matthew, Bone, Allsion, Horton, Michelle, Salerno, Tania, Sterba, Martin, Geng, Wenli, Depuydt, Pieter, De Waele, Jan, De Bus, Liesbet, Fierens, Jan, Bracke, Stephanie, Reeve, Brenda, Dechert, William, Chassé, Michaël, Carrier, François Martin, Boumahni, Dounia, Benettaib, Fatna, Ghamraoui, Ali, Bellemare, David, Cloutier, Ève, Francoeur, Charles, Lamontagne, François, D’Aragon, Frédérick, Carbonneau, Elaine, Leblond, Julie, Vazquez-Grande, Gloria, Marten, Nicole, Wilson, Maggie, Albert, Martin, Serri, Karim, Cavayas, Alexandros, Duplaix, Mathilde, Williams, Virginie, Rochwerg, Bram, Karachi, Tim, Oczkowski, Simon, Centofanti, John, Millen, Tina, Duan, Erick, Tsang, Jennifer, Patterson, Lisa, English, Shane, Watpool, Irene, Porteous, Rebecca, Miezitis, Sydney, McIntyre, Lauralyn, Brochard, Laurent, Burns, Karen, Sandhu, Gyan, Khalid, Imrana, Binnie, Alexandra, Powell, Elizabeth, McMillan, Alexandra, Luk, Tracy, Aref, Noah, Andric, Zdravko, Cviljevic, Sabina, Đimoti, Renata, Zapalac, Marija, Mirković, Gordan, Baršić, Bruno, Kutleša, Marko, Kotarski, Viktor, Vujaklija Brajković, Ana, Babel, Jakša, Sever, Helena, Dragija, Lidija, Kušan, Ira, Vaara, Suvi, Pettilä, Leena, Heinonen, Jonna, Kuitunen, Anne, Karlsson, Sari, Vahtera, Annukka, Kiiski, Heikki, Ristimäki, Sanna, Azaiz, Amine, Charron, Cyril, Godement, Mathieu, Geri, Guillaume, Vieillard-Baron, Antoine, Pourcine, Franck, Monchi, Mehran, Luis, David, Mercier, Romain, Sagnier, Anne, Verrier, Nathalie, Caplin, Cecile, Siami, Shidasp, Aparicio, Christelle, Vautier, Sarah, Jeblaoui, Asma, Fartoukh, Muriel, Courtin, Laura, Labbe, Vincent, Leparco, Cécile, Muller, Grégoire, Nay, Mai-Anh, Kamel, Toufik, Benzekri, Dalila, Jacquier, Sophie, Mercier, Emmanuelle, Chartier, Delphine, Salmon, Charlotte, Dequin, PierreFrançois, Schneider, Francis, Morel, Guillaume, L’Hotellier, Sylvie, Badie, Julio, Berdaguer, Fernando Daniel, Malfroy, Sylvain, Mezher, Chaouki, Bourgoin, Charlotte, Megarbane, Bruno, Voicu, Sebastian, Deye, Nicolas, Malissin, Isabelle, Sutterlin, Laetitia, Guitton, Christophe, Darreau, Cédric, Landais, Mickaël, Chudeau, Nicolas, Robert, Alain, Moine, Pierre, Heming, Nicholas, Maxime, Virginie, Bossard, Isabelle, Nicholier, Tiphaine Barbarin, Colin, Gwenhael, Zinzoni, Vanessa, Maquigneau, Natacham, Finn, André, Kreß, Gabriele, Hoff, Uwe, Friedrich Hinrichs, Carl, Nee, Jens, Hagel, Stefan, Ankert, Juliane, Kolanos, Steffi, Bloos, Frank, Petros, Sirak, Pasieka, Bastian, Kunz, Kevin, Appelt, Peter, Schütze, Bianka, Kluge, Stefan, Nierhaus, Axel, Jarczak, Dominik, Roedl, Kevin, Weismann, Dirk, Frey, Anna, Klinikum Neukölln, Vivantes, Reill, Lorenz, Distler, Michael, Maselli, Astrid, Bélteczki, János, Magyar, István, Fazekas, Ágnes, Kovács, Sándor, Szőke, Viktória, Szigligeti, Gábor, Leszkoven, János, Collins, Daniel, Breen, Patrick, Frohlich, Stephen, Whelan, Ruth, McNicholas, Bairbre, Scully, Michael, Casey, Siobhan, Kernan, Maeve, Doran, Peter, O’Dywer, Michael, Smyth, Michelle, Hayes, Leanne, Hoiting, Oscar, Peters, Marco, Rengers, Els, Evers, Mirjam, Prinssen, Anton, Bosch Ziekenhuis, Jeroen, Simons, Koen, Rozendaal, Wim, Polderman, F, de Jager, P, Moviat, M, Paling, A, Salet, A, Rademaker, Emma, Peters, Anna Linda, de Jonge, E, Wigbers, J, Guilder, E, Butler, M, Cowdrey, Keri-Anne, Newby, Lynette, Chen, Yan, Simmonds, Catherine, McConnochie, Rachael, Ritzema Carter, Jay, Henderson, Seton, Van Der Heyden, Kym, Mehrtens, Jan, Williams, Tony, Kazemi, Alex, Song, Rima, Lai, Vivian, Girijadevi, Dinu, Everitt, Robert, Russell, Robert, Hacking, Danielle, Buehner, Ulrike, Williams, Erin, Browne, Troy, Grimwade, Kate, Goodson, Jennifer, Keet, Owen, Callender, Owen, Martynoga, Robert, Trask, Kara, Butler, Amelia, Schischka, Livia, Young, Chelsea, Lesona, Eden, Olatunji, Shaanti, Robertson, Yvonne, José, Nuno, Amaro dos Santos Catorze, Teodoro, de Lima Pereira, Tiago Nuno Alfaro, Neves Pessoa, Lucilia Maria, Castro Ferreira, Ricardo Manuel, Pereira Sousa Bastos, Joana Margarida, Aysel Florescu, Simin, Stanciu, Delia, Zaharia, Miahela Florentina, Kosa, Alma Gabriela, Codreanu, Daniel, Marabi, Yaseen, Al Qasim, Eman, Moneer Hagazy, Mohamned, Al Swaidan, Lolowa, Arishi, Hatim, Muñoz-Bermúdez, Rosana, Marin-Corral, Judith, Salazar Degracia, Anna, Parrilla Gómez, Francisco, Mateo López, Maria Isabel, Rodriguez Fernandez, Jorge, Cárcel Fernández, Sheila, Carmona Flores, Rosario, León López, Rafael, de la Fuente Martos, Carmen, Allan, Angela, Polgarova, Petra, Farahi, Neda, McWilliam, Stephen, Hawcutt, Daniel, Rad, Laura, O’Malley, Laura, Whitbread, Jennifer, Kelsall, Olivia, Wild, Laura, Thrush, Jessica, Wood, Hannah, Austin, Karen, Donnelly, Adrian, Kelly, Martin, O’Kane, Sinéad, McClintock, Declan, Warnock, Majella, Johnston, Paul, Gallagher, Linda Jude, Mc Goldrick, Clare, Mc Master, Moyra, Strzelecka, Anna, Jha, Rajeev, Kalogirou, Michael, Ellis, Christine, Krishnamurthy, Vinodh, Deelchand, Vashish, Silversides, Jon, McGuigan, Peter, Ward, Kathryn, O’Neill, Aisling, Finn, Stephanie, Phillips, Barbara, Mullan, Dee, Oritz-Ruiz de Gordoa, Laura, Thomas, Matthew, Sweet, Katie, Grimmer, Lisa, Johnson, Rebekah, Pinnell, Jez, Robinson, Matt, Gledhill, Lisa, Wood, Tracy, Morgan, Matt, Cole, Jade, Hill, Helen, Davies, Michelle, Antcliffe, David, Templeton, Maie, Rojo, Roceld, Coghlan, Phoebe, Smee, Joanna, Mackay, Euan, Cort, Jon, Whileman, Amanda, Spencer, Thomas, Spittle, Nick, Kasipandian, Vidya, Patel, Amit, Allibone, Suzanne, Genetu, Roman Mary, Ramali, Mohamed, Ghosh, Alison, Bamford, Peter, London, Emily, Cawley, Kathryn, Faulkner, Maria, Jeffrey, Helen, Smith, Tim, Brewer, Chris, Gregory, Jane, Limb, James, Cowton, Amanda, O’Brien, Julie, Nikitas, Nikitas, Wells, Colin, Lankester, Liana, Pulletz, Mark, Birch, Jenny, Wiseman, Sophie, Horton, Sarah, Alegria, Ana, Turki, Salah, Elsefi, Tarek, Crisp, Nikki, Allen, Louise, McCullagh, Iain, Robinson, Philip, Hays, Carole, Babio-Galan, Maite, Stevenson, Hannah, Khare, Divya, Pinder, Meredith, Selvamoni, Selvin, Gopinath, Amitha, Pugh, Richard, Menzies, Daniel, Mackay, Callum, Allan, Elizabeth, Davies, Gwyneth, Puxty, Kathryn, McCue, Claire, Cathcart, Susanne, Hickey, Naomi, Ireland, Jane, Yusuff, Hakeem, Isgro, Graziella, Brightling, Chris, Bourne, Michelle, Craner, Michelle, Watters, Malcolm, Prout, Rachel, Davies, Louisa, Pegler, Suzannah, Kyeremeh, Lynsey, Arbane, Gill, Wilson, Karen, Gomm, Linda, Francia, Federica, Brett, Stephen, Sousa Arias, Sonia, Elin Hall, Rebecca, Budd, Joanna, Small, Charlotte, Birch, Janine, Collins, Emma, Henning, Jeremy, Bonner, Stephen, Hugill, Keith, Cirstea, Emanuel, Wilkinson, Dean, Karlikowski, Michal, Sutherland, Helen, Wilhelmsen, Elva, Woods, Jane, North, Julie, Sundaran, Dhinesh, Hollos, Laszlo, Coburn, Susan, Walsh, Joanne, Turns, Margaret, Hopkins, Phil, Smith, John, Noble, Harriet, Depante, Maria Theresa, Clarey, Emma, Laha, Shondipon, Verlander, Mark, Williams, Alexandra, Huckle, Abby, Hall, Andrew, Cooke, Jill, Gardiner-Hill, Caroline, Maloney, Carolyn, Qureshi, Hafiz, Flint, Neil, Nicholson, Sarah, Southin, Sara, Nicholson, Andrew, Borgatta, Barbara, Turner-Bone, Ian, Reddy, Amie, Wilding, Laura, Chamara Warnapura, Loku, Agno Sathianathan, Ronan, Golden, David, Hart, Ciaran, Jones, Jo, Bannard-Smith, Jonathan, Henry, Joanne, Birchall, Katie, Pomeroy, Fiona, Quayle, Rachael, Makowski, Arystarch, Misztal, Beata, Ahmed, Iram, KyereDiabour, Thyra, Naiker, Kevin, Stewart, Richard, Mwaura, Esther, Mew, Louise, Wren, Lynn, Willams, Felicity, Innes, Richard, Doble, Patricia, Hutter, Joanne, Shovelton, Charmaine, Plumb, Benjamin, Szakmany, Tamas, Hamlyn, Vincent, Hawkins, Nancy, Lewis, Sarah, Dell, Amanda, Gopal, Shameer, Ganguly, Saibal, Smallwood, Andrew, Harris, Nichola, Metherell, Stella, Lazaro, Juan Martin, Newman, Tabitha, Fletcher, Simon, Nortje, Jurgens, Fottrell-Gould, Deirdre, Randell, Georgina, Zaman, Mohsin, Elmahi, Einas, Jones, Andrea, Hall, Kathryn, Mills, Gary, Ryalls, Kim, Bowler, Helen, Sall, Jas, Bourne, Richard, Borrill, Zoe, Duncan, Tracey, Lamb, Thomas, Shaw, Joanne, Fox, Claire, Moreno Cuesta, Jeronimo, Xavier, Kugan, Purohit, Dharam, Elhassan, Munzir, Bakthavatsalam, Dhanalakshmi, Rowland, Matthew, Hutton, Paula, Bashyal, Archana, Davidson, Neil, Hird, Clare, Chhablani, Manish, Phalod, Gunjan, Kirkby, Amy, Archer, Simon, Netherton, Kimberley, Reschreiter, Henrik, Camsooksai, Julie, Patch, Sarah, Jenkins, Sarah, Pogson, David, Rose, Steve, Daly, Zoe, Brimfield, Lutece, Claridge, Helen, Parekh, Dhruv, Bergin, Colin, Bates, Michelle, Dasgin, Joanne, McGhee, Christopher, Sim, Malcolm, Hay, Sophie Kennedy, Henderson, Steven, Phull, Mandeep-Kaur, Zaidi, Abbas, Pogreban, Tatiana, Rosaroso, Lace Paulyn, Harvey, Daniel, Lowe, Benjamin, Meredith, Megan, Ryan, Lucy, Hormis, Anil, Walker, Rachel, Collier, Dawn, Kimpton, Sarah, Oakley, Susan, Rooney, Kevin, Rodden, Natalie, Hughes, Emma, Thomson, Nicola, McGlynn, Deborah, Walden, Andrew, Jacques, Nicola, Coles, Holly, Tilney, Emma, Vowell, Emma, Schuster-Bruce, Martin, Pitts, Sally, Miln, Rebecca, Purandare, Laura, Vamplew, Luke, Spivey, Michael, Bean, Sarah, Burt, Karen, Moore, Lorraine, Day, Christopher, Gibson, Charly, Gordon, Elizabeth, Zitter, Letizia, Keenan, Samantha, Baker, Evelyn, Cherian, Shiney, Cutler, Sean, Roynon-Reed, Anna, Harrington, Kate, Raithatha, Ajay, Bauchmuller, Kris, Ahmad, Norfaizan, Grecu, Irina, Trodd, Dawn, Martin, Jane, Wrey Brown, Caroline, Arias, Ana-Marie, Craven, Thomas, Hope, David, Singleton, Jo, Clark, Sarah, Rae, Nicola, Welters, Ingeborg, Hamilton, David Oliver, Williams, Karen, Waugh, Victoria, Shaw, David, Puthucheary, Zudin, Martin, Timothy, Santos, Filipa, Uddin, Ruzena, Somerville, Alastair, Tatham, Kate Colette, Jhanji, Shaman, Black, Ethel, Dela Rosa, Arnold, Howle, Ryan, Tully, Redmond, Drummond, Andrew, Dearden, Joy, Philbin, Jennifer, Munt, Sheila, Vuylsteke, Alain, Chan, Charles, Victor, Saji, Matsa, Ramprasad, Gellamucho, Minerva, Creagh-Brown, Ben, Tooley, Joe, Montague, Laura, De Beaux, Fiona, Bullman, Laetitia, Kersiake, Ian, Demetriou, Carrie, Mitchard, Sarah, Ramos, Lidia, White, Katie, Donnison, Phil, Johns, Maggie, Casey, Ruth, Mattocks, Lehentha, Salisbury, Sarah, Dark, Paul, Claxton, Andrew, McLachlan, Danielle, Slevin, Kathryn, Lee, Stephanie, Hulme, Jonathan, Joseph, Sibet, Kinney, Fiona, Senya, Ho Jan, Oborska, Aneta, Kayani, Abdul, Hadebe, Bernard, Orath Prabakaran, Rajalakshmi, Nichols, Lesley, Thomas, Matt, Worner, Ruth, Faulkner, Beverley, Gendall, Emma, Hayes, Kati, Hamilton-Davies, Colin, Chan, Carmen, Mfuko, Celina, Abbass, Hakam, Mandadapu, Vineela, Leaver, Susannah, Forton, Daniel, Patel, Kamal, Paramasivam, Elankumaran, Powell, Matthew, Gould, Richard, Wilby, Elizabeth, Howcroft, Clare, Banach, Dorota, Fernández de Pinedo Artaraz, Ziortza, Cabreros, Leilani, White, Ian, Croft, Maria, Holland, Nicky, Pereira, Rita, Zaki, Ahmed, Johnson, David, Jackson, Matthew, Garrard, Hywel, Juhaz, Vera, Roy, Alistair, Rostron, Anthony, Woods, Lindsey, Cornell, Sarah, Pillai, Suresh, Harford, Rachel, Rees, Tabitha, Ivatt, Helen, Sundara Raman, Ajay, Davey, Miriam, Lee, Kelvin, Barber, Russell, Chablani, Manish, Brohi, Farooq, Jagannathan, Vijay, Clark, Michele, Purvis, Sarah, Wetherill, Bill, Dushianthan, Ahilanandan, Cusack, Rebecca, de Courcy-Golder, Kim, Smith, Simon, Jackson, Susan, Attwood, Ben, Parsons, Penny, Page, Valerie, Zhao, Xiao Bei, Oza, Deepali, Rhodes, Jonathan, Anderson, Tom, Morris, Sheila, Xia Le Tai, Charlotte, Thomas, Amy, Keen, Alexandra, Digby, Stephen, Cowley, Nicholas, Southern, David, Reddy, Harsha, Campbell, Andy, Watkins, Claire, Smuts, Sara, Touma, Omar, Barnes, Nicky, Alexander, Peter, Felton, Tim, Ferguson, Susan, Sellers, Katharine, Bradley-Potts, Joanne, Yates, David, Birkinshaw, Isobel, Kell, Kay, Marshall, Nicola, Carr-Knott, Lisa, Writing Committee for the REMAP-CAP Investigators, Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, Medical Microbiology and Infection Prevention, and AII - Infectious diseases

Subjects
Male, Hydrocortisone, Anti-Inflammatory Agents, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], 01 natural sciences, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Adrenal Cortex Hormones, Clinical endpoint, Medicine, 030212 general & internal medicine, Hydrocortisone/administration & dosage, Original Investigation, 2. Zero hunger, Mortality rate, Shock, Covid19, General Medicine, Middle Aged, Intensive care unit, 3. Good health, Intensive Care Units, Treatment Outcome, Early Termination of Clinical Trials, Corticosteroid, Female, Coronavirus Infections, medicine.drug, Adult, medicine.medical_specialty, Respiration, Artificial/statistics & numerical data, medicine.drug_class, Anti-Inflammatory Agents/administration & dosage, Pneumonia, Viral, UNCOVER, Adrenal Cortex Hormones/therapeutic use, 03 medical and health sciences, Betacoronavirus, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Humans, 0101 mathematics, Adverse effect, Pandemics, business.industry, SARS-CoV-2, 010102 general mathematics, COVID-19, Odds ratio, Coronavirus Infections/drug therapy, Pneumonia, Viral/drug therapy, Respiration, Artificial, COVID-19 Drug Treatment, Shock/drug therapy, Human medicine, business
Abstract

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited.Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19.Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020.Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108).Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%).Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively.Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions.Trial Registration: ClinicalTrials.gov Identifier: NCT02735707.

Published
2020

33. Chest Compression-Related Flail Chest Is Associated with Prolonged Ventilator Weaning in Cardiac Arrest Survivors.

Author

Kunz, Kevin, Petros, Sirak, Ewens, Sebastian, Yahiaoui-Doktor, Maryam, Denecke, Timm, Struck, Manuel Florian, and Krämer, Sebastian

Subjects
*CHEST compressions, *ARTIFICIAL respiration, *CARDIAC arrest, *MEDICAL digital radiography, *INTENSIVE care units, *LOGISTIC regression analysis, *RIB fractures
Abstract

Chest compressions during cardiopulmonary resuscitation (CPR) may be associated with iatrogenic chest wall injuries. The extent to which these CPR-associated chest wall injuries contribute to a delay in the respiratory recovery of cardiac arrest survivors has not been sufficiently explored. In a single-center retrospective cohort study, surviving intensive care unit (ICU) patients, who had undergone CPR due to medical reasons between 1 January 2018 and 30 June 2019, were analyzed regarding CPR-associated chest wall injuries, detected by chest radiography and computed tomography. Among 109 included patients, 38 (34.8%) presented with chest wall injuries, including 10 (9.2%) with flail chest. The multivariable logistic regression analysis identified flail chest to be independently associated with the need for tracheostomy (OR 15.5; 95% CI 2.77–86.27; p = 0.002). The linear regression analysis identified pneumonia (β 11.34; 95% CI 6.70–15.99; p < 0.001) and the presence of rib fractures (β 5.97; 95% CI 1.01–10.93; p = 0.019) to be associated with an increase in the length of ICU stay, whereas flail chest (β 10.45; 95% CI 3.57–17.33; p = 0.003) and pneumonia (β 6.12; 95% CI 0.94–11.31; p = 0.021) were associated with a prolonged duration of mechanical ventilation. Four patients with flail chest underwent surgical rib stabilization and were successfully weaned from the ventilator. The results of this study suggest that CPR-associated chest wall injuries, flail chest in particular, may impair the respiratory recovery of cardiac arrest survivors in the ICU. A multidisciplinary assessment may help to identify patients who could benefit from a surgical treatment approach. [ABSTRACT FROM AUTHOR]

Published
2022
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34. Sepsis Mortality Is high in Patients With Connective Tissue Diseases Admitted to the Intensive Care Unit (ICU).

Author

Krasselt, Marco, Baerwald, Christoph, Petros, Sirak, and Seifert, Olga

Subjects
SEPSIS, SYSTEMIC lupus erythematosus, CONNECTIVE tissue diseases, DERMATOMYOSITIS, MYOSITIS, INTENSIVE care units
Abstract

Objectives: Patients with connective tissue diseases (CTD) such as systemic lupus erythematosus (SLE) have an increased risk for infections. This study investigated the outcome and characteristics of CTD patients under intensive care unit (ICU) treatment for sepsis. Methods: A single-center retrospective analysis was conducted and reviewed all patients with a CTD diagnosis admitted to the ICU of a university hospital for sepsis between 2006 and 2019. Mortality was computed and multivariate logistic regression was used to detect independent risk factors for sepsis mortality. Furthermore, the positive predictive value of ICU scores such as Sequential Organ Failure Assessment (SOFA) score was evaluated. Results: This study included 44 patients with CTD (mean age 59.8 ± 16.1 years, 68.2% females), most of them with a diagnosed SLE (61.4%) followed by systemic sclerosis (15.9%). 56.8% (n = 25) were treated with immunosuppressives and 81.8% (n = 36) received glucocorticoids. Rituximab was used in 3 patients (6.8%). The hospital mortality of septic CTD patients was high with 40.9%. It was highest among systemic sclerosis (SSc) patients (85.7%). SOFA score and diagnosis of SSc were independently associated with mortality in multivariate logistic regression (P = 0.004 and 0.03, respectively). The Simplified Acute Physiology Score II (SAPS II), SOFA and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were good predictors of sepsis mortality in the investigated cohort (SAPS II AUC 0.772, P = 0.002; SOFA AUC 0.756, P = 0.004; APACHE II AUC 0.741, P = 0.007). Conclusions: In-hospital sepsis mortality is high in CTD patients. SSc diagnoses and SOFA were independently associated with mortality. Additionally, common ICU scores were good predictors for mortality. [ABSTRACT FROM AUTHOR]

Published
2022
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37. Influence of direct oral anticoagulants on thrombin generation on Ceveron TGA.

Author

Pfrepper, Christian, Behrendt, Lisa‐Charlott, Bönigk, Hagen, Siegemund, Thomas, Metze, Michael, Franke, Dirk, Petros, Sirak, and Siegemund, Annelie

Subjects
ANTICOAGULANTS, RIVAROXABAN, HEMOSTATICS, BLOOD coagulation factors, THROMBIN
Abstract

Introduction: Monitoring of direct oral anticoagulants (DOACs) with calibrated anti‐Xa assay is limited by the high intra‐ and interindividual variations of the test results. Thrombin generation (TG) is a global hemostatic assay that reflects the patient´s individual coagulation status. The aim of this study was to investigate the influence of DOACs on TG measured with a fully automated assay system. Methods: All consecutive patients under apixaban and rivaroxaban coming to the outpatient coagulation center MVZ Limbach, Magdeburg, Germany between October 2017 and April 2020 were included. DOAC plasma levels were correlated with TG assessed using the fully automated Ceveron TG analyzer. Results: A total of 703 rivaroxaban and 252 apixaban containing plasma samples were included. There was a significant correlation between DOAC plasma levels and all TG parameters except for lag time regarding apixaban. Time to peak and peak thrombin followed an exponential regression curve, while this was linear for the endogenous thrombin potential (ETP). Apixaban showed a lower correlation coefficient for all TG parameters compared with rivaroxaban, and thrombin generation was less influenced by apixaban than rivaroxaban at plasma levels >100 ng/ml. The sensitivity and negative predictive value of normal TG parameters for the prediction of DOAC plasma levels <30 ng/ml was >85%. Conclusion: The present data show a moderate predominantly nonlinear correlation between TG parameters and plasma levels of apixaban and rivaroxaban. Rivaroxaban has a stronger effect on TG than apixaban. [ABSTRACT FROM AUTHOR]

Published
2022
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38. Plasma levels do not predict thrombin generation in patients taking direct oral anticoagulants.

Author

Metze, Michael, Klöter, Tristan, Stöbe, Stephan, Rechenberger, Björn, Siegemund, Roland, Siegemund, Thomas, Laufs, Ulrich, Petros, Sirak, and Pfrepper, Christian

Subjects
PYRIDINE, BLOOD plasma, ORAL drug administration, ANTICOAGULANTS, BENZIMIDAZOLES, RIVAROXABAN, TREATMENT effectiveness, DOSE-effect relationship in pharmacology, THROMBIN, PHARMACODYNAMICS
Abstract

Background: The antithrombotic effect of direct oral anticoagulants (DOAC) in specific clinical scenarios is difficult to assess. Objective: This study aimed to evaluate the effect of DOAC on thrombin generation (TG) in relation to their plasma level. Methods: Eighty patients newly started on anticoagulation were included, 20 patients for each DOAC—apixaban, edoxaban, rivaroxaban, and dabigatran. Plasma was sampled before DOAC (baseline), at plasma peak time, 6 and 12 hours after starting DOAC for quantification of drug levels and TG. Results: The baseline TG before DOAC intake showed inter‐individual variability. All DOACs significantly prolonged lag time (LT) and time to peak (TTP), but did not change endogenous thrombin potential (ETP). Anti‐Xa inhibitors but not dabigatran reduced thrombin peak, but the effect of apixaban at plasma peak was less pronounced (factor 1.6). LT and TTP prolongation of dabigatran was lower compared to anti‐Xa inhibitors. All DOACs showed a nonlinear dose‐response relationship, with the greatest antithrombotic effect at lower DOAC plasma levels. The inhibition of TG parameters between baseline and peak was parallel between individual patients but the coefficient of variation of TG was lower compared to drug levels. Conclusion: The antithrombotic effect at DOAC peak plasma level measured by TG depends on the patient‐specific baseline TG level and the drug‐specific inhibition by the particular DOAC. Although peak plasma levels have a high variability, the variation of TG is lower compared to drug levels. Therefore, TG assays may be superior to plasma levels in the assessment of the intensity of anticoagulation. [ABSTRACT FROM AUTHOR]

Published
2021
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39. Outcome of Patients With Necrotizing Vasculitis Admitted to the Intensive Care Unit (ICU) for Sepsis: Results of a Single-Centre Retrospective Analysis.

Author

Krasselt, Marco, Baerwald, Christoph, Petros, Sirak, and Seifert, Olga

Subjects
VASCULITIS, INTENSIVE care patients, SEPSIS, CYCLOPHOSPHAMIDE, GLUCOCORTICOIDS
Abstract

Introduction/Background: Vasculitis patients have a high risk for infections that may require intensive care unit (ICU) treatment in case of resulting sepsis. Since data on sepsis mortality in this patient group is limited, the present study investigated the clinical characteristics and outcomes of vasculitis patients admitted to the ICU for sepsis. Methods: The medical records of all necrotizing vasculitis patients admitted to the ICU of a tertiary hospital for sepsis in a 13-year period have been reviewed. Mortality was calculated and multivariate logistic regression was used to determine independent risk factors for sepsis mortality. Moreover, the predictive power of common ICU scores was further evaluated. Results: The study included 34 patients with necrotizing vasculitis (mean age 69 + 9.9 years, 35.3% females). 47.1% (n = 16) were treated with immunosuppressives (mostly cyclophosphamide, n = 35.3%) and 76.5% (n = 26) received glucocorticoids. Rituximab was used in 4 patients (11.8%). The inhospital mortality of septic vasculitis patients was 41.2%. The Sequential Organ Failure Assessment (SOFA) score (p = 0.003) was independently associated with mortality in multivariate logistic regression. Acute Physiology And Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II) and SOFA scores were good predictors of sepsis mortality in the investigated vasculitis patients (APACHE II AUC 0.73, p = 0.02; SAPS II AUC 0.81, p < 0.01; SOFA AUC 0.898, p < 0.0001). Conclusions: Sepsis mortality was high in vasculitis patients. SOFA was independently associated with mortality in a logistic regression model. SOFA and other well-established ICU scores were good mortality predictors. [ABSTRACT FROM AUTHOR]

Published
2021
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41. Mortality of Sepsis in Patients With Rheumatoid Arthritis: A Single-Center Retrospective Analysis and Comparison With a Control Group.

Author

Krasselt, Marco, Baerwald, Christoph, Petros, Sirak, and Seifert, Olga

Subjects
RHEUMATOID arthritis treatment, SEPSIS, RENAL replacement therapy, INTENSIVE care units, DATA analysis
Abstract

Introduction/Background: Patients with rheumatoid arthritis (RA) have a high risk of infections that may require intensive care unit (ICU) admission in case of resulting sepsis. Data regarding the mortality of these patients are very limited. This study investigated clinical characteristics and outcomes of patients with RA admitted to the ICU for sepsis and compared the results to a control cohort without RA. Methods: All patients with RA as well as sex-, age-, and admission year-matched controls admitted to the ICU of a university hospital for sepsis between 2006 and 2019 were retrospectively analyzed. Mortality was calculated for both the groups, and multivariate logistic regression was used to determine independent risk factors for sepsis mortality. The positive predictive value of common ICU scores was also investigated. Results: The study included 49 patients with RA (mean age 67.2 ± 9.0 years, 63.3% females) and 51 matched controls (mean age 67.4 ± 9.5 years, 64.7% females). Among the patients with RA, 42.9% (n = 21) were treated with conventional synthetic (cs) disease-modifying antirheumatic drugs (DMARDs) and 30.6% (n = 15) received glucocorticoids only. Seven (14.3%) patients received biologic (b) DMARDs. The hospital mortality was higher among patients with RA (42.9% vs 15.7%, P = .0016). Rheumatoid arthritis was independently associated with mortality in multivariate logistic regression (P = .001). In patients with RA, renal replacement therapy (P = .024), renal failure (P = .027), and diabetes mellitus (P = .028) were independently associated with mortality. Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), and Sequential Organ Failure Assessment (SOFA) scores were good predictors of sepsis mortality in patients with RA (APACHE II area under the curve [AUC]: 0.78, P = .001; SAPS II AUC: 0.78, P < .001; SOFA AUC 0.78, P < .001), but their predictive power was higher among controls. Conclusions: Hospital sepsis mortality was higher in patients with RA than in controls. Rheumatoid arthritis itself is independently associated with an increased sepsis mortality. Renal replacement therapy, renal failure, and diabetes were associated with an increased mortality. Common ICU scores were less well predictors of sepsis mortality in patients with RA compared to non-RA controls. [ABSTRACT FROM AUTHOR]

Published
2021
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42. Safety and efficacy of direct oral anticoagulants under long‐term immunosuppressive therapy after liver, kidney and pancreas transplantation.

Author

Pfrepper, Christian, Herber, Adam, Weimann, Antje, Siegemund, Roland, Engelmann, Cornelius, Aehling, Niklas, Seehofer, Daniel, Berg, Thomas, and Petros, Sirak

Subjects
DRUG efficacy, KIDNEY transplantation, IMMUNOSUPPRESSIVE agents, GRAFT rejection, ANTICOAGULANTS, IMMUNOSUPPRESSION
Abstract

Summary: The safety of direct oral anticoagulants (DOACs) in patients after solid organ transplantation (SOT) is not well defined. This study aimed at describing the safety and efficacy of DOACs in patients after SOT. Patients after kidney and/or liver transplantation under maintenance immunosuppression treated with rivaroxaban (n = 26), apixaban (n = 20) and edoxaban (n = 1) were included. Clinical data were collected retrospectively and using a questionnaire. DOAC plasma levels and thrombin generation (TG) were measured in patients after SOT and compared with nontransplanted controls receiving DOACs. DOACs were administered for 84.6 patient‐years. Mean immunosuppressive trough levels after DOAC initiation increased from baseline by 18.8 ± 29.6% compared to 3.0 ± 16.5% in matched controls (P = 0.004), without significant differences in dose adjustments. No transplant rejection or significant change in liver or renal function was observed. There was one major bleeding after the observation period but no thromboembolic complication. DOAC plasma levels reached the expected range in all patients. The intrinsic hemostatic activity in transplanted patients was higher compared to nontransplant controls. Treatment with DOACs after SOT is safe and effective. Immunosuppressive trough levels should be monitored after DOAC initiation, particularly in the early phase after SOT. These data should be confirmed in a prospective study. [ABSTRACT FROM AUTHOR]

Published
2021
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43. Emicizumab treatment in chronic intermittent haemodialysis.

Author

Weise, Maria, Siegemund, Annelie, Böhme, Lydia, Grey, Daniel, Halbritter, Jan, Petros, Sirak, and Pfrepper, Christian

Subjects
EMICIZUMAB, BISPECIFIC antibodies, HEPARIN, HEMODIALYSIS
Abstract

Patients with severe haemophilia A can nowadays achieve normal life expectancy thanks to current therapeutic options. Although emicizumab is widely used for bleeding prophylaxis to date4 there are still limited data about the use of emicizumab in patients with comorbidities,5 particularly in patients with advanced CKD with or without kidney replacement therapy. Although our findings support the use of emicizumab in haemodialysis patients without relevant non-selective proteinuria, data on more patients with a longer follow-up are needed to generally recommend the use of emicizumab in this patient cohort. [Extracted from the article]

Published
2022
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45. Evaluation of Biomarkers for the Prediction of Venous Thromboembolism in Ambulatory Cancer Patients.

Author

Schorling, Ruth Maria, Pfrepper, Christian, Golombek, Thomas, Cella, Chiara Alessandra, Muñoz-Unceta, Nerea, Siegemund, Roland, Engel, Christoph, Petros, Sirak, Lordick, Florian, and Knödler, Maren

Subjects
CANCER patients, MEAN platelet volume, THROMBOEMBOLISM, FORECASTING, FIBRIN fragment D
Abstract

Background: Venous thromboembolism (VTE) is a common complication of cancer. This study aimed to evaluate immature platelet fraction (IPF), mean platelet volume (MPV), P-selectin, D-dimer, and thrombin generation (TG) as predictive biomarkers for VTE and further the improvement of existing risk assessment models (RAMs). Methods: A prospective, observational, exploratory study was conducted on ambulatory cancer patients with indication for systemic chemotherapy. Baseline RAMs included the Khorana-, Vienna Cancer, Thrombosis-, Protecht-, ONKOTEV-, and Catscore. IPF, MPV, P-selectin, D-dimer, and TG were analysed at baseline and 3-month follow-up. Results: We enrolled 100 patients, of whom 89 completed the follow-up. Frequent tumour types were breast (30%), gastric (14%), gynaecological (14%), and colorectal (14%) cancer. Ten of the 89 patients (11.2%) developed VTE. The highest VTE rate was observed in patients with cholangiocarcinoma (3/5; 60%). Baseline D-dimer levels but not IPF, MPV, or P-selectin were associated with the risk of developing VTE (HR 6.9; p = 0.021). None of the RAMs showed statistical significance in predicting VTE. Peak thrombin and endogenous thrombin potential were lower in patients who developed VTE. Biomarker changes between baseline and follow-up were not associated with VTE risk. Conclusions: VTE risk was well predicted by baseline D-dimer levels. Adding D-dimer could improve existing RAMs to better identify patients who may benefit from primary VTE prophylaxis. The VTE risk among patients with cholangiocarcinoma should be further evaluated. [ABSTRACT FROM AUTHOR]

Published
2020
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47. Middle molecule clearance with high cut-off dialyzer versus high-flux dialyzer using continuous veno-venous hemodialysis with regional citrate anticoagulation: A prospective randomized controlled trial.

Author

Weidhase, Lorenz, Haussig, Elena, Haussig, Stephan, Kaiser, Thorsten, de Fallois, Jonathan, and Petros, Sirak

Subjects
RANDOMIZED controlled trials, MYOGLOBIN, CLINICAL trial registries, CITRATES, ACUTE kidney failure, MOLECULES
Abstract

Background: Regional anticoagulation with citrate during renal replacement therapy (RRT) reduces the risk of bleeding, extends dialyzer lifespan and is cost-effective. Therefore, current guidelines recommend its use if patients are not anticoagulated for another reason and if there are no contraindications against citrate. RRT with regional citrate anticoagulation has been established in critically ill patients as continuous veno-venous hemodialysis (CVVHD) to reduce citrate load. However, CVVHD is inferior regarding middle molecule clearance compared to continuous veno-venous hemofiltration (CVVH). The use of a high cut-off dialyzer in CVVHD may thus present an option for middle molecule clearance similar to CVVH. This may allow combining the advantages of both techniques. Methods: In this prospective, randomized, single-blinded single-center-trial, sixty patients with acute renal failure and established indication for renal replacement therapy were randomized 1:1 into two groups. The control group was put on CVVHD using regional citrate anticoagulation and a high-flux dialyzer, while the intervention group was on CVVHD using regional citrate anticoagulation and a high-cut-off dialyzer. The concentrations of urea, creatinine, β2-microglobulin, myoglobin, interleukin 6 and albumin were measured pre- and post-dialyzer 1, 6, 12, 24 and 48 hours after initiating CVVHD. Results: Mean plasma clearance for β2-microglobulin was 19.6±5.8 ml/min in the intervention group vs. 12.2±3.6 ml/min in the control group (p<0.001). For myoglobin (8.0±4.5 ml/min vs. 0.2±3.6 ml/min, p<0.001) and IL-6 (1.5±4.3 vs. -2.5±3.5 ml/min, p = 0.002) a higher mean plasma clearance using high-cut-off dialyzer could be detected too, but no difference for urea, creatinine and albumin could be observed concerning this parameter between the two groups. Conclusion: CVVHD using a high cut-off dialyzer results in more effective middle molecule clearance than that with high-flux dialyzer. Trial registration: German Clinical Trials Register (, registered 26th November 2013) [ABSTRACT FROM AUTHOR]

Published
2019
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49. Percutaneous tracheostomy

Author

Petros, Sirak

Subjects
learning curve, complications, comparison, surgical tracheostomy, percutaneous tracheostomy, Review, techniques
Abstract

BACKGROUND: Percutaneous tracheostomy (PT) has gained an increasing acceptance as an alternative to the conventional surgical tracheostomy (ST). In experienced hands, and with proper patient selection, it is safe, easy and quick. COMPLICATIONS: Perioperative complications are comparable with those of ST and these are mostly minor. An important advantage of PT over ST is that there is no need to move a critically ill patient to the operating room and the rate of stomal infection is very low. Although data on late complications of PT are not yet sufficient, available reports show a favourable result. TECHNIQUES: Ciaglia's method is the most commonly applied, but no study has shown superiority of any of the percutaneous techniques described. The decision on which method to use should solely be made depending on the clinical situation and the experience of the operator. The learning curve demands caution, attention to detail and adequate experience on the part of the intensive care physician. Although PT is unfortunately declared 'easy', it must be left in the hands of experienced physicians to avoid unnecessary complications, and the risk of overimplementation should be kept in mind.

Published
1999

50. Early Flow Disturbances of Tunnelled Haemodialysis Catheters and Topographic Landmarks in Chest X-Ray.

Author

Fahnert, Jeanette, Stumpp, Patrick, Kahn, Thomas, Keller, Frieder, Schiekofer, Stephan, Petros, Sirak, Halbritter, Jan, Lindner, Tom H., and Rasche, Franz Maximilian

Subjects
HEMODIALYSIS, COMPUTED tomography, CARDIAC surgery, PATIENT safety, HEALTH outcome assessment
Abstract

Background/Aims: The position of the tip of tunnelled haemodialysis (HD) catheters (THC) might influence flow characteristics during HD. In chest X-ray (CXR), carina-related landmarks may be practicable to verify the THC position, and tip-carina distance (TCD) might be useful to predict early-flow dysfunctions. Methods: In this single-centre, retrospective study, the TCD and the angle between the distal catheter and the body vertical axis (tip-body vertical-angle [TVA]) was measured in 115 THC by post-procedure CXR with 2 investigators. The parameters were proved to be feasible by interrater-reliability and correlated with the incidence of flow-dysfunction within 10 days after insertion. Results: Steep-aligned (TVA <40°, p < 0.01) and deep-ending catheters (TCD: right-sighted >1.5 cm or left-sighted >4.5 cm below the carina; p < 0.01) showed a significantly less dysfunction with a good interrater-reliability (R[TVA] = 0.8, R[TCD] = 0.9). Conclusions: Carina-related landmarks in CXR might be helpful to predict early-flow dysfunctions. However, randomized studies will be necessary to confirm this in fluoroscopic-guided placement during the insertion of THC. [ABSTRACT FROM AUTHOR]

Published
2018
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