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Die mechanische Kreislaufunterstützung mittels extrakorporaler Life-Support-Systeme (ECLS) hat in den letzten Jahren stark zugenommen. Diese kritisch Kranken stellen besondere Herausforderungen an das multiprofessionelle Behandlungsteam und erfordern umfassende, interdisziplinäre und interprofessionelle Konzepte. Aus diesem Grunde wurde zur Gewährleistung einer bestmöglichen Patientenversorgung ein standardisiertes „Ausbildungsmodul ECLS“ auf nationaler, fachgesellschaftlicher Ebene unter Berücksichtigung des notfall- und intensivmedizinischen Managements geschaffen.

The susceptibility of the brain to ischaemic injury dramatically limits its viability following interruptions in blood flow. However, data from studies of dissociated cells, tissue specimens, isolated organs and whole bodies have brought into question the temporal limits within which the brain is capable of tolerating prolonged circulatory arrest. This Review assesses cell type-specific mechanisms of global cerebral ischaemia, and examines the circumstances in which the brain exhibits heightened resilience to injury. We suggest strategies for expanding such discoveries to fuel translational research into novel cytoprotective therapies, and describe emerging technologies and experimental concepts. By doing so, we propose a new multimodal framework to investigate brain resuscitation following extended periods of circulatory arrest.

We sought to clarify the benefit of cytokine adsorption in patients with COVID-19 supported with venovenous extracorporeal membrane oxygenation (ECMO).

WITH 500,000 inhabitants, Nuremberg is the second largest city in the German state of Bavaria after Munich. In the 1990s it was decided to add a third metro line (U3) [...]

The aim of this study was to report our experience with patients on the extracorporeal life support system (ECLS) who presented with thigh compartment syndrome, a yet unreported complication.

The study was to test the hypothesis that mesenteric and renal arteries may be occluded by intra-aortic balloon pumps (IABPs), despite correct positioning. Computed tomography scans of 107 patients (34.6 women and 65.4 men) were evaluated for diameter and distance measurements of the descending aorta. Renal perfusion was examined with duplex sonography. Mean distances between left subclavian artery and celiac trunk, between the left subclavian and superior mesenteric artery, and between the left subclavian and renal artery were 214.5 ± 22.3, 229.5 ± 22.3, and 242.9 ± 22.1 mm, respectively. Statistical assessment of aortic distances in patient population showed no correlation between the length of the descending aorta and body mass index (BMI) and height (men: R2< 0.13; women: R2< 0.3). An impaired arterial perfusion of the renal parenchyma existed in three of the 12 patients; three of the 12 demonstrated diastolic oscillatory flow over the renal arteries; two of the 12 patients presented both during IABP support. Autopsy observation was used to observe the position of the IABP catheter. The correlation between patient heightBMI and the distances between subclavian artery and renalvisceral branches is weak. Therefore, even if positioned correctly, intra-aortic balloon catheters may be too long and could potentially cause occlusion of aortic branches.

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Geisen: Roche: Research Funding. Berchtold-Herz:Novartis: Consultancy; Thoratec: Consultancy. Zieger:CSL Behring: Research Funding; Baxalta: Research Funding; Bayer: Research Funding; German Research Foundation, Bonn, Germany [ZI 486/7-1]: Research Funding.