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3. Antifungal prophylaxis for prevention of COVID-19-associated pulmonary aspergillosis in critically ill patients: an observational study

Author

Hatzl, Stefan, Reisinger, Alexander C, Posch, Florian, Prattes, Juergen, Stradner, Martin, Pilz, Stefan, Eller, Philipp, Schoerghuber, Michael, Toller, Wolfgang, Gorkiewicz, Gregor, Metnitz, Philipp, Rief, Martin, Prüller, Florian, Rosenkranz, Alexander R, Valentin, Thomas, Krause, Robert, Hoenigl, Martin, and Schilcher, Gernot

Subjects
Comparative Effectiveness Research, Lung, Clinical Research, Prevention, Clinical Trials and Supportive Activities, Respiratory, Infection, Good Health and Well Being, Aged, Antifungal Agents, COVID-19, Critical Illness, Female, Humans, Intensive Care Units, Male, Middle Aged, Pulmonary Aspergillosis, Respiratory Distress Syndrome, Triazoles, ICU, CAPA, COVID-19-associated aspergillosis, Posaconazole, Mould prophylaxis, Medical and Health Sciences, Emergency & Critical Care Medicine
Abstract

BackgroundCoronavirus disease 19 (COVID-19)-associated pulmonary aspergillosis (CAPA) emerged as important fungal complications in patients with COVID-19-associated severe acute respiratory failure (ARF). Whether mould active antifungal prophylaxis (MAFP) can prevent CAPA remains elusive so far.MethodsIn this observational study, we included all consecutive patients admitted to intensive care units with COVID-19-associated ARF between September 1, 2020, and May 1, 2021. We compared patients with versus without antifungal prophylaxis with respect to CAPA incidence (primary outcome) and mortality (secondary outcome). Propensity score adjustment was performed to account for any imbalances in baseline characteristics. CAPA cases were classified according to European Confederation of Medical Mycology (ECMM)/International Society of Human and Animal Mycoses (ISHAM) consensus criteria.ResultsWe included 132 patients, of whom 75 (57%) received antifungal prophylaxis (98% posaconazole). Ten CAPA cases were diagnosed, after a median of 6 days following ICU admission. Of those, 9 CAPA cases were recorded in the non-prophylaxis group and one in the prophylaxis group, respectively. However, no difference in 30-day ICU mortality could be observed. Thirty-day CAPA incidence estimates were 1.4% (95% CI 0.2-9.7) in the MAFP group and 17.5% (95% CI 9.6-31.4) in the group without MAFP (p = 0.002). The respective subdistributional hazard ratio (sHR) for CAPA incidence comparing the MAFP versus no MAFP group was of 0.08 (95% CI 0.01-0.63; p = 0.017).ConclusionIn ICU patients with COVID-19 ARF, antifungal prophylaxis was associated with significantly reduced CAPA incidence, but this did not translate into improved survival. Randomized controlled trials are warranted to evaluate the efficacy and safety of MAFP with respect to CAPA incidence and clinical outcomes.

Published
2021

4. Nationwide analysis of hospital admissions and outcomes of patients with SARS-CoV-2 infection in Austria in 2020 and 2021

Author

Paul Zajic, Michael Hiesmayr, Peter Bauer, David M. Baron, Anastasiia Gruber, Michael Joannidis, Martin Posch, and Philipp G. H. Metnitz

Subjects
Medicine, Science
Abstract

Abstract This retrospective study evaluated temporal and regional trends of patient admissions to hospitals, intensive care units (ICU), and intermediate care units (IMCU) as well as outcomes during the COVID-19 pandemic in Austria. We analysed anonymous data from patients admitted to Austrian hospitals with COVID-19 between January 1st, 2020 and December 31st, 2021. We performed descriptive analyses and logistic regression analyses for in-hospital mortality, IMCU or ICU admission, and in-hospital mortality following ICU admission. 68,193 patients were included, 8304 (12.3%) were primarily admitted to ICU, 3592 (5.3%) to IMCU. Hospital mortality was 17.3%; risk factors were male sex (OR 1.67, 95% CI 1.60–1.75, p

Published
2023
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5. Association of immediate versus delayed extubation of patients admitted to intensive care units postoperatively and outcomes: A retrospective study.

Author

Paul Zajic, Michael Eichinger, Michael Eichlseder, Barbara Hallmann, Gabriel Honnef, Tobias Fellinger, Barbara Metnitz, Martin Posch, Martin Rief, and Philipp G H Metnitz

Subjects
Medicine, Science
Abstract

Aim of this studyThis study seeks to investigate, whether extubation of tracheally intubated patients admitted to intensive care units (ICU) postoperatively either immediately at the day of admission (day 1) or delayed at the first postoperative day (day 2) is associated with differences in outcomes.Materials and methodsWe performed a retrospective analysis of data from an Austrian ICU registry. Adult patients admitted between January 1st, 2012 and December 31st, 2019 following elective and emergency surgery, who were intubated at the day 1 and were extubated at day 1 or day 2, were included. We performed logistic regression analyses for in-hospital mortality and over-sedation or agitation following extubation.Results52 982 patients constituted the main study population. 1 231 (3.3%) patients extubated at day 1 and 958 (5.9%) at day 2 died in hospital, 464 (1.3%) patients extubated at day 1 and 613 (3.8%) at day 2 demonstrated agitation or over-sedation after extubation during ICU stay; OR (95% CI) for in-hospital mortality were OR 1.17 (1.01-1.35, p = 0.031) and OR 2.15 (1.75-2.65, pConclusionsWe conclude that immediate extubation as soon as deemed feasible by clinicians is associated with favourable outcomes and may thus be considered preferable in tracheally intubated patients admitted to ICU postoperatively.

Published
2023
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6. Evaluation of the usefulness of non-invasive serum haemoglobin measurement in a perioperative setting in a prospective observational study

Author

Gabriel Honnef, Daniel Auinger, Michael Eichinger, Michael Eichlseder, Philipp G. H. Metnitz, Martin Rief, Paul Zajic, Philipp Zoidl, and Helmar Bornemann-Cimenti

Subjects
Medicine, Science
Abstract

Abstract Patient Blood Management (PBM) programmes seek to reduce the number of missed anaemic patients in the run-up to surgery. The aim of this study was to evaluate the usefulness of haemoglobin (Hb) measured non-invasively (SpHb) in preoperative screening for anaemia. We conducted a prospective observational study in a preoperative clinic. Adult patients undergoing examination for surgery who had their Hb measured by laboratory means also had their Hb measured non-invasively by a trained health care provider. 1216 patients were recruited. A total of 109 (9.3%) patients (53 men and 56 women) was found to be anaemic by standard laboratory Hb measurement. Sensitivity for SpHb to detect anaemic patients was 0.50 (95% CI 0.37–0.63) in women and 0.30 (95% CI 0.18–0.43) in men. Specificity was 0.97 (95% CI 0.95–0.98) in men and 0.93 (95% CI 0.84–1.0) in women. The rate of correctly classified patients was 84.7% for men and 89.4% for women. Positive predictive value for SpHb was 0.50 (95% CI 0.35–0.65) in men and 0.40 (95% CI 0.31–0.50) in women; negative predictive value was 0.93 (95% CI 0.92–0.94) in men and 0.95 (95% CI 0.94–0.96) in women. We conclude that due to low sensitivity, SpHb is poorly suitable for detecting preoperative anaemia in both sexes under standard of care conditions.

Published
2022
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7. Data for: Reliability of mechanical ventilation during continuous chest compressions: A crossover study of transport ventilators in a human cadaver model of CPR

Author

Simon Orlob, Christoph Hobisch, Johannes Wittig, Daniel Auinger, Otto Touzil, Gabriel Honnef, Otmar Schindler, Philipp Metnitz, Georg Feigl, and Gerhard Prause

Subjects
cardiopulmonary resuscitation, Mechanical ventilation, Mechanical chest-compression, Respiratory monitoring, Thiel embalmed cadaver, Biomechanics, Computer applications to medicine. Medical informatics, R858-859.7, Science (General), Q1-390
Abstract

The data presented in this article relate to the research article, “Reliability of mechanical ventilation during continuous chest compressions: a crossover study of transport ventilators in a human cadaver model of CPR” [1].This article contains raw data of continuous recordings of airflow, airway and esophageal pressure during the whole experiment. Data of mechanical ventilation was obtained under ongoing chest compressions and from repetitive measurements of pressure-volume curves. All signals are presented as raw time series data with a sample rate of 200Hz for flow and 500 Hz for pressure. Additionally, we hereby publish extracted time series recordings of force and compression depth from the used automated chest compression device. Concomitantly, we report tables with time stamps from our laboratory book by which the data can be sequenced into different phases of the study protocol.We also present a dataset of derived volumes which was used for statistical analysis in our research article together with the used exclusion list.The reported dataset can help to understand mechanical properties of Thiel-embalmed cadavers better and compare different models of cardiopulmonary resuscitation (CPR). Future research may use this data to translate our findings from bench to bedside. Our recordings may become useful in developing respiratory monitors for CPR, especially in prototyping and testing algorithms of such devices.

Published
2023
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10. A retrospective cohort study on association of age and physician decision making for or against rapid sequence intubation in unconscious patients

Author

Michael Eichlseder, Michael Eichinger, Barbara Hallmann, Gabriel Honnef, Philipp Metnitz, Gerhard Prause, Philipp Zoidl, and Paul Zajic

Subjects
Medicine, Science
Abstract

Abstract In unconscious individuals, rapid sequence intubation (RSI) may be necessary for cardiopulmonary stabilisation and avoidance of secondary damage. Opinions on such invasive procedures in people of older age vary. We thus sought to evaluate a possible association between the probability of receiving prehospital RSI in unconsciousness and increasing age. We conducted a retrospective study in all missions (traumatic and non-traumatic) of the prehospital emergency physician response unit in Graz between January 1st, 2010 and December 31st, 2019, which we searched for Glasgow Coma Scale (GCS) below 9. Cardiac arrests were excluded. We performed multivariable regression analysis for RSI with age, GCS, independent living, and suspected cause as independent variables. Of the 769 finally included patients, 256 (33%) received RSI, whereas 513 (67%) did not. Unadjusted rates of RSI were significantly lower in older patients (aged 85 years and older) compared to the reference group aged 50–64 years (13% vs. 51%, p

Published
2022
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11. Antifungal prophylaxis for prevention of COVID-19-associated pulmonary aspergillosis in critically ill patients: an observational study

Author

Stefan Hatzl, Alexander C. Reisinger, Florian Posch, Juergen Prattes, Martin Stradner, Stefan Pilz, Philipp Eller, Michael Schoerghuber, Wolfgang Toller, Gregor Gorkiewicz, Philipp Metnitz, Martin Rief, Florian Prüller, Alexander R. Rosenkranz, Thomas Valentin, Robert Krause, Martin Hoenigl, and Gernot Schilcher

Subjects
ICU, CAPA, COVID-19-associated aspergillosis, Posaconazole, Mould prophylaxis, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Coronavirus disease 19 (COVID-19)-associated pulmonary aspergillosis (CAPA) emerged as important fungal complications in patients with COVID-19-associated severe acute respiratory failure (ARF). Whether mould active antifungal prophylaxis (MAFP) can prevent CAPA remains elusive so far. Methods In this observational study, we included all consecutive patients admitted to intensive care units with COVID-19-associated ARF between September 1, 2020, and May 1, 2021. We compared patients with versus without antifungal prophylaxis with respect to CAPA incidence (primary outcome) and mortality (secondary outcome). Propensity score adjustment was performed to account for any imbalances in baseline characteristics. CAPA cases were classified according to European Confederation of Medical Mycology (ECMM)/International Society of Human and Animal Mycoses (ISHAM) consensus criteria. Results We included 132 patients, of whom 75 (57%) received antifungal prophylaxis (98% posaconazole). Ten CAPA cases were diagnosed, after a median of 6 days following ICU admission. Of those, 9 CAPA cases were recorded in the non-prophylaxis group and one in the prophylaxis group, respectively. However, no difference in 30-day ICU mortality could be observed. Thirty-day CAPA incidence estimates were 1.4% (95% CI 0.2–9.7) in the MAFP group and 17.5% (95% CI 9.6–31.4) in the group without MAFP (p = 0.002). The respective subdistributional hazard ratio (sHR) for CAPA incidence comparing the MAFP versus no MAFP group was of 0.08 (95% CI 0.01–0.63; p = 0.017). Conclusion In ICU patients with COVID-19 ARF, antifungal prophylaxis was associated with significantly reduced CAPA incidence, but this did not translate into improved survival. Randomized controlled trials are warranted to evaluate the efficacy and safety of MAFP with respect to CAPA incidence and clinical outcomes.

Published
2021
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12. Reliability of mechanical ventilation during continuous chest compressions: a crossover study of transport ventilators in a human cadaver model of CPR

Author

Simon Orlob, Johannes Wittig, Christoph Hobisch, Daniel Auinger, Gabriel Honnef, Tobias Fellinger, Robin Ristl, Otmar Schindler, Philipp Metnitz, Georg Feigl, and Gerhard Prause

Subjects
Cardiac arrest, Artificial respiration, Ventilators, mechanical, Cardiopulmonary resuscitation, Tidal volume, Reversed airflow, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Previous studies have stated that hyperventilation often occurs in cardiopulmonary resuscitation (CPR) mainly due to excessive ventilation frequencies, especially when a manual valve bag is used. Transport ventilators may provide mandatory ventilation with predetermined tidal volumes and without the risk of hyperventilation. Nonetheless, interactions between chest compressions and ventilations are likely to occur. We investigated whether transport ventilators can provide adequate alveolar ventilation during continuous chest compression in adult CPR. Methods A three-period crossover study with three common transport ventilators in a cadaver model of CPR was carried out. The three ventilators ‘MEDUMAT Standard²’, ‘Oxylog 3000 plus’, and ‘Monnal T60’ represent three different interventions, providing volume-controlled continuous mandatory ventilation (VC-CMV) via an endotracheal tube with a tidal volume of 6 mL/kg predicted body weight. Proximal airflow was measured, and the net tidal volume was derived for each respiratory cycle. The deviation from the predetermined tidal volume was calculated and analysed. Several mixed linear models were calculated with the cadaver as a random factor and ventilator, height, sex, crossover period and incremental number of each ventilation within the period as covariates to evaluate differences between ventilators. Results Overall median deviation of net tidal volume from predetermined tidal volume was − 21.2 % (IQR: 19.6, range: [− 87.9 %; 25.8 %]) corresponding to a tidal volume of 4.75 mL/kg predicted body weight (IQR: 1.2, range: [0.7; 7.6]). In a mixed linear model, the ventilator model, the crossover period, and the cadaver’s height were significant factors for decreased tidal volume. The estimated effects of tidal volume deviation for each ventilator were − 14.5 % [95 %-CI: −22.5; −6.5] (p = 0.0004) for ‘Monnal T60’, − 30.6 % [95 %-CI: −38.6; −22.6] (p

Published
2021
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13. Factors associated with physician decision making on withholding cardiopulmonary resuscitation in prehospital medicine

Author

Paul Zajic, Philipp Zoidl, Marlene Deininger, Stefan Heschl, Tobias Fellinger, Martin Posch, Philipp Metnitz, and Gerhard Prause

Subjects
Medicine, Science
Abstract

Abstract This study seeks to identify factors that are associated with decisions of prehospital physicians to start (continue, if ongoing) or withhold (terminate, if ongoing) CPR in patients with OHCA. We conducted a retrospective study using anonymised data from a prehospital physician response system. Data on patients attended for cardiac arrest between January 1st, 2010 and December 31st, 2018 except babies at birth were included. Logistic regression analysis with start of CPR by physicians as the dependent variable and possible associated factors as independent variables adjusted for anonymised physician identifiers was conducted. 1525 patient data sets were analysed. Obvious signs of death were present in 278 cases; in the remaining 1247, resuscitation was attempted in 920 (74%) and were withheld in 327 (26%). Factors significantly associated with higher likelihood of CPR by physicians (OR 95% CI) were resuscitation efforts by EMS before physician arrival (60.45, 19.89–184.29), first monitored heart rhythm (3.07, 1.21–7.79 for PEA; 29.25, 1.93–442. 51 for VF / pVT compared to asystole); advanced patient age (modelled using cubic splines), physician response time (0.92, 0.87–0.97 per minute) and malignancy (0.22, 0.05–0.92) were significantly associated with lower odds of CPR. We thus conclude that prehospital physicians make decisions to start or withhold resuscitation routinely and base those mostly on situational information and immediately available patient information known to impact outcomes.

Published
2021
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14. Adsorption therapy in critically ill with septic shock and acute kidney injury: a retrospective and prospective cohort study

Author

Gregor A. Schittek, Philipp Zoidl, Michael Eichinger, Simon Orlob, Holger Simonis, Martin Rief, Philipp Metnitz, Tobias Fellinger, and Jens Soukup

Subjects
Cytosorb, Haemoadsorption, Mortality, Outcome, Sepsis, Septic shock, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Haemoadsorption has been described as an effective way to control increased pro- and anti-inflammatory mediators (“cytokine storm”) in septic shock patients. No prospective or randomised clinical study has yet confirmed these results. However, no study has yet prospectively specifically investigated patients in severe septic shock with sepsis-associated acute kidney injury (SA-AKI). Therefore, we aimed to examine whether haemoadsorption could influence intensive care unit (ICU) and hospital mortality in these patients. Furthermore, we examined the influence of haemoadsorption on length of stay in the ICU and therapeutic support. Methods Retrospective control group and prospective intervention group design in a tertiary hospital in central Europe (Germany). Intervention was the implementation of haemoadsorption for patients in septic shock with SA-AKI. 76 patients were included in this analysis. Results Severity of illness as depicted by APACHE II was higher in patients treated with haemoadsorption. Risk-adjusted ICU mortality rates (O/E ratios) did not differ significantly between the groups (0.80 vs. 0.83). We observed in patients treated with haemoadsorption a shorter LOS and shorter therapeutic support such as catecholamine dependency and duration of RRT. However, in multivariate analysis (logistic regression for mortality, competing risk for LOS), we found no significant differences between the two groups. Conclusions The implementation of haemoadsorption for patients in septic shock with acute renal failure did not lead to a reduction in ICU or hospital mortality rates. Despite univariate analysis delivering some evidence for a shorter duration of ICU-related treatments in the haemoadsorption group, these results did not remain significant in multivariate analysis. Trial registration CytoSorb® registry https://clinicaltrials.gov/ct2/show/NCT02312024 . December 9, 2014. Database: https://www.cytosorb-registry.org/ (registration for content acquisition is necessary)

Published
2020
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17. Atlanto-occipital dislocation in a patient presenting with out-of-hospital cardiac arrest: a case report and literature review

Author

Martin Rief, Philipp Zoidl, Paul Zajic, Stefan Heschl, Simon Orlob, Günther Silbernagel, Philipp Metnitz, Paul Puchwein, and Gerhard Prause

Subjects
Advanced trauma life support, Multiple trauma, Neck injuries, Spinal cord injuries, Out-of-hospital cardiac arrest, Medicine
Abstract

Abstract Background Atlanto-occipital dislocation is a rare and severe injury of the upper spine associated with a very poor prognosis. Case presentation We report the case of a 59-year-old European man who suffered from out-of-hospital cardiac arrest following a motor vehicle accident. Cardiopulmonary resuscitation was initiated immediately by bystanders and continued by emergency medical services. After 30 minutes of cardiopulmonary resuscitation with a total of five shocks following initial ventricular fibrillation, return of spontaneous circulation was achieved. An electrocardiogram recorded after return of spontaneous circulation at the scene showed signs of myocardial ischemia as a possible cause for the cardiac arrest. No visible signs of injury were found. He was transferred to the regional academic trauma center. Following an extended diagnostic and therapeutic workup in the emergency room, including extended focused assessment with sonography for trauma ultrasound, whole-body computed tomography, and magnetic resonance imaging (of his head and neck), a diagnosis of major trauma (atlanto-occipital dislocation, bilateral serial rip fractures and pneumothoraces, several severe intracranial bleedings, and other injuries) was made. An unfavorable outcome was initially expected due to suspected tetraplegia and his inability to breathe following atlanto-occipital dislocation. Contrary to initial prognostication, after 22 days of intensive care treatment and four surgical interventions (halo fixation, tracheostomy, intracranial pressure probe, chest drains) he was awake and oriented, spontaneously breathing, and moving his arms and legs. Six weeks after the event he was able to walk without aid. After 2 months of clinical treatment he was able to manage all the activities of daily life on his own. It remains unclear, whether cardiac arrest due to a cardiac cause resulted in complete atony of the paravertebral muscles and caused this extremely severe lesion (atlanto-occipital dislocation) or whether cardiac arrest was caused by apnea due the paraplegia following the spinal injury of the trauma. Conclusions A plausible cause for the trauma was myocardial infarction which led to the car accident and the major trauma in relation to the obviously minor trauma mechanism. With this case report we aim to familiarize clinicians with the mechanism of injury that will assist in the diagnosis of atlanto-occipital dislocation. Furthermore, we seek to emphasize that patients presenting with electrocardiographic signs of myocardial ischemia after high-energy trauma should primarily be transported to a trauma facility in a percutaneous coronary intervention-capable center rather than the catheterization laboratory directly.

Published
2019
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18. Comparison of Two Nuclear Magnetic Resonance Spectroscopy Methods for the Measurement of Lipoprotein Particle Concentrations

Author

Martin Rief, Reinhard Raggam, Peter Rief, Philipp Metnitz, Tatjana Stojakovic, Markus Reinthaler, Marianne Brodmann, Winfried März, Hubert Scharnagl, and Günther Silbernagel

Subjects
nuclear magnetic resonance spectroscopy, ultracentrifugation, lipoproteins, lipoprotein subclasses, methods, analysis, Biology (General), QH301-705.5
Abstract

Background: Measuring lipoprotein particle concentrations may help to improve cardiovascular risk stratification. Both the lipofit (Numares) and lipoprofile (LabCorp) NMR methods are widely used for the quantification of lipoprotein particle concentrations. Objective: The aim of the present work was to perform a method comparison between the lipofit and lipoprofile NMR methods. In addition, there was the objective to compare lipofit and lipoprofile measurements of standard lipids with clinical chemistry-based results. Methods: Total, LDL, and HDL cholesterol and triglycerides were measured with ß-quantification in serum samples from 150 individuals. NMR measurements of standard lipids and lipoprotein particle concentrations were performed by Numares and LabCorp. Results: For both NMR methods, differences of mean concentrations compared to ß-quantification-derived measurements were ≤5.5% for all standard lipids. There was a strong correlation between ß-quantification- and NMR-derived measurements of total and LDL cholesterol and triglycerides (all r > 0.93). For both, the lipofit (r = 0.81) and lipoprofile (r = 0.84) methods, correlation coefficients were lower for HDL cholesterol. There was a reasonable correlation between LDL and HDL lipoprotein particle concentrations measured with both NMR methods (both r > 0.9). However, mean concentrations of major and subclass lipoprotein particle concentrations were not as strong. Conclusions: The present analysis suggests that reliable measurement of standard lipids is possible with these two NMR methods. Harmonization efforts would be needed for better comparability of particle concentration data.

Published
2022
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19. Weekends affect mortality risk and chance of discharge in critically ill patients: a retrospective study in the Austrian registry for intensive care

Author

Paul Zajic, Peter Bauer, Andrew Rhodes, Rui Moreno, Tobias Fellinger, Barbara Metnitz, Faidra Stavropoulou, Martin Posch, and Philipp G. H. Metnitz

Subjects
Critical care, Mortality, Patient discharge, Quality of health care, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background In this study, we primarily investigated whether ICU admission or ICU stay at weekends (Saturday and Sunday) is associated with a different risk of ICU mortality or chance of ICU discharge than ICU admission or ICU stay on weekdays (Monday to Friday). Secondarily, we analysed whether weekend ICU admission or ICU stay influences risk of hospital mortality or chance of hospital discharge. Methods A retrospective study was performed for all adult patients admitted to 119 ICUs participating in the benchmarking project of the Austrian Centre for Documentation and Quality Assurance in Intensive Care (ASDI) between 2012 and 2015. Readmissions to the ICU during the same hospital stay were excluded. Results In a multivariable competing risk analysis, a strong weekend effect was observed. Patients admitted to ICUs on Saturday or Sunday had a higher mortality risk after adjustment for severity of illness by Simplified Acute Physiology Score (SAPS) 3, year, month of the year, type of admission, ICU, and weekday of death or discharge. Hazard ratios (95% confidence interval) for death in the ICU following admission on a Saturday or Sunday compared with Wednesday were 1.15 (1.08–1.23) and 1.11 (1.03–1.18), respectively. Lower hazard ratios were observed for dying on a Saturday (0.93 (0.87–1.00)) or Sunday (0.85 (0.80–0.91)) compared with Wednesday. This is probably related to the reduced chance of being discharged from the ICU at the weekend (0.63 (0.62–064) for Saturday and 0.56 (0.55–0.57) for Sunday). Similar results were found for hospital mortality and hospital discharge following ICU admission. Conclusions Patients admitted to ICUs at weekends are at increased risk of death in both the ICU and the hospital even after rigorous adjustment for severity of illness. Conversely, death in the ICU and discharge from the ICU are significantly less likely at weekends.

Published
2017
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22. Hemodynamic management of critically ill burn patients: an international survey

Author

Sabri Soussi, Mette M. Berger, Kirsten Colpaert, Martin W. Dünser, Anne Berit Guttormsen, Nicole P. Juffermans, Paul Knape, Guniz Koksal, Athina Lavrentieva, Thomas Leclerc, José A. Lorente, Ignacio Martin-Loeches, Philipp Metnitz, Olivier Pantet, Paolo Pelosi, Anne-Françoise Rousseau, Folke Sjöberg, Matthieu Legrand, and for the ESICM Burn ICU working group

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published
2018
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24. Hemodynamic management of critically ill burn patients: an international survey

Author

Soussi, Sabri, Berger, Mette M., Colpaert, Kirsten, Dünser, Martin W., Guttormsen, Anne Berit, Juffermans, Nicole P., Knape, Paul, Koksal, Guniz, Lavrentieva, Athina, Leclerc, Thomas, Lorente, José A., Martin-Loeches, Ignacio, Metnitz, Philipp, Pantet, Olivier, Pelosi, Paolo, Rousseau, Anne-Françoise, Sjöberg, Folke, Legrand, Matthieu, and for the ESICM Burn ICU working group

Published
2018
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25. ERAS bei der Sectio: Wo stehen wir in Österreich?

Author

Hochstätter, R, additional, Schütz, A-M, additional, Taumberger, N, additional, Bornemann-Cimenti, H, additional, Oppelt, P, additional, Fazelnia, C, additional, Petricevic, L, additional, Tsibulak, I, additional, Batiduan, L-M, additional, Tomasch, G, additional, Weiss, E-C, additional, Tamussino, K, additional, Metnitz, P, additional, Schöll, W, additional, and Fluhr, Herbert, additional

Published
2022
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28. Herausforderungen bei der Implementierung von neuen Behandlungskonzepten

Author

Lumenta, DB, Bauer, B, Muench, A, Fuchs, A, Metnitz, P, and Kamolz, LP

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung: Bei Einführung neuer Behandlungskonzepte müssen Aspekte Berücksichtigung finden, die eine Herausarbeitung von verschiedenen Motivationen erfordern. Am Beispiel der Akutversorgung von Brandverletzungen der oberen Extremitäten soll die Einführung eines neuen Behandlungskonzepts[zum vollständigen Text gelangen Sie über die oben angegebene URL], 38. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2020)

Published
2020
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31. Mortality after surgery in Europe: a 7 day cohort study

Author

Pearse, R, Moreno, R, Bauer, P, Pelosi, P, Metnitz, P, Spies, C, Vallet, B, Vincent, J, Hoeft, A, Rhodes, A, Fagnoul, D, van Obbergh, L, Al Subaie, N, Arif, F, Cashman, J, Cecconi, M, Edsell, M, Fossati, N, Hammond, S, Hamilton, M, Lonsdale, D, Moran, C, Siegmueller, C, Velzeboer, F, Wong, P, Awlakpui, E, Scheidemann, M, Wittmann, M, Damster, S, Golder, K, Hewson, R, Januszewska, M, Leva, B, Ramos, V, Hoste, E, Huyghens, L, Jacobs, R, Van Mossevelde, V, Opdenacker, G, Poelaert, J, Spapen, H, Leleu, K, Rijckaert, D, De Decker, K, Foubert, L, De Neve, N, Biston, P, Piagnerelli, M, Collin, V, den Blauwen, N, Clauwaert, C, De Crop, L, Verbeke, A, Derumeaux, P, Gardin, C, Kindt, S, Louage, S, Verhamme, B, Druwé, P, Lahaye, I, Rosseel, F, Rutsaert, R, Vanlinthout, L, De Kock, M, Forget, P, Georges, P, Grosu, I, Kahn, D, Lois, F, Momeni, M, Pospiech, A, Yemnga, B, Jadoul, J, Malbrain, M, Bosinceanu, D, Collard, E, Jorens, P, Reyntiens, D, Smitz, C, Vercauteren, M, Goranović, T, Mazul Sunko, B, Toplice, K, Oremuš, K, Bešlić, G, Duzel, V, Hauptman, A, Peremin, S, Šribar, A, Župčić, M, Brod, S, Mirković, I, Šarić Bauer, Z, Belavić, M, Blažanin, B, Katušin, M, Brozović Krijan, A, Mišković, P, Šimić Korać, N, Topić, J, Žilić, A, Žuni, J, Acan, I, Adanić, M, Ivanov, N, Pavičić Šarić, J, Tomulić, K, Visković, N, Bošnjak, S, Haršanji Drenjančevic, I, Kristek, G, Kvolik, S, Markić, S, Stojanovic Rakipovic, A, Katarina Tot, O, Venzera Azenic, D, Kalagac Fabris, L, Bačak Kocman, I, Balenović, I, Bandić, D, Judith Deutsch, P, Divjak, L, Filipović, I, Gužvinec, Z, Krznarić, Z, Lončarić, Y, Magaš, J, Mitrović, M, Okić, M, Pavlek, M, Ramov, E, Rezek, K, Sekulić, A, Tomasevic, B, Mirić, M, Tomašević, A, Tomić Mahečić, T, Vrbanović, V, Bobinac, M, Božić, A, Debelic, D, Frkovic, V, Batinica, I, Baranović, S, Gavranović, Ž, Kikec, M, Maldini, B, Marić, S, Agnić, I, Delić, N, Dropulić, N, Kljaković Gašpić, T, Ilić, D, Ivančev, B, Karanović, N, Kuščević, D, Marović, Z, Milić, M, Nevešćanin, A, Petković, T, Smoje, M, Brozović, G, Jelisavac, M, Matolić, M, Oberhofer, D, Marija Pavičić, A, Šakić, K, Delija Bozovic, M, Kotorac Krecek, Z, Krobot, R, Andabaka, T, Bratanić, M, Dzepina, O, Kraljev, M, Šeric, J, Šimurina, T, Grujić, R, Nacevski Bulaja, B, Barižon, M, Danira, V, Dražen, B, Dušanka, K, Bašić Halužan, M, Joško, Ž, Katica, R, Labor, M, Grgurević Marinković, T, Mihovilčević, D, Marija, B, Srečko, M, Vranković, S, Kyprianou, T, Neophytou, K, Cerny, V, Cvachovec, K, Belikova, B, Drab, M, Hudacek, K, Krikava, I, Stourac, P, Zadrazilova, K, Bicek, V, Brabcová, M, Klozová, R, Vajter, J, Vymazal, T, Toft, P, Blichfeldt, L, Dilling Hansen, B, Moller, K, Sylvest Nielsen, J, Frederiksen, J, Dohn Andersen, J, Peter Kühne, J, Leivdal, S, Stendell, L, Simonsen, M, Konrad Zoltowski, M, Salman Ali, Z, Freundlich, M, Pilypaite, J, Groes Clausen, N, Thorup, L, Hansen, F, Bestle, M, Steen Hansen, C, Afshari, A, Bastholm Bille, A, Lefort, M, Secher, E, Liboriussen, L, Herodes, V, Härma, E, Marvet, K, Pool, K, Kallas, P, Mägi, T, Sütt, J, Vijar, K, Visk, E, Vinnal, M, Ellermaa, J, Liibusk, L, Tikkerberi, A, Falk, I, Mällo, E, Talving, J, Pettilä, V, Hovilehto, S, Kirsi, A, Mustola, S, Tiainen, P, Toivonen, J, Dabnell, S, Kaminski, T, Sysimetsa, A, Kaukonen, M, Silvasti, P, Vainio, K, Lund, V, Sjövall, S, Saarinen, K, Viitanen, M, Ahonen, T, Alaspää, A, Zittling, R, Saarinen, A, Moisander, A, Wagner, B, Laru Sompa, R, Elomaa, E, Lavonen, L, Nevantaus, J, Geier, K, Kavasmaa, T, Koorits, U, Kubjas, M, Lauritsalo, S, Ottelin, L, Palve, M, Pynnönen, J, Rääbis, I, Saarelainen, M, Heikkilä, T, Kontula, T, Lehtimäki, M, Liimatainen, J, Moilanen Oikarinen, M, Pakarinen, M, Palanne, R, Seppänen, H, Pulkkinen, A, Vääräniemi, H, Koskenkari, J, Sälkiö, S, Vakkala, M, Koskue, T, Loisa, P, Laitio, R, Hautamäki, R, Koivisto, S, Futier, E, Lefrant, J, Leon, A, Bonnet, F, Marret, E, Spielvogel, C, Papageorgiou, C, Szymkiewicz, O, Tounou Akue, F, Aubrun, F, Bonnet, A, Gazon, M, Guiraud, M, Laurent, V, Tachon, G, Demars, N, Dumenil, A, Mercier, F, Landais, A, Mentec, H, Bazin, M, Gonnu, S, Petit, A, Albaladejo, P, Almeras, L, Bataillard, A, Rossi Blancher, M, Yves Lefrant, J, Barthel, F, Hallel, D, Sbai, H, Khalifeh, P, Lidzborski, L, Jully, M, Platon, E, Pottecher, J, Baumgarten, R, Schultz, C, Elmiloudi, F, Lefebvre, J, Waton, K, Sprunck, A, Steib, A, Thibaud, A, Thuet, V, Kieffer, V, Dubois Vallaud, D, Jacob, L, Becanne, X, Cherfaoui, S, Gauzit, R, Godier, A, Lakhdari, M, Samma, C, Bigeon, J, Burtin, P, Halchini, C, Lacroix, M, Pinna, F, Barbes, A, Just, B, Mateu, P, Benayoun, L, Berger, P, Granier, N, Francois Perrigault, P, Libert, N, De Rudnicki, S, Merat, S, Bourdet, B, Ferré, F, Minville, V, Piriou, V, Rague, P, Wallet, F, Lebuffe, G, Desbordes, J, Robin, E, Ichai, C, Orban, J, Marx, G, Sander, M, Gottschalk, A, Piontek, A, Unterberg, M, Hilpert, J, Kees, M, Triltsch, A, Wiegand Löhnert, C, Glöckner, C, Hohn, A, Rose, E, Schröder, S, Wiese, O, Ramminger, A, Dresden, C, de Abreu, M, Heller, A, Marx, C, Neidel, J, Goldmann, A, von Heymann, C, Laetsch, B, Maahs, E, Scholz, L, Frenzel, D, Massarat, K, Lenhart, F, Reichle, F, Rudlof, K, Borchers, F, Buettner, C, Schmutzler, M, Burgard, G, Lucht, A, Wagner, J, Pilge, S, Schneider, G, Untergehrer, G, Bis, B, Krassler, J, Dittmann, J, Haberkorn, J, Eberitsch, J, Eberitsch, K, Nippraschk, T, Wepler, U, Engelen, W, Nau, C, Scholler, A, Schüttler, J, Wintzheimer, S, Bloos, F, Braune, A, Fergen, D, Ludewig, K, Paxian, M, Reinhart, K, Graf, N, Schwarzkopf, K, Berger, K, Habicher, M, Kasperiunaite, R, Savelsberg, S, Krep, H, Reindl, M, Weber, M, Bauer, W, Bingold, F, Christ, S, Friederich, P, Kaviani, R, Auer, P, Bonnländer, G, Drescher, J, Braun, R, Eichenauer, T, Kerner, J, Bierbaum, K, Brünner, H, Grond, S, Perez Platz, U, Andresen, B, Linstedt, U, Stegmann, N, Erkens, U, Kopcke, J, Meyer, A, Brestrich, H, Ernst, S, Merkel, S, Krieger, L, Luers, F, Weyland, A, Noeldge Schomburg, G, Menckie, T, Wasmund, C, Bredtmann, R, Erler, I, Raufhake, C, Haumann, C, Möllemann, A, Oehmichen, U, Sergejewa, O, Lehning, B, Czeslick, E, Geyer, M, Malcharek, M, Sablotzki, A, Stier, M, Feld, F, Rossaint, R, Simon, V, Armaganidis, A, Koulenti, D, Kotanidou, A, Nanas, S, Papastylianou, A, Psevdi, A, Stathopoulos, A, Voulas, A, Kanna, E, Koutsikou, A, Moustaka, A, Chovas, A, Komnos, A, Zafiridis, T, Franses, J, Lavrentieva, A, Koraki, E, Katsenos, C, Flora Kasianidou, M, Nasopoulou, P, Spyropoulou, E, Gousia, C, Katsanoulas, C, Lathyris, D, Kyriazopoulos, G, Sfyras, D, Tsirogianni, A, Kostopanagiotou, G, Lignos, M, Matsota, P, Christopoulos, C, Mouratidou, A, Vrettou, E, Boufidis, S, Moka, E, Arnaoutoglou, E, Koulouras, V, Nakos, G, Papathanakos, G, Anthopoulos, G, Choutas, G, Karapanos, D, Tzani, V, Gkiokas, G, Nastos, K, Nikolakopoulos, F, Dragoumanis, C, Nikitidis, N, Pneumatikos, I, Theodorou, V, Zacharouli, D, Kandi, S, Tasopoulos, K, Arvaniti, K, Matamis, D, Mplougoura, E, Petropoulou, P, Soumpasis, I, Amaniti, E, Giannakou Peftoulidou, M, Gkeka, E, Soultati, I, Kokinou, M, Papatheodorou, L, Stafylaraki, M, Giasnetsova, T, Gritsi Gerogianni, N, Kydona, C, Kiskira, O, Koulentis, I, Apsokardos, A, Dimitropoulos, K, Soldatou, O, Nathanail, C, Papazotos, A, Tsakas, P, Clouva Molyvdas, P, Kolotoura, A, Sartzi, M, Papanikolaou, S, Polakis, P, Karatzas, S, Kyparissi, A, Papavasilopoulou, T, Koukoubani, T, Mastora, E, Spyropoulou Pagdatoglou, K, Nyktari, V, Malliotakis, P, Papaioannou, A, Bekos, V, Maragkou, E, Spring, A, Evagelatos, S, Ioakeimidou, A, Noulas, N, Molnár, Z, Csüllög, E, Elekes, E, Molnár, T, Katona, Z, Kremer, I, Miko, A, Csomos, A, Galambos, Z, Szucs, A, Nyikos, G, Szekeres, G, Szabo, E, Kranitz, K, Simon, M, Szigeti, J, Gaál, E, Havas, A, Ille, A, Bráz, K, Nagy, G, Sigurdsson, G, Sigurbjörnsson, F, Kárason, S, Edda Sigurdardottir, E, Blöndal, Á, Gunnarsson, B, Westbrook, A, Broderick, A, Hafeez, P, Hanumanthaiah, D, Brohan, J, O'Chroinin, D, Bailey, K, Ramamoorthy, K, Doyle, Y, Freir, N, O'Rourke, J, Jonson, P, Saeed, S, Hayes, I, Loughrey, J, Frohlich, S, Mccauley, N, Ryan, D, Fitzpatrick, G, Kevin, L, Thomas, J, Warde, B, Woolhead, A, Duggan, M, Egan, C, Crowley, S, Lebese, S, Bergin, A, Page, R, Collins, D, Mckenny, M, Della Rocca, G, Grasso, S, Bresciani, A, Carmino, L, Ghelfi, S, Lorenzelli, L, Teresa Novelli, M, Pescarmona, C, Roasio, A, Gatta, A, Nastasi, M, Sanseverino, M, Tinti, C, Bianchin, A, Tormena, M, Franco, A, Marini, F, Di Mauro, P, Rapido, F, Tommasino, C, Bellotti, F, Boninsegna, D, Castellani, G, Sances, D, Spano, G, Tredici, S, Vezzoli, D, Fucecchio, I, Bacci, A, Coppini, R, Dell'Unto, S, Mori, E, Rosa Stanzani, M, Tosi, M, Collareta, M, Forfori, F, Franchi, M, Mancino, G, Battistella, M, Baricocchi, E, Bona, F, Debernardi, F, Giacoletto, G, Iacobellis, A, Massucco, P, Moselli, N, Muratore, A, Palomba, G, Sardo, E, De Simone, M, Suita, L, Zocca, E, Bucci, B, Della Corte, F, Piciucco, T, Viarengo, V, Bettelli, G, Cantarini, E, Giampieri, M, Tanfani, A, Recchia, E, Bignami, E, Bruno, G, Costagliola, R, Gandolfi, A, Greco, M, Lembo, R, Monti, G, Nicelli, E, Pasculli, N, Turi, S, Baroselli, A, Brazzoni, M, Buttazzoni, M, Buttera, S, Centonze, C, Serena, G, Spagnesi, L, Toretti, I, Vilardi, A, Zearo, E, Arpino, I, Baraldi, S, Guarnerio, C, Molene, V, Concetta Monea, M, Vaccarisi, E, Vicari, L, Albante, A, Aversano, M, Loiacono, C, Marandola, M, Fusari, M, Petrucci, N, Galla, A, Mascia, A, Primieri, P, Di Noto, A, Gratarola, A, Molin, A, Spagnolo, L, Spena, C, Calligaro, P, Marchiotto, S, Merlini, A, Pedrazzoli, E, Perina, G, Visentin, R, Garbagnati, A, Manetti, B, Snaier, C, Somaini, M, Farnia, A, Nani, R, Pierantonio, N, De Michele, M, Gazzanelli, S, Pugliese, F, Ruberto, F, Bergamini, E, Tassinati, T, Capuzzo, M, Cirillo, V, Tufano, R, Oggioni, R, Parrini, V, Brunori, E, Capone, M, Carbone, L, Corradetti, F, Elisei, D, Fiorentino, S, Francesconi, M, Gattari, D, Gorgoglione, M, Lacobone, E, Minnucci, F, Montironi, C, Riccioni, G, Tappata, G, Zompanti, V, Verdenelli, P, Cerutti, E, Marco Ranieri, V, Golubovska, I, Grigorjevs, S, Rikmane, M, Rozkalne, D, Stepanovs, J, Suba, O, Kazune, S, Miscuk, A, Nemme, J, Oss, P, Sipylaite, J, Macas, A, Ragaisis, V, Kontrimaviciute, E, Tomkute, G, Boerma, C, Fleur Kramer, I, Poeze, M, Maria, J, Pelzer, G, Winsser, L, Nijsten, M, Schoorl, M, Spanjersberg, R, Buhre, W, Dieleman, S, van Klei, W, Bouw, M, Pickkers, P, van der Marieke, A, Schreiner, F, Zandvliet, R, van den Berg, R, De Wit, E, Keijzer, C, Hollmann, M, Preckel, B, van Acker, G, Dennesen, P, Veld, B, Kuijpers Visser, A, Inan, T, Koopman van Gemert, A, Ponssen, H, Brouwer, T, Koopmans, M, van Bommel, J, van Duijn, D, van der Hoven, B, Ormskerk, P, Beck, O, Schiere, S, Reidinga, A, Venema, A, Hoogendoorn, M, Olthof, K, Flaatten, H, Jammer, I, Dokka, V, Arne Monsen, S, Marius Ytrebo, L, Noursadeghi, M, Shahzad, A, Dagfinn Boksasp, O, Roiss, C, Frank Strietzel, H, Gina, A, Berntsen, S, Haugland, H, Ove Vingsnes, S, Axelsson, P, Risom Olsen, T, Katre, S, Aakeroey, K, Mikstacki, A, Tamowicz, B, Boziłow, D, Goch, R, Grabowski, P, Kupisiak, J, Małłek, M, Szyca, R, Kostyrka, W, Choma, R, Jankowski, G, Kościelniak, W, Pietraszek, P, Szarowar, B, Matos, R, França, C, Pais Lacerda, A, Ormonde, L, Rosa, R, Pereira, I, Vitor, P, Completo Bento, H, Raquel Lopes, M, Carvalho, M, Faria, M, Cláudia de Sousa, A, de Freitas, P, Almeida, E, Mealha, R, Vicente, R, Monte, R, Rua, F, Barros, N, Esteves, F, Gouveia Pinheiro, C, Real, V, Miguel Oliveira, V, Fátima Oliveira, M, Martins, I, Pedro Saraiva, J, Pedro Assunção, J, Bártolo, A, Carvalho, A, Correia, C, Martins, S, Milheiro, R, Diaz, A, Imelda Gonçalves, M, Ribeiro, R, Estilita, J, Glória, C, de Almeida, J, Barros, F, Ramos, A, Camara, M, Richard Maul, E, Nobrega, J, Langner, A, Faria Maia, D, Afonso, O, Faria, F, Serra, S, Manuela Botelho, M, Ferreira, P, Mourão, L, Vintém Oliveira, A, Resende, M, Aleman, M, Fonseca, J, Isidoro, M, de Meneses, H, Pêgas, A, Pereira, J, Pereira, L, Ramos, B, Matos, F, Gonçalves Castro, M, Martins, A, Ramos, C, de Sousa, M, Bento, L, Botas, C, Lopes, V, Mendes, R, Grigoras, I, Blaj, M, Damian, M, Lupusoru, A, Ristescu, I, Codreanu, M, Diaconescu, C, Nistor, A, Stanescu Stelian, D, Streanga, L, Berneanu, M, Bordeianu, C, Florenta, C, Iacob, A, Nicoleta Lupu, M, Mocanu, I, Moraru, C, Meran, C, Nicolae, B, Sandu, M, Turcanu, R, Epure, F, Grigore, M, Hotaranu, C, Popescu, N, Baban, O, Baciu, M, Ciobanu, A, Ioan Denciu, C, Gurau, V, Maftei, I, Moldovan, I, Ungureanu, L, Bogdan, P, Corneci, D, Dinu, M, Madalina, D, Rely, M, Silvius, N, Tomescu, D, Gabriela, D, Adrian Dinescu, S, Calin, M, Ionescu, D, Margarit, S, Vasian, H, Albu, C, Balasa, C, Cadrigati, A, Dragulescu, D, Gavra, L, Hentia, C, Macarie, C, Manescu, M, Nediglea, I, Ocica, D, Ovidiu, B, Papurica, M, Plavat, C, Popa, C, Ramneantu, M, Sandesc, D, Sandici, Z, Sarandan, M, Belciu, I, Tincu, E, Ursu, I, Aignatoaie, M, Huzuneanu, M, Cocu, S, Hagau, N, Ciubotaru, R, Copotoiu, S, Copotoiu, R, Ioana, G, Kovacs, J, Leonard, A, Szederjesi, I, Genoveva, V, Mosnegutu, S, Surbatovic, M, Djordjevic, D, Djordjevic, B, Grujic, K, Jovanovic, D, Krstic Lecic, I, Obradovic, J, Zeba, S, Jevdjic, J, Miletic, M, Zunic, F, Bulasevic, A, Brko, R, Gazibegovic, N, Kendrisic, M, Vojinovic, R, Firment, J, Zahorec, R, Capková, J, Grochova, M, Trenkler, S, Griger, M, Bakosova, E, Kvasnica, M, Saniova, B, Sulaj, M, Zacharovska, A, Simkova, A, Číková, A, Gebhardtova, A, Hanuljaková, S, Koutun, J, Martonová, A, Žilinčárová, V, Galkova, K, Krbila, S, Sobona, V, Ocenasova, M, Novak Jankovic, V, Stecher, A, Stivan, F, Grynyuk, A, Damjanovska, M, Kostadinov, I, Knezevic, M, Malivojevic, M, Borovsak, Z, Kamenik, M, Mekiš, D, Osojnik, I, Kosec, L, Ostojič Kapš, S, Aleksic, D, Gerjevič, B, Kalan, K, Ursic, T, Aldecoa, C, Montejo González, J, Artigas, A, Garcia, A, Lisi, A, Perez, I, Perez, G, Poch, N, Vaquer, S, Balciscueta, G, Barrasa, H, Cabanes, S, Maynar, J, Poveda, Y, Quintano Rodero, A, Vallejo, A, Duque, P, Garcia Bunger, B, Adoracion Elvira, M, María Lajara, A, Palencia, M, Ramos, R, Saez Fernandez, A, Tirapu León, J, Iza López, J, Yoldi Murillo, F, Turumbay Ramirez, E, Unzué Rico, P, Patricia, M, Vizcaíno, M, Bernat Álvarez, M, Planas Real, K, Mas Serra, A, Aracil, N, Menendez Bodega, B, Fernández García, R, Álvarez García, M, Gordon, B, Gutiérrez Jodrá, A, De Santos López, A, Llavador Ros, J, Ayala Soto, R, Sepúlveda, I, Pascual Díez, E, Fernández Fernández, L, Soria Gulina, C, Pérez Arviza, L, Fernandez, L, Río Gómez, A, Alonso Martínez, C, Rodríguez Rodríguez, A, Lopez Soto, C, Garcia, C, Lorenzo, M, Pinilla, E, Rico, J, Ruperez, I, Alonso, E, Leira, F, Emilio Maseda, D, Royo, C, Villagran, J, Murillo Candi, G, Eduardo Esteva, G, Mansilla Folgado, R, Joan Fornaguera, N, Calonge Montse, P, Sape Prat, A, Sintes, D, Arteta Arteta, D, García Delgado, H, Fajardo López Cuervo, J, López, M, Ramírez, A, José Saldaña, F, Aliste, P, Hermira Anchuelo, A, García Campos, A, Catalán, M, García Gómez, M, Gonzalez Gonzalaez, O, López López, E, Real Navacerrada, I, de Quevedo, S, Gonzalez Serrano, M, Silvestre, F, Martinez Torrente, F, Arocas, B, Pastor Martinez, E, Soro, M, Maroto, F, Robledo Algarra, R, Silla Aleixandre, I, Argente, G, Lleó, A, Rubio, A, Vicente Sánchez, J, Enríquez Valcárcel, I, Balust, C, Balust, J, Borrat, X, Jose Carretero, M, Gracia, I, Matute, P, Mercadal, J, Pujol, R, Tena, B, Ubre, M, Dorda Albalad, D, Muñoz Alcaide, C, Caballero, J, Camps Cervantes, A, de Nadal Clanchet, M, Montferrer Estruch, N, Ballvé Ferrer, M, Lacasta Fornells, A, Terrer Galera, E, Garcia Martinez, I, Manrique Muñoz, S, Pelavski, A, Tormos Perez, P, Gonzalez Posada, M, de Prat, I, Rello, J, García Serrano, L, Naya Sieiro, J, Silva, L, Colomina Sole, M, Biarnes Suñé, A, Rochera Villach, I, Gómez Herreras, J, Poves, R, Martinez Rafael, B, Martinez Almeida, I, Fernandez Collates, A, Jose Bartolomé, M, Cimadevilla, B, González González, A, Rabanal Llevot, J, de Terán Mira, J, González Molina, B, Pardo, S, López Sánchez, C, Williams, M, Zaldibar, E, Muñoz Corsini, L, Rodríguez Fraile, J, de la Lastra, M, Kabiri Sacramento, M, López Saña, F, Trenado Ålvarez, J, Cantón Bulnes, M, Gándara Carrasco, V, Crespo, M, Narváez Cubillos, D, Laza Laza, E, Pérez, M, Arenzana Seisdedos, Á, Fernández Torres, B, Santos Ampuero, M, Chicot Llano, M, Mata, E, Munoz, M, Orts, M, Planas, A, Ramasco, F, Roman, C, Varela Durán, M, Fernandez, S, Sanduende Otero, Y, Lopez Pineiro, S, Barreiro Pardal, C, Fernández Alcantud, J, Ayuso Antolinos, M, Barrios, F, Collantes Casanova, A, Ruiz Castro, M, Infantes Crespo, B, Lancha Felipe, U, Liceras Fuster, M, Sanz García, M, Herrero Garrote, B, Moreno Gonzalez, R, Montes Granero, M, de la Guía, C, Chaves López, R, de Frutos López, S, Marco Martinez, J, Garcia Mostaza, A, Jiménez Moreno, A, Riquelme Osado, I, Bardina Pastor, A, Peña, R, Rustarazo Pérez, M, Aliaño 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Kangaraj, M, Pissay, N, Smith, N, Gopalakrishnan, S, Mackinnon, J, Strandvik, G, Francis, R, Jennings, A, Keating, M, Kumar, S, Leese, S, Magee, C, Pilsbury, J, Ralph, J, Riddington, D, Sachdeva, R, Snelson, C, Vasanth, S, Wilde, J, Lavender, B, Lyons, R, Watters, M, Adams, T, Dyer, S, Tindall, L, Claxton, A, Netke, M, Akouds, E, Bates, D, Gallagher, H, Hatton, J, Holroyd, W, Mitra, A, Nurse, T, Reed, D, Desikan, S, Barber, R, Childs, S, O'Carroll Kuehn, B, Wyldbore, M, Al Abdaly, A, Amatya, S, Bhaskaran, S, Chandan, G, Chaudhry, S, Chikungwa, M, Earnshaw, G, Grewal, M, Haque, S, Hawkins, J, Javaid, A, Jackson, C, Kamel, M, Marla, R, Mculloch, D, Parker, T, Salib, Y, Saravanmuthu, R, Secker, C, Sockalingam, S, Taylor, A, Austine, P, Kanade, V, Paal, D, Sam Mok, M, Burtenshaw, A, Davis, L, Ellahee, P, Freeman, D, Pierson, R, Wollaston, J, Karmarkar, A, Ball, C, Calton, E, Maxwell, L, Walker, R, Bland, M, Bullock, L, Harrison Briggs, D, Hodge, P, Krige, A, Dempsey, G, Hammell, C, Loveridge, R, Parker, R, Snell, J, Wright, C, Baker, A, Barr, K, Belcher, A, Bonnington, S, Bougeard, A, Fitzgerald, E, Ford, R, Gillard, C, Griffiths, L, Greenberg, L, Huber, J, Mathieu, S, Richardson, N, Tompsett, L, White, N, Patel, S, Corner, V, Thomas, R, Trodd, D, Wilson, J, Copley, E, Flutter, L, Hulme, J, Susarla, J, Thwaites, A, Jayasundera, S, Mcafee, S, Chantler, J, Mckechnie, S, Neely, J, Mouton, R, Scarth, E, Soar, J, Buss, J, Currie, V, Sange, M, Kuttler, A, Power, F, Alexander, D, Dunne, K, Shinner, G, Black, E, Haldane, G, Kerr, J, Saran, T, Ward, G, Jefferies, F, Alexander, P, Royle, A, Nahla, F, Bowles, T, Gregory, M, Ahern, R, Cartlidge, D, Craker, L, Thompson, C, Bidd, H, Giles, J, Manser, A, Parry, G, Chan, P, Das, D, Fahmy, N, Higgins, D, Khader, A, Stone, A, Leonardi, S, Rose, O, Bright, E, Ercole, A, Amir Rafi, M, Ramasamy, R, Sheshgiri, B, Merrill, C, Page, V, Walker, E, Harris, S, Hughes, S, Morrison, A, Razouk, K, Ayman, M, Jakeman, A, Mowatt, C, Paananen, S, Translational Physiology, Other departments, ACS - Amsterdam Cardiovascular Sciences, AII - Amsterdam institute for Infection and Immunity, Anesthesiology, APH - Amsterdam Public Health, Pearse Rupert, Moreno Rui P., Bauer Peter, Pelosi Paolo, Metnitz Philipp, Spies Claudia, Vallet Benoit, Vincent Jean-Loui, Hoeft Andrea, Rhodes Andrew, Fagnoul David, van Obbergh Luc, Al-Subaie Nawaf, Arif Fuhazia, Cashman Jeremy, Cecconi Maurizio, Edsell Mark, Fossati Nicoletta, Hammond Sarah Jane, Hamilton Mark, Lonsdale Dagan, Moran Carl, Siegmueller Claa, Velzeboer Freya, Wong Patrick, Awlakpui Eli, Scheidemann Mona, Wittmann Maria, Damster Sandrine, Golder Kim, Hewson Russell, Januszewska Marta, Leva Brigitte, Ramos Vasco, Hoste Eric, Huyghens Luc, Jacobs Rita, Van Mossevelde Veerle, Opdenacker Godelieve, Poelaert Jan, Spapen Herbert, Leleu Kri, Rijckaert Dirk, De Decker Koen, Foubert Luc, De Neve Nikolaa, Biston Patrick, Piagnerelli Michael, Collin Vincent, den Blauwen Nadia, Clauwaert Charlotte, De Crop Luc, Verbeke An, Derumeaux Pieter, Gardin Christophe, Kindt Sebastiaan, Louage Sofie, Verhamme Bruno, Druwé Patrick, Lahaye Ingrid, Rosseel Franci, Rutsaert Robert, Vanlinthout Luc, De Kock Marc, Forget Patrice, Georges Pascal, Grosu Irina, Kahn David, Lois Fernande, Momeni Mona, Pospiech Audrey, Yemnga Bernadette, Jadoul Jean-Luc, Malbrain Manu, Bosinceanu Dana, Collard Edith, Jorens Philippe, Reyntiens Dirk, Smitz Carine, Vercauteren Marcel, Goranović Tatjana, Mazul-Sunko Branka, Toplice Krapinske, Oremuš Krešimir, Bešlić Gabrijela, Duzel Viktor, Hauptman Ada, Peremin Sanja, Šribar Andrej, Župčić Miroslav, Brod Slavonski, Mirković Ivan, Šarić Bauer Zlata, Belavić Matija, Blažanin Božidar, Katušin Mirjana Lončarić, Brozović Krijan Antonija, Mišković Petar, Šimić-Korać Nataša, Topić Jasna, Žilić Antonio, Žuni Josip, Acan Ivana, Adanić Mirta, Ivanov Nikola, Pavičić Šarić Jadranka, Tomulić Katarina, Visković Nataša, Bošnjak Silvana, Haršanji Drenjančevic Ivana, Kristek Gordana, Kvolik Slavica, Markić Stela, Stojanovic Rakipovic Andreja, Katarina Tot Ozana, Venzera-Azenic Darija, Kalagac Fabris Lada, Bačak-Kocman Iva, Balenović Igor, Bandić Daniela, Judith Deutsch Patricia Adrianne, Divjak Loredana, Filipović Ina Grčić, Gužvinec Zvonka, Krznarić Zrinka, Lončarić Yvonne, Magaš Jelena Vadlja, Mitrović Marek, Okić Marija, Pavlek Mario, Ramov Elza, Rezek Karolina, Sekulić Ante, Tomasevic Bori, Mirić Mirjana, Tomašević Anita, Tomić Mahečić Tina, Vrbanović Vilena, Bobinac Mirna, Božić Alfred, Debelic Danijela, Frkovic Vedran, Batinica Inga Mladić, Baranović Senka, Gavranović Željka, Kikec Mirna, Maldini Branka, Marić Stela, Agnić Ivan, Delić Nikola, Dropulić Nataša, Kljaković Gašpić Toni, Ilić Darko, Ivančev Božena, Karanović Nenad, Kuščević Dorjan, Marović Zlatko, Milić Matija, Nevešćanin Ana, Petković Tatjana, Smoje Mario, Brozović Gordana, Jelisavac Milana, Matolić Martina, Oberhofer Dagmar, Marija Pavičić Ana, Šakić Kata, Delija Bozovic Margarita, Kotorac Krecek Zvjezdana, Krobot Renata, Andabaka Tatjana, Bratanić Mislav, Dzepina Orjana, Kraljev Martina, Šeric Julija, Šimurina Tatjana, Grujić Rosa, Nacevski-Bulaja Biljana, Barižon Mirna, Danira Vrančić, Dražen Bulaja, Dušanka Kimer, Bašić Halužan Marijana, Joško Žaja, Katica Roca, Labor Magda, Grgurević Marinković Tea, Mihovilčević Danči, Marija Bego, Srečko Marinković, Vranković Srdan, Kyprianou Theodoro, Neophytou Kyriako, Cerny Vladimir, Cvachovec Karel, Belikova Barbora, Drab Michal, Hudacek Kamil, Krikava Ivo, Stourac Petr, Zadrazilova Katarina, Bicek Vladimír, Brabcová Milena, Klozová Radka, Vajter Jaromír, Vymazal Tomáš, Toft Palle, Blichfeldt Louise, Dilling Hansen Bo, Moller Kirsten, Sylvest Nielsen Jeppe, Frederiksen Joachim, Dohn Andersen Johnny, Peter Kühne Jan, Leivdal Siv, Stendell Line, Simonsen Martin, Konrad Zoltowski Marcin, Salman Ali Zahida, Freundlich Morten, Pilypaite Jurgita, Groes Clausen Nicola, Thorup Line, Hansen Frank, Bestle Morten, Steen Hansen Christian, Afshari Arash, Bastholm Bille Ander, Lefort Michele, Secher Erik L., Liboriussen Lisbeth, Herodes Veiko, Härma Eve, Marvet Kadri, Pool Kristiina, Kallas Pille, Mägi Triinu-Kreete, Sütt Jaan, Vijar Kerli, Visk Evelin, Vinnal Mare, Ellermaa Jaanu, Liibusk Liia, Tikkerberi Artur, Falk Ilme, Mällo Esta, Talving Jaak, Pettilä Ville, Hovilehto Seppo, Kirsi Anne, Mustola Seppo, Tiainen Pekka, Toivonen Juhani, Dabnell Sandra, Kaminski Tadeusz, Sysimetsa Anu, Kaukonen Maija, Silvasti Päivi, Vainio Kaisa, Lund Vesa, Sjövall Sari, Saarinen Kari, Viitanen Matti, Ahonen Tommi, Alaspää Ari, Zittling Ritva, Saarinen Aarne, Moisander Annette, Wagner Bodo, Laru-Sompa Raili, Elomaa Esa, Lavonen Leena, Nevantaus Juha, Geier Klau, Kavasmaa Tomi, Koorits Ursula, Kubjas Mare, Lauritsalo Seppo, Ottelin Lauri, Palve Markki, Pynnönen Jari, Rääbis Inga, Saarelainen Minna, Heikkilä Tapani, Kontula Timo, Lehtimäki Markku, Liimatainen Jari, Moilanen-Oikarinen Mari, Pakarinen Marika, Palanne Riku, Seppänen Hanna, Pulkkinen Anni, Vääräniemi Heikki, Koskenkari Juha, Sälkiö Sinikka, Vakkala Merja, Koskue Talvikki, Loisa Pekka, Laitio Ruut, Hautamäki Raku, Koivisto Simo-Pekka, Futier Emmanuel, Lefrant Jean-Yve, Leon Alain, Bonnet Franci, Marret Emmanuel, Spielvogel Catherine, Papageorgiou Chryssa, Szymkiewicz Olga, Tounou-Akue Felix, Aubrun Frederic, Bonnet Aurélie, Gazon Mathieu, Guiraud Michel, Laurent Virginie, Tachon Guillaume, Demars Nadège, Dumenil Anne-Sylvie, Mercier Frederic, Landais Alain, Mentec Herve, Bazin Marie, Gonnu Sophie, Petit Antoine, Albaladejo Pierre, Almeras Luc, Bataillard Amélie, Rossi-Blancher Marine, Yves Lefrant Jean, Barthel Florian, Hallel Dan, Sbai Hicham, Khalifeh Pamela, Lidzborski Lionel, Jully Marion, Platon Ecaterina, Pottecher Julien, Baumgarten Romain, Schultz Christel, Elmiloudi Fayçal, Lefebvre Julie, Waton Karen, Sprunck Adrien, Steib Annick, Thibaud Adrien, Thuet Vincent, Kieffer Vianney, Dubois-Vallaud Delphine, Jacob Laurent, Becanne Xavier, Cherfaoui Salim, Gauzit Remy, Godier Anne, Lakhdari Mourad, Samma Charle, Bigeon Jean-Yve, Burtin Philippe, Halchini Constantin, Lacroix Magali, Pinna Frederic, Barbes Aurélie, Just Bernard, Mateu Philippe, Benayoun Laurent, Berger Philippe, Granier Nathalie, Francois Perrigault Pierre, Libert Nicola, De Rudnicki Stephan, Merat Stéphane, Bourdet Benoit, Ferré Fabrice, Minville Vincent, Piriou Vincent, Rague Philippe, Wallet Florent, Lebuffe Gille, Desbordes Jacque, Robin Emmanuel, Ichai Carole, Orban Jean-Christophe, Marx Gernot, Sander Michael, Gottschalk André, Piontek André, Unterberg Matthia, Hilpert Justu, Kees Martin, Triltsch Andrea, Wiegand-Löhnert Carola, Glöckner Christiane, Hohn Andrea, Rose Elmar, Schröder Stefan, Wiese Oliver, Ramminger Axel, Dresden Caru, de Abreu Marcelo Gama, Heller Axel, Marx Christine, Neidel Julia, Goldmann Anton, von Heymann Christian, Laetsch Beatrix, Maahs Esther, Scholz Lar, Frenzel Dirk, Massarat Kyro, Lenhart Franz-Peter, Reichle Florian, Rudlof Kristina, Borchers Friedrich, Buettner Christoph, Schmutzler Martin, Burgard Gerald, Lucht Alexander, Wagner Jan, Pilge Stefanie, Schneider Gerhard, Untergehrer Gisela, Bis Beata, Krassler Jen, Dittmann Jan, Haberkorn Jörg, Eberitsch Jürgen, Eberitsch Karola, Nippraschk Thoma, Wepler Ulrich, Engelen Wolf-Christian, Nau Carla, Scholler Axel, Schüttler Jürgen, Wintzheimer Simone, Bloos Frank, Braune Anke, Fergen Daniela, Ludewig Katrin, Paxian Marku, Reinhart Konrad, Graf Nikolau, Schwarzkopf Konrad, Berger Katharina, Habicher Marit, Kasperiunaite Ruta, Savelsberg Sabine, Krep Henning, Reindl Michael, Weber Matthia, Bauer Wolfgang, Bingold Florian, Christ Saskia, Friederich Patrick, Kaviani Reza, Auer Patrick, Bonnländer Georg, Drescher Jürgen, Braun Roland, Eichenauer Tim, Kerner John, Bierbaum Kathrin, Brünner Horst, Grond Stefan, Perez-Platz Ursula, Andresen Bent, Linstedt Ulf, Stegmann Nil, Erkens Uwe, Kopcke Jen, Meyer Andrea, Brestrich Hartmut, Ernst Sandra, Merkel Stella, Krieger Lena, Luers Frank, Weyland Andrea, Noeldge-Schomburg Gabriele, Menckie Thoma, Wasmund Christina, Bredtmann Ralph-Dieter, Erler Ine, Raufhake Carsten, Haumann Christine, Möllemann Angela, Oehmichen Uwe, Sergejewa Olga, Lehning Brigitte, Czeslick Elke, Geyer Michaela, Malcharek Michael, Sablotzki Armin, Stier Marina, Feld Florian, Rossaint Rolf, Simon Verena, Armaganidis Apostolo, Koulenti Despoina, Kotanidou Anastasia, Nanas Serafim, Papastylianou Androula, Psevdi Aikaterini, Stathopoulos Anastasio, Voulas Asklepieion, Kanna Efthymia, Koutsikou Anastasia, Moustaka Alexandra, Chovas Achillea, Komnos Apostolo, Zafiridis Tilemacho, Franses Josef, Lavrentieva Athena, Koraki Eleni, Katsenos Chrysostomo, Flora Kasianidou Maria, Nasopoulou Pantelia, Spyropoulou Eleni, Gousia Chrysoula, Katsanoulas Constantine, Lathyris Dimitrio, Kyriazopoulos George, Sfyras Dimitrio, Tsirogianni Athanasia, Kostopanagiotou Georgia, Lignos Mihail, Matsota Paraskevi, Christopoulos Christo, Mouratidou Alexandra, Vrettou Efstratia, Boufidis Spyro, Moka Eleni, Arnaoutoglou Eleni, Koulouras Vasileio, Nakos George, Papathanakos Georgio, Anthopoulos Georgio, Choutas Georgio, Karapanos Dimitrio, Tzani Vaso, Gkiokas Georgio, Nastos Konstantino, Nikolakopoulos Fotio, Dragoumanis Christo, Nikitidis Niko, Pneumatikos Ioanni, Theodorou Vassiliki, Zacharouli Danai, Kandi Stella, Tasopoulos Konstantino, Arvaniti Kostoula, Matamis Dimitrio, Mplougoura Eva, Petropoulou Polixeni, Soumpasis Ioanni, Amaniti Ekaterini, Giannakou-Peftoulidou Maria, Gkeka Eleni, Soultati Ioanna, Kokinou Maria, Papatheodorou Lambrini, Stafylaraki Maria, Giasnetsova Tatiana, Gritsi-Gerogianni Nikoleta, Kydona Christina, Kiskira Olga, Koulentis Ioanni, Apsokardos Alexandro, Dimitropoulos Konstantino, Soldatou Ourania, Nathanail Christodoulo, Papazotos Alexio, Tsakas Pirro, Clouva-Molyvdas Phyllis-Maria, Kolotoura Athina, Sartzi Monika, Papanikolaou Spiro, Polakis Pavlo, Karatzas Styliano, Kyparissi Aikaterini, Papavasilopoulou Theonymfi, Koukoubani Triantafillia, Mastora Evangelia, Spyropoulou-Pagdatoglou Kyriaki, Nyktari Vasileia, Malliotakis Polychroni, Papaioannou Alexandra, Bekos Vasileio, Maragkou Elisavet, Spring Anna, Evagelatos Stavro, Ioakeimidou Aikaterini, Noulas Niko, Molnár Zsolt, Csüllög Emese, Elekes Eniko, Molnár Tamá, Katona Zsuzsana, Kremer Ildiko, Miko Angela, Csomos Ako, Galambos Zsuzsanna, Szucs Ako, Nyikos Gyorgy, Szekeres Gabor, Szabo Ervin, Kranitz Katalin, Simon Melinda, Szigeti Jano, Gaál Emánuel, Havas Attila, Ille Alexandru, Bráz Krisztina, Nagy Geza, Sigurdsson Gisli, Sigurbjörnsson Fridrik T., Sigurdsson Gisli H., Kárason Sigurbergur, Edda Sigurdardottir Elin, Blöndal Ásbjörn, Gunnarsson Björn, Westbrook Andrew, Broderick Alan, Hafeez Parvaiz, Hanumanthaiah Deepak, Brohan Janette, O'Chroinin Donal, Bailey Kevin, Ramamoorthy Karthik, Doyle Yvonne, Freir Noelle, O'Rourke Jame, Jonson Philip, Saeed Sabir, Hayes Ivan, Loughrey John, Frohlich Stephen, Mccauley Nuala, Ryan Donal, Fitzpatrick Gerry, Kevin Leo, Thomas Jubil, Warde Barry, Woolhead Alan, Duggan Michelle, Egan Cara, Crowley Seamu, Lebese Soloman, Bergin Anne, Page Rory, Collins Daniel, Mckenny Michael, Della Rocca Giorgio, Grasso Salvatore, Bresciani Anna, Carmino Livio, Ghelfi Silvia, Lorenzelli Laura, Teresa Novelli Maria, Pescarmona Chiara, Roasio Agostino, Gatta Alessandro, Nastasi Mauro, Sanseverino Manlio, Tinti Carla, Bianchin Andrea, Tormena Maria, Franco Antonio, Marini Federica, Di Mauro Piero, Rapido Francesca, Tommasino Concezione, Bellotti Ferdinando, Boninsegna Daniele, Castellani Gianluca, Sances Daniele, Spano Gianluca, Tredici Stefano, Vezzoli Dario, Fucecchio Igneo, Bacci Alessandro, Coppini Roberta, Dell'Unto Sandro, Mori Emanuele, Rosa Stanzani Maria, Tosi Monica, Collareta Michele, Forfori Francesco, Franchi Matteo, Mancino Giuseppe, Battistella Massimo, Baricocchi Elisa, Bona Francesco, Debernardi Felicino, Giacoletto Gianmarco, Iacobellis Antonio, Massucco Paolo, Moselli Nora, Muratore Andrea, Palomba Graziella, Sardo Elena, De Simone Michele, Suita Luisa, Zocca Edoardo, Bucci Barbara, Della Corte Francesco, Piciucco Tiziana, Viarengo Valeria, Bettelli Gabriella, Cantarini Eugenia, Giampieri Marina, Tanfani Alessandra, Recchia Eugenio, Bignami Elena, Bruno Giovanna, Costagliola Roberto, Gandolfi Azzurra, Greco Massimiliano, Lembo Rosalba, Monti Giacomo, Nicelli Elisa, Pasculli Nicola, Turi Stefano, Baroselli Antonio, Brazzoni Marcella, Buttazzoni Mattia, Buttera Stefania, Centonze Carlo, Serena Giovanni, Spagnesi Lorenzo, Toretti Ilaria, Vilardi Anna, Zearo Ester, Arpino Ine, Baraldi Sara, Guarnerio Chiara, Molene Vincenzo, Concetta Monea Maria, Vaccarisi Enrico, Vicari Luigi, Albante Alida, Aversano Marco, Loiacono Cinzia, Marandola Maurizio, Fusari Maurizio, Petrucci Nicola, Galla Amerigo, Mascia Antonio, Primieri Paolo, Di Noto Anna, Gratarola Angelo, Molin Alessandro, Spagnolo Luigi, Spena Claudio, Calligaro Plinio, Marchiotto Simonetta, Merlini Alberto, Pedrazzoli Eleonora, Perina Giulia, Visentin Renea, Fumagalli Roberto, Garbagnati Andrea, Manetti Bruna, Snaier Chiara, Somaini Marta, Farnia Antonio, Nani Roberto, Pierantonio Novello, De Michele Michele, Gazzanelli Sergio, Pugliese Francesco, Ruberto Franco, Bergamini Elena, Tassinati Tania, Capuzzo Maurizia, Cirillo Vera, Tufano Rosalba, Oggioni Roberto, Parrini Vieri, Brunori Emanuela, Capone Micaela, Carbone Luigi, Corradetti Francesco, Elisei Daniele, Fiorentino Stefano, Francesconi Maurizio, Gattari Diego, Gorgoglione Maria, Lacobone Emanuele, Minnucci Francesco, Montironi Claudio, Riccioni Gianrenato, Tappata Giuseppe, Zompanti Valeria, Verdenelli Paola, Cerutti Elisabetta, Ranieri Vito Marco, Golubovska Iveta, Grigorjevs Sergej, Rikmane Maija, Rozkalne Daina, Stepanovs Jevgenij, Suba Oleg, Kazune Sigita, Miscuk Aleksej, Nemme Jani, Oss Peteri, Sipylaite Jurate, Macas Andriu, Ragaisis Vytauta, Kontrimaviciute Egle, Tomkute Gabija, Boerma Christiaan, Fleur Kramer Irene, Poeze Martijn, Maria John, Pelzer Gerardu, Winsser Lex, Nijsten Maarten, Schoorl Michiel, Spanjersberg Rob, Buhre Wolfgang, Dieleman Stefan, van Klei Wilton, Bouw Martijn, Pickkers Peter, van der Marieke A., Schreiner Frodo, Zandvliet Ria, van den Berg Roy, De Wit Esther, Keijzer Christaan, Hollmann Marku, Preckel Benedikt, van Acker Gij, Dennesen Paul, Veld Ba, Kuijpers-Visser Agne, Inan T., Koopman-van Gemert A., Ponssen Huibert, Brouwer Tammo, Koopmans Matty, van Bommel Jasper, van Duijn Ditty, van der Hoven Ben, Ormskerk Patricia, Beck Oliver, Schiere Sjouke, Reidinga Auke, Venema Allart, Hoogendoorn Marga, Olthof Kee, Flaatten Han, Jammer Ib, Dokka Vegard, Arne Monsen Svein, Marius Ytrebo Lar, Noursadeghi Mostafa, Shahzad Ahmed, Dagfinn Boksasp Ola, Roiss Christoph, Frank Strietzel Han, Gina Anne, Berntsen Schie, Haugland Helge, Ove Vingsnes Svein, Axelsson Patric, Risom Olsen Thoma, Katre Sanjay, Aakeroey Kristin, Mikstacki Adam, Tamowicz Barbara, Boziłow Dominika, Goch Robert, Grabowski Piotr, Kupisiak Jacek, Małłek Małgorzata, Szyca Robert, Kostyrka Włodzimierz, Choma Robert, Jankowski Grzegorz, Kościelniak Władysław, Pietraszek Paweł, Szarowar Bartosz, Matos Ricardo, França Carlo, Pais Lacerda António, Ormonde Lucindo, Rosa Rosário, Pereira Inê, Vitor Paula, Completo Bento Henrique, Raquel Lopes Maria, Carvalho Marque, Faria Manuela, Cláudia de Sousa Ana, de Freitas Pereira, Almeida Eduardo, Mealha Rui, Vicente Rachel, Monte Raquel, Rua Fernando, Barros Nelson, Esteves Francisco, Gouveia Pinheiro Célia Maria, Real Vila, Miguel Oliveira Vítor, Fátima Oliveira Maria, Martins Isabel, Pedro Saraiva José, Pedro Assunção José, Bártolo Anabela, Carvalho Anabela, Correia Carlo, Martins Salomé, Milheiro Ruth, Diaz Alejandro, Imelda Gonçalves Maria, Ribeiro Rosa, Estilita Joana, Glória Carlo, de Almeida José, Barros Filipa, Ramos Armindo, Camara Margarida, Richard Maul Edward, Nobrega Julio, Langner Anuscka, Faria Maia Dionísio, Afonso Ofélia, Faria Filomena, Serra Sofia, Manuela Botelho Maria, Ferreira Pedro, Mourão Luí, Vintém Oliveira Ana, Resende Margarida, Aleman Miguel, Fonseca Jorge, Isidoro Marta, de Meneses Helena, Pêgas António, Pereira José, Pereira Lui, Ramos Bárbara, Matos Francisco, Gonçalves Castro Maria de Lurde, Martins Ana, Ramos Cristina, de Sousa Manuel, Bento Luí, Botas Conceição, Lopes Vitor, Mendes Rosa, Grigoras Ioana, Blaj Mihaela, Damian Mihaela, Lupusoru Andreea, Ristescu Irina, Codreanu Monica, Diaconescu Ciresica, Nistor Alina, Stanescu Stelian Dorin, Streanga Livia, Berneanu Maria, Bordeianu Cristina, Florenta Calarasu, Iacob Alina, Nicoleta Lupu Mary, Mocanu Iulian, Moraru Coca, Meran Carleta, Nicolae Bacalbasa, Sandu Madalina, Turcanu Roxana, Epure Florina, Grigore Monica, Hotaranu Cristina, Popescu Nicoleta, Baban Oleg, Baciu Manuela, Ciobanu Aurica, Ioan Denciu Catalin, Gurau Vitalie, Maftei Ion, Moldovan Ion, Ungureanu Liviu, Bogdan Prodan, Corneci Dan, Dinu Melania, Madalina Dutu, Rely Manolescu, Silvius Negoita, Tomescu Dana, Gabriela Droc, Adrian Dinescu Stelian, Calin Mitre, Ionescu Daniela, Margarit Simona, Vasian Horatiu, Albu Corina, Balasa Carmen, Cadrigati Alina, Dragulescu Dorian, Gavra Loredana, Hentia Ciprian, Macarie Claudiu, Manescu Mihaela, Nediglea Ioan, Ocica Dana, Ovidiu Bedreag, Papurica Mariu, Plavat Cosmin, Popa Claudia, Ramneantu Mihaela, Sandesc Dorel, Sandici Zoran, Sarandan Mihaela, Belciu Ioana, Tincu Eugen, Ursu Irina, Aignatoaie Mariana, Huzuneanu Mariana, Cocu Simona, Hagau Natalia, Ciubotaru Roxana, Copotoiu Sanda-Maria, Copotoiu Ruxandra, Ioana Ghitescu, Kovacs Judit, Leonard Azamfirei, Szederjesi Iano, Genoveva Vanvu, Mosnegutu Simona, Surbatovic Maja, Djordjevic Dragan, Djordjevic Biljana, Grujic Krasimirka, Jovanovic Dusko, Krstic-Lecic Ivana, Obradovic Jovana, Zeba Snjezana, Jevdjic Jasna, Miletic Milo, Zunic Filip, Bulasevic Aleksandra, Brko Radoslava, Gazibegovic Narcisa, Kendrisic Mirjana, Vojinovic Radisa, Firment Jozef, Zahorec Roman, Capková Judita, Grochova Monika, Trenkler Stefan, Griger Martin, Bakosova Erika, Kvasnica Martin, Saniova Beata, Sulaj Miroslav, Zacharovska Andrea, Simkova Alexandra, Číková Andrea, Gebhardtova Andrea, Hanuljaková Slávka, Koutun Juraj, Martonová Andrea, Žilinčárová Veronika, Galkova Katarína, Krbila Stefan, Sobona Viliam, Ocenasova Marieta, Novak-Jankovic Vesna, Stecher Adela, Stivan Feri, Grynyuk Andriy, Damjanovska Marija, Kostadinov Ivan, Knezevic Mile, Malivojevic Marko, Borovsak Zvonko, Kamenik Mirt, Mekiš Dušan, Osojnik Irena, Kosec Lučka, Ostojič Kapš Silva, Aleksic Dragoslav, Gerjevič Božena, Kalan Katja, Ursic Tomaz, Aldecoa Cesar, Montejo González Juan, Artigas Anna, Garcia Andre, Lisi Alberto, Perez Isabel, Perez Gisela, Poch Nuria, Vaquer Sergi, Balciscueta Goiatz, Barrasa Helena, Cabanes Sara, Maynar Javier, Poveda Yolanda, Quintano Rodero Amaia, Vallejo Ana, Duque Patrícia, Garcia-Bunger Beatriz, Adoracion Elvira Maria, María Lajara Ana, Palencia María, Ramos Rafael, Saez Fernandez Ana, Tirapu León Juan, Iza López Jaione, Yoldi Murillo Francisco, Turumbay Ramirez Eva, Unzué Rico Patricia, Patricia Marta, Vizcaíno Martín, Bernat Álvarez Maria José, Planas Real Kenneth, Mas Serra Arantxa, Aracil Norma, Menendez Bodega Begoña, Fernández García Raquel, Álvarez García Marivi, Gordon Borja de la Quintana, Gutiérrez Jodrá Alicia, De Santos López Angela, Llavador Ros Juan José, Ayala Soto Rocío, Sepúlveda Isabel, Pascual Díez Esperanza, Fernández Fernández Luisa, Soria Gulina Carlo, Pérez Arviza Laura, Fernandez Lorena Mouriz, Río Gómez Antía, Alonso Martínez Concepción, Rodríguez Rodríguez Ana Belén, Lopez Soto Carmen, Garcia Clara, Lorenzo Mario, Pinilla Elena, Rico Jesu, Ruperez Irene, Saiz Alonso Eduardo, Leira Fernando, Emilio Maseda David Pestaña, Royo Concepcion, Villagran Jose, Murillo Candi Giralt, Eduardo Esteva Garcia, Mansilla Folgado Raquel, Joan Fornaguera Nadal, Calonge Montse Pijoan, Sape Prat Anna, Sintes Dolore, Arteta Arteta Donaldo, García Delgado Horacio, Fajardo López-Cuervo Juan, López Mikel Celaya, Ramírez Alejandro, José Saldaña Francisco, Aliste Pilar, Hermira Anchuelo Ana, García Campos Ascensión, Catalán Mercede, García Gómez Mónica, Gonzalez Gonzalaez Olga, López López Eloísa, Real Navacerrada Isabel, de Quevedo Sara Arlanzón, Gonzalez Serrano Matilde, Silvestre Francisco Perez-Cerdá, Martinez Torrente Francisco, Arocas Blanca, Pastor Martinez Ernesto, Soro Marina, Maroto Fernando, Robledo Algarra Ruth, Silla Aleixandre Iné, Argente Gemma Rodriguez, Lleó Ana Broseta, Rubio Antonio Vela, Vicente Sánchez José Lui, Enríquez Valcárcel Irene, Balust Clara, Balust Jaume, Borrat Xavier, Jose Carretero Maria, Gracia Isabel, Matute Purificacion, Mercadal Jordi, Pujol Roger, Tena Beatriz, Ubre Marta, Dorda Albalad Dolore, Muñoz Alcaide Concepción, Caballero Jesu, Camps Cervantes Angel, de Nadal Clanchet Miriam, Montferrer Estruch Nuria, Ballvé Ferrer Mercè, Lacasta Fornells Albert, Terrer Galera Eduard, Garcia Martinez Irene, Manrique Muñoz Susana, Pelavski Andre, Tormos Perez Pilar, Gonzalez Posada Miguel Angel, de Prat Ivette Chocron, Rello Jordi, García Serrano Llum, Naya Sieiro José Manuel, Silva Lorena, Colomina Sole Maria Jose, Biarnes Suñé Alfon, Rochera Villach Isabel, Gómez Herreras José Ignacio, Poves Rodrigo, Martinez Rafael Beatriz, Martinez Almeida Icier, Fernandez Collates Angel, Jose Bartolomé Maria, Cimadevilla Bonifacio, González González Antonio Manuel, Rabanal Llevot Jose Manuel, de Terán Mira Juan Carlos Diaz, González Molina Begoña, Pardo Sara, López Sánchez Carlo, Williams Monica, Zaldibar Estibaliz, Muñoz Corsini Lourde, Rodríguez Fraile José Ramón, de la Lastra Maria, Kabiri Sacramento Monir, López Saña Francisco Javier, Trenado Ålvarez Josep, Cantón Bulnes Maria Luisa, Gándara Carrasco Violeta, Crespo Ma del Rocío Míguez, Narváez Cubillos Diana, Laza Laza Enrique, Pérez Ma del Pino Heredia, Arenzana Seisdedos Ángel, Fernández Torres Bartolomé, Santos Ampuero Marian, Chicot Llano Marta, Mata Esperanza, Munoz Manuel, Orts Mar, Planas Antonio, Ramasco Fernando, Roman Carlo, Varela Durán Marina, Fernandez Sabela del Río, Sanduende Otero Yolanda, Lopez Pineiro Susana, Barreiro Pardal Cristina, Fernández Alcantud Jesú, Ayuso Antolinos Mercede, Barrios Francisco, Collantes Casanova Ana, Ruiz Castro Manuel, Infantes Crespo Beatriz, Lancha Felipe Uzuri, Liceras Fuster Marta, Sanz García Máximo, Herrero Garrote Begoña, Moreno Gonzalez Ricardo, Montes Granero Maria José, de la Guía Carlos Lloreda, Chaves López Raquel, de Frutos López Santiago, Marco Martinez Jose Javier, Garcia Mostaza Angel, Jiménez Moreno Antonio, Riquelme Osado Irene, Bardina Pastor Ana, Peña Rosa, Rustarazo Pérez Mónica, Aliaño Piña María, Aranda Romero Carlo, Rodríguez Elena Rodríguez, Pedroviejo Sáez Vicente, Safatle Fernando, Hernández Salvan Javier, Galán Sampedro Mar, de la Torre Patricia Alfaro, Pérez Toro Jonatan, Lasa Unzúe Crsitina, José Vargas Maria, Garcia Bernal David, Echevarria Mercede, Ubeda Iglesias Alejandro, Loza Ana, Rodriguez Morillo Araceli, Diaz Serrano Pedro, Barrientos Sevilla Fernando Caba, Cacho Elena, Calderón Ricardo, Dufur Mercede, Marginet Carolina, Monedero Pablo, José Yepes Maria, Rellán Alvarez Luzdivina, Fernández Carballal Francisca, Pensado Castiñeiras Alberto, Dieguez García Paula, Ramos López Lorena, Rama Maceiras Pablo, Martínez Puente María Socorro, Rey Rilo Maria Teresa, Trujillo Alonso Ana Esther, Rodríguez Fernández Sonia, Omaña García Rafael, Pérez García Aníbal, Bello Puentes Rafael, Nunez Aguado Domingo, Lopez Carballo Carlo, Fernandez Fernandez Ricardo, Toledo Presedo Amadeo, de Rabago Ricardo Bermejo Diaz, Rodriguez Velasco Ana, Jiménez Capel Yolanda, Fernández Cortés Ana, Martínez García Esther, Martinez Gimeno Laura, Klamburg Jordi, Castillo Omedas Rosa, González Núñez Miriam, Llubià Maristany Clara, Moret Ruiz Enrique, Artigas Xavier, Castrillón Sebastian, Espinosa Nieve, Gomez-Caro Ana M., Illa Susana, India Inmaculada, Martín-Huerta Beatriz, Moral Victoria, Moreno Marisa, Iglesias Fernández Cristina, Fernández García Violeta, Picatto Hernández Pedro, Honrubia Checa Angel Alberto, Salvatierra Diaz David, Linero Noguera Manuel, Pujol Varela Ignacio, González Gallego Miguel, Martínez García Oscar, Ariño Irujo José Javier, González Perrino Carlo, Rey Picazo Julio, López Timoneda Francisco, Manzanero Arroyo María, Albalá Blanco Isabel, Martínez Borja Marco, Martín Burcio Sara, Martinez Castro Nilda, Puente Cerdeiriña Aránzazu, de la Torre Concostrina Marta, Viñas Cristina Medrano, Dorado Díaz Trinidad, Avellanosa Esteruelas Juan, Ingelmo Ingelmo Ildefonso, Duran Insuga Paco, Claros Llamas Elisabeth, Martín Lopez Jose Juan, Beltran Martín María, Elías Martín Elena, Ureta Mesa Eva, Loren Monterde Manuela, Alonso Montoiro Paloma, Gonzalez Móstoles Maria Luisa, Velasco Olarte Eva, Martínez Pérez Adolfo, Domínguez Perez Fernando, Serrano Romero Ana, Parise Rous Diego, Mané Ruiz Nuria, Palomo Ruiz Jose Angel, Ruigomez Saiz Alvaro, Terol Alvaro de la Vega, Candela Toha Angel, Alvarez Utrera Fernando, Alberdi Fermín, Elósegui Itxaso, García Javier, Marco Garde Pilar, Itziar Mintegui Escudero, García Sáez Iker, Salas Estibaliz, Zabarte Mercede, Diaz-Boladeras Rosa-Maria, Mora-Guevara Emilio, Ferreras Zamora Julia, Bonet Alfon, Salo Lidia, Salinas Unai, Zaballos Juan, Abella Alvarez Ana, Jimenez Garrido Carlo, Hita Roa Juan Ramón, Gordo Vidal Federico, Garcia-Egea Jorge, Zamora Elson Monica, Seron-Arbeloa Carlo, Mendiola Asensio Miguel Angel, Gastaldo Simeón Rosa, Muñoz Alameda Luis Enrique, Oeding Angulo Guillermo, Aranzubia Monserrat, Juan Arcas Jose, Arevalo Julian, Quesada Belvert Belén, Pérez Calvo César, Cremades Marta, Crespo Pascual, Cuarental Ana, Del Olmo Mercede, Turrión Fernández Pablo, Garcia Vega José Luis Franqueza García Isabel, Herrera Elena, Alcala Llorente Miguel Angel, Martin Rabes Cecilia, de Maeyer Ana Gamo, Pérez Marquez Manuel, López Mendoza Diego, Milicua Muñoz José María, Arias Martínez Natividad, Santos Oviedo Arnoldo, Benavent Garrigues Pau, Alonso Íñigo José, Tormo Ferrandiz Sergi, Sanchez-Morcillo Silvia, Lafuente Sánchez Matilde, Marqués Parra Asunción, Gomar Vidal Sonia, Montoiro Allué Raquel, Zalba Etayo Begoña, Bustamante Rodriguez Raquel, Martin Villen Lui, Molla Jimenez Cristina, de Zayas Ricardo Sala, Dolera Moreno Cristina, SanJose Pacheco Fernando, Anton Pascual Jose Lui, Tejera Gude Fernando, Manteiga Riestra Eva, Cota Delgado Francisco, de la Torre Prados Maria Victoria, Barrios Javier, Cervera-Montes Manuel, García-Sanz Mercede, García Vicente, Sanmiguel Guillermo, López Álvaro Julian, Bornay Barrachima Beatriz, Romero Bermejo Francisco Jose, Martinez Garcia Alberto Garcia Fernandez Pilar, Navarro Ramírez Carolina, Gómez Ramos Jorge, Angel Samaniego Lui, Belenguer-Muncharaz Alberto, Ferrándiz-Selles Amparo, Mateu-Campos Maria-Lidon, Domínguez David, Espinosa Elena, León Teresa, Ojeda Betancor Nazario, Garcia Cortes Javier, Díaz Díaz Juan José, Manzano Canalechevarria Ana, Fores Novales Beatriz, Garcia Peña Jose Manuel, Rodriguez Delgado Toma, Santamaria Roquerio Beatriz, Gomez Sainz Juan Jose, Tebar Soto Teresa, Chew Michelle, Seeman-Lodding Heléne, Dahm Peter, Odenstedt Hergès Helena, Lundborg Christoffer, Söndergaard Sören, Rylander Christian, Sari Ferenc, Oscarsson Tibblin Anna, Adolfsson Anne, Klarin Bengt, Schrey Susann, Merisson Edyta, Rydén Jörgen, Britt Divander Mona, Hedin Annika, Hedlund Daniel, Axelsson Lindkvist Mikael, Jawad Monir, Layous Lona, Wernerman Jan, Björne Håkan, Brattström Olof, Olheden Staffan, Oldner Ander, Sellden Eva, Walder Bernhard, Wickboldt Nadine, Rossi Ariane, Steiner Luziu, Djurdjevic Mirjana, Lussmann Roger, Geisen Martin, Hofer Christoph, Turina Matthia, Grocott Mike, Goldhill David, Everett Lynn, Harris Katy, Wright Maggie, Adams David, Alderson Lorraine, Baker Julie, Christie Iain, Ferguson Colin, Hill Matthew, Holmes Kate, Hutton Andrew, Minto Gary, Moor Paul, Porter Andrew, Struthers Richard, Akotia Niven, Belhaj Alaa, Chang Serene, Collantes Enrique, Eigener Katrin, Husband Michael, Khan Ahsun, Kong Ming-Li, Jane McAlees Eleanor, Macdonald Neil, Niebrzegowska Edyta, Parnell Wendy, Smith Amanda, Chhatwal Ally, Jhingan Smriti, Muswell Richard, Poon Yoyo, Singh Nidhita, Stephens Robert, Vasan Robin, Waife Nicola, Weda Tahmina, Clarke Adrian, Szakmany Tama, Fletcher Simon, Rosbergen Melissa, Blunt Mark, Prince Liz, Wong Kate, Kumar Ram, Stilwell Sarah, Couper Keith, Crooks Neil, Gao-Smith Fang, Melody Teresa, Snaith Catherine, Patel Jaimin, Parekh Dhruv, Yeung Joyce, Loughnan Bernadette, Moosajee Va, Rope Tamsin, Edger Lliam, Dawson Julie, Hadfield Daniel, Hopkins Phil, Mcdonald Lisa, Willars Chri, Campbell Gillian, Craig Jayne, Smith Andrew, Ladipo Karleen, Lockwood Geoff, Moreno Juan, Ballington Ruth, Hamandishe Sibongilele, Rogerson David, Cowman Sarah, Hayden Paul, Pinto Nuno, Sandhar Taj, Arawwawala Dilshan, Brotherston Lauren, Mitchell-Inwang Christine, Walsh Helena, Alagarsamy Famila, Goon Serena, Karcheva Sylvia, Krepska Amy, Mckinney Brian, Patil Vishal, Batchelor Nichola, Day Christopher, Finch Louise, Gibson Charlie, Grayling Matthew, Hubble Sheena, Key William, Knight Thoma, Loosley Alexander, Margetts Paul, Stewart Hannah, Bewley Jeremy, Hurley Katrina, Murphy Ruth, Philpott Catherine, Pollock Kathryn, Sweet Katie, Thomas Matthew, Tucker Katy, Windsor David, Conway Daniel, Gold Steve, Quraishi Tanviha, Cupitt Jason, Baddeley Sally, Brown John David, Foo Irwin, Mantle Damien, Carvalho Peter, Huddart Sam, Kirk-Bayley Justin, Smith Rebecca, Milligan Lisa, Poulose Sonia, Sarkar Som, Nolan Jerry, Pedley Emma, Padkin Andrew, Pesian Siamak, Rajamanickam Satish, Ramkumar Konnur, Thomas Jerry, Crayford Alison, Turner Angu, Bottrill Fiona, Webb Stephen, Jhanji Shaman, Maccallum Niall, Wessels Kate, Wigmore Tim, Meikle Alistair, Wilson Stephen, White Stuart, Bonnett Andrew, Rushton Andrew, Williams Colin, Zuzan Oliver, Hall Andrew, Montgomery Jane, Piggot Ailie, Read Richard, Stocker Mary, Tamm Tiina, Agarwal Banwari, Ward Stephen, Brown Lucy, Joy Manju, Venkatesh Suresh, Hughes Thoma, Zsisku Lajo, Roy Alistair, Hooper Victoria, Mouland Johanna, Nightingale Jeremy, Rose Steve, Chiam Patrick, Chohan Harnita, Dickson Chri, Gibb Sarah, Higham Charley, Harvey Caroline, Janarthanan Chandra, Jones Laura, Kapoor Avinash, Moll Mark, Roberts Louise, Saunders David, Arnold Glenn, Gibbs Claire, Jhurgursing Mhairi, Pierro Dena, Pritchard France, Doyle Patrick, Templeton Maie, Wilson Robert, Zantua Kim, Collyer Thoma, Featherstone Jame, Worton Rachael, Bruce Jean, Mcguigan Kate, Price Grant, Moreton Sarah, Pulletz Mark, Anderson Helen, Baxter Ian, Beckingsale Alex, Callaghan Mark, Datta Ansu, Dawson Jo, Gollogly Jackit, Izod Chri, Lobaz Steve, Macfie Caroline, Patel Manju, Payne Heather, Singh Raj, Timms Gemma, Mcleod Shaun, O'Brian Peter, Horner Elspeth, Joshi Vivekananda, Stuart-Smith Karen, Seale Tania, Bolger Clare, Collins Hannah, Ekins Emma, Hawkins Lesley, Jonas Max, Linford Karen, Wadams Beverley, Beach Madeleine, Vizcaychipi Marcela, Jewsbury William, Davies Simon, Balaji Packianathaswamy, Kangaraj Muthuraj, Pissay Nagesh, Smith Neil, Gopalakrishnan Senthilkumar, Mackinnon John, Strandvik Gustav, Francis Ruth, Jennings Adrian, Keating Matthew, Kumar Sajith, Leese Sarah, Magee Cliona, Pilsbury Jane, Ralph Jame, Riddington David, Sachdeva Rajneesh, Snelson Catherine, Vasanth Suresh, Wilde Judith, Lavender Beth, Lyons Rachel, Watters Malcolm, Adams Tim, Dyer Simon, Tindall Lucy, Claxton Andrew, Netke Meenu, Akouds Esam, Bates Debrah, Gallagher Heather, Hatton Jonathan, Holroyd William, Mitra Atideb, Nurse Trudy, Reed Deborah, Desikan Somi, Barber Russell, Childs Sophie, O'Carroll-Kuehn Britta, Wyldbore Mark, Al-Abdaly Ayad, Amatya Suman, Bhaskaran Sherly, Chandan Garud, Chaudhry Suman, Chikungwa Mose, Earnshaw Greg, Grewal Moni, Haque Shamimul, Hawkins John, Javaid Ahmed, Jackson Clare, Kamel Miriam, Marla Ruchira, Mculloch Dori-Ann, Parker Tom, Salib Yussof, Saravanmuthu Ramesh, Secker Chri, Sockalingam Siva, Taylor Anne, Austine Pauline, Kanade Vrushali, Paal Dora, Sam Mok May Un, Burtenshaw Andrew, Davis Laura, Ellahee Parvez, Freeman David, Pierson Richard, Wollaston Julie, Karmarkar Amara, Ball Clare, Calton Emily, Maxwell Louise, Walker Rachel, Bland Martin, Bullock Lynne, Harrison-Briggs Donna, Hodge Paul, Krige Anton, Dempsey Ged, Hammell Claire, Loveridge Robert, Parker Robert, Snell Jane, Wright Carl, Baker Andy, Barr Katharine, Belcher Alex, Bonnington Sam, Bougeard Anne-Marie, Fitzgerald Emma, Ford Rachael, Gillard Chantal, Griffiths Liz, Greenberg Lizzie, Huber Jonathan, Mathieu Steve, Richardson Neil, Tompsett Laura, White Nigel, Patel Santosh, Corner Victoria, Thomas Richard, Trodd Dawn, Wilson Jennifer, Copley Ed, Flutter Laura, Hulme Jonathan, Susarla Jay, Thwaites Alison, Jayasundera Suraj, Mcafee Sean, Chantler Jonathan, Mckechnie Stuart, Neely Julia, Mouton Ronelle, Scarth Edward, Soar Jasmeet, Buss Joanne, Currie Vicki, Sange Mansoor, Kuttler Anja, Power Fiona, Alexander David, Dunne Kevin, Shinner Guy, Black Euan, Haldane Grant, Kerr Jennie, Saran Taj, Ward Geraldine, Jefferies Fiona, Alexander Peter, Royle Alison, Nahla Farid, Bowles Tim, Gregory Maggie, Ahern Rebecca, Cartlidge David, Craker Lloyd, Thompson Christopher, Bidd Heena, Giles Julian, Manser Amanda, Parry Gareth, Chan Peter, Das Dinesh, Fahmy Nisreen, Higgins David, Khader Ahmed, Stone Alex, Leonardi Silvia, Rose Oliver, Bright Elizabeth, Ercole Ari, Amir Rafi Muhammed, Ramasamy Radhika, Sheshgiri Bengeri, Merrill Colin, Page Valerie, Walker Elaine, Harris Stephen, Hughes Sarah, Morrison Alan, Razouk Khaled, Ayman Mustafa, Jakeman Alicia, Mowatt Chri, Paananen Sami, Supporting clinical sciences, Intensive Care, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'anesthésiologie, Surgery, and RS: NUTRIM - R2 - Gut-liver homeostasis

Subjects
Male, The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients, Hospital admission, Hospital discharge, Intensive care, Length of stay, Surgical mortality, Epidemiology, Iron metabolism Pathogenesis and modulation of inflammation [IGMD 7], surgery, Cohort Studies, Clinical endpoint, Medicine, Hospital Mortality, Hospital discharge, education.field_of_study, Mortality rate, Medicine (all), Confounding, General Medicine, Middle Aged, Surgical mortality, Operative, Europe, Hospitalization, Treatment Outcome, Surgical Procedures, Operative, outcomes, surgery, mortality, Female, mortality, cohort study, Cohort study, Human, Adult, medicine.medical_specialty, Critical Care, Population, MEDLINE, Settore MED/41 - ANESTESIOLOGIA, Humans, ddc:610, Mortality, education, surgery, mortality, Europe, Aged, Postoperative Care, Surgical Procedures, business.industry, Length of Stay, Hospital admission, Surgery, Clinical outcomes, Intensive care, Mann–Whitney U test, Cohort Studie, business
Abstract

Item does not contain fulltext BACKGROUND: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe. METHODS: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used chi(2) and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p

Published
2012

32. Preoperative abnormalities in serum sodium concentrations are associated with higher in-hospital mortality in patients undergoing major surgery.

Author

Cecconi, M, Hochrieser, H, Chew, Michelle, Grocott, M, Hoeft, A, Hoste, A, Jammer, I, Posch, M, Metnitz, P, Pelosi, P, Moreno, R, Pearse, R M, Vincent, J L, Rhodes, A, Cecconi, M, Hochrieser, H, Chew, Michelle, Grocott, M, Hoeft, A, Hoste, A, Jammer, I, Posch, M, Metnitz, P, Pelosi, P, Moreno, R, Pearse, R M, Vincent, J L, and Rhodes, A

Abstract

BACKGROUND: Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS: This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 539 patients undergoing inpatient non-cardiac surgery. Patients were included in this study if they had a recorded value of preoperative serum sodium within the 28 days immediately before surgery. Data describing preoperative risk factors and serum sodium concentrations were analysed to investigate the relationship with in-hospital mortality using univariate and multivariate logistic regression techniques. RESULTS: Of 35 816 (77.0%) patients from the EuSOS database, 21 943 (61.3%) had normal values of serum sodium (138-142 mmol litre(-1)) before surgery, 8538 (23.8%) had hyponatraemia (serum sodium ≤137 mmol litre(-1)) and 5335 (14.9%) had hypernatraemia (serum sodium ≥143 mmol litre(-1)). After adjustment for potential confounding factors, moderate to severe hypernatraemia (serum sodium concentration ≥150 mmol litre(-1)) was independently associated with mortality [odds ratio 3.4 (95% confidence interval 2.0-6.0), P<0.0001]. Hyponatraemia was not associated with mortality. CONCLUSIONS: Preoperative abnormalities in serum sodium concentrations are common, and hypernatraemia is associated with increased mortality after surgery. Abnormalities of serum sodium concentration may be an important biomarker of perioperative risk resulting from co-morbid disease.

Published
2016
Full Text
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33. Nonelective surgery at night and in-hospital mortality: Prospective observational data from the European Surgical Outcomes Study

Author

Zaane, B. van, Klei, W.A. van, Buhre, W.F., Bauer, P., Boerma, E.C., Hoeft, A., Metnitz, P., Moreno, R.P., Pearse, R., Pelosi, P., Sander, M., Vallet, B., Pettila, V., Vincent, J.L., Rhodes, A., Bouw, M.P., Pickkers, P., et al., Zaane, B. van, Klei, W.A. van, Buhre, W.F., Bauer, P., Boerma, E.C., Hoeft, A., Metnitz, P., Moreno, R.P., Pearse, R., Pelosi, P., Sander, M., Vallet, B., Pettila, V., Vincent, J.L., Rhodes, A., Bouw, M.P., Pickkers, P., and et al.

Abstract

Contains fulltext : 152541.pdf (publisher's version ) (Closed access), BACKGROUND: Evidence suggests that sleep deprivation associated with night-time working may adversely affect performance resulting in a reduction in the safety of surgery and anaesthesia. OBJECTIVE: Our primary objective was to evaluate an association between nonelective night-time surgery and in-hospital mortality. We hypothesised that urgent surgery performed during the night was associated with higher in-hospital mortality and also an increase in the duration of hospital stay and the number of admissions to critical care. DESIGN: A prospective cohort study. This is a secondary analysis of a large database related to perioperative care and outcome (European Surgical Outcome Study). SETTING: Four hundred and ninety-eight hospitals in 28 European countries. PATIENTS: Men and women older than 16 years who underwent nonelective, noncardiac surgery were included according to time of the procedure. INTERVENTION: None. MAIN OUTCOME MEASURES: Primary outcome was in-hospital mortality; the secondary outcome was the duration of hospital stay and critical care admission. RESULTS: Eleven thousand two hundred and ninety patients undergoing urgent surgery were included in the analysis with 636 in-hospital deaths (5.6%). Crude mortality odds ratios (ORs) increased sequentially from daytime [426 deaths (5.3%)] to evening [150 deaths (6.0%), OR 1.14; 95% confidence interval 0.94 to 1.38] to night-time [60 deaths (8.3%), OR 1.62; 95% confidence interval 1.22 to 2.14]. Following adjustment for confounding factors, surgery during the evening (OR 1.09; 95% confidence interval 0.91 to 1.31) and night (OR 1.20; 95% confidence interval 0.9 to 1.6) was not associated with an increased risk of postoperative death. Admittance rate to an ICU increased sequentially from daytime [891 (11.1%)], to evening [347 (13.8%)] to night time [149 (20.6%)]. CONCLUSION: In patients undergoing nonelective urgent noncardiac surgery, in-hospital mortality was associated with well known risk factors related t

Published
2015

34. Benötigen Brandverletzte mehr oder weniger Intensivmedizin?

Author

Metnitz, P. and Rath, T.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Brandverletzungen größeren Ausmaßes stellen eine Herausforderung für alle Behandelnden Berufsgruppen dar. Neben der präklinischen Versorgung spielt vor allem die rasche Aufnahme in ein Zentrum für Brandverletzte und die dort erfolgende Versorgung an einer intensivmedizinischen[for full text, please go to the a.m. URL], 30. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2012)

Published
2012

36. Modeling in-Hospital Patient Survival During the First 28 Days After Intensive Care Unit Admission: a Prognostic Model for Clinical Trials in General Critically Ill Patients

Author

Moreno, R, Metnitz, P, Metnitz, B, Bauer, P, Afonso de Carvalho, S, Hoechtl, A, and SAPS 3 Investigators

Subjects
Factores de Tempo, Índice de Gravidade da Doença, Modelos Estatísticos, Ensaios Clínicos Como Assunto, Prognóstico, Mortalidade Hospitalar, Unidades de Cuidados Intensivos, Avaliação de Risco, Estado Terminal
Abstract

OBJECTIVE: The objective of the study was to develop a model for estimating patient 28-day in-hospital mortality using 2 different statistical approaches. DESIGN: The study was designed to develop an outcome prediction model for 28-day in-hospital mortality using (a) logistic regression with random effects and (b) a multilevel Cox proportional hazards model. SETTING: The study involved 305 intensive care units (ICUs) from the basic Simplified Acute Physiology Score (SAPS) 3 cohort. PATIENTS AND PARTICIPANTS: Patients (n = 17138) were from the SAPS 3 database with follow-up data pertaining to the first 28 days in hospital after ICU admission. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: The database was divided randomly into 5 roughly equal-sized parts (at the ICU level). It was thus possible to run the model-building procedure 5 times, each time taking four fifths of the sample as a development set and the remaining fifth as the validation set. At 28 days after ICU admission, 19.98% of the patients were still in the hospital. Because of the different sampling space and outcome variables, both models presented a better fit in this sample than did the SAPS 3 admission score calibrated to vital status at hospital discharge, both on the general population and in major subgroups. CONCLUSIONS: Both statistical methods can be used to model the 28-day in-hospital mortality better than the SAPS 3 admission model. However, because the logistic regression approach is specifically designed to forecast 28-day mortality, and given the high uncertainty associated with the assumption of the proportionality of risks in the Cox model, the logistic regression approach proved to be superior.

Published
2008

37. Evaluation of clinical practice in perioperative patient blood management.

Author

Baron, D. M., Metnitz, P. G. H., Fellinger, T., Metnitz, B., Rhodes, A., and Kozek-Langenecker, S. A.

Subjects
*HEMORRHAGE treatment, *MEDICAL practice, *PERIOPERATIVE care, *ANESTHESIOLOGY, *ELECTIVE surgery, *BLOOD transfusion, *INTERNET surveys, *HEMOSTATICS, *SURGICAL blood loss, *HEMOSTASIS, *SURVEYS, *PREVENTION, *THERAPEUTICS
Abstract

Background: Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM.Methods: An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms. Data distributions for five European regions and the workplace and experience of physicians were analysed using a χ2 test.Results: We received 706 fully completed surveys from physicians in 57 countries. Most (99%) respondents were anaesthetists or intensive care physicians, and 68% worked at university or university-affiliated hospitals. A standardised bleeding history before surgery is routinely obtained by 48% of physicians. When bleeding history is negative, 55% of physicians routinely order preoperative coagulation testing. Only 24% of physicians timely assess patients at risk of bleeding during surgery for anaemia before elective surgery. When anaemia is diagnosed, 38% of physicians routinely investigate its cause. The rate of routinely performed targeted haemostatic interventions with fibrinogen, vitamin K or prothrombin complex, and tranexamic acid was 60%, 52%, and 54%, respectively. Algorithms to guide PBM are used by 62% of physicians. Results varied between geographic regions.Conclusions: Major deficits exist in the use of recommended PBM among anaesthetists, indicating an opportunity to improve clinical standards. [ABSTRACT FROM AUTHOR]

Published
2016
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38. Mortality after surgery in Europe: a 7 day cohort study

Author

Pearse, R.M., Moreno, R.P., Bauer, P., Pelosi, P., Metnitz, P., Spies, C., Vallet, B., Vincent, J.L., Hoeft, A., Rhodes, A., Pickkers, P., Bouw, M.P., et al., Pearse, R.M., Moreno, R.P., Bauer, P., Pelosi, P., Metnitz, P., Spies, C., Vallet, B., Vincent, J.L., Hoeft, A., Rhodes, A., Pickkers, P., Bouw, M.P., and et al.

Abstract

Item does not contain fulltext, BACKGROUND: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe. METHODS: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used chi(2) and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0.05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries. FINDINGS: We included 46,539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1.2 days (IQR 0.9-3.6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1.2% [95% CI 0.0-3.0] for Iceland to 21.5% [16.9-26.2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0.44 [95% CI 0.19-1.05; p=0.06] for Finland to 6.92 [2.37-20.27; p=0.0004] for Poland). INTERPRETATION: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and internation

Published
2012

40. Mortality after surgery in Europe: a 7 day cohort study

Author

Pearse, Rm, Moreno, Rp, Bauer, P, Pelosi, P, Metnitz, P, Spies, C, Vallet, B, Vincent, J, Hoeft, A, Rhodes, A, Galla, Amerigo, Mascia, Antonio, Primieri, Paolo, Mascia, Antonio (ORCID:0000-0002-4173-396X), Primieri, Paolo (ORCID:0000-0001-6411-3125), Pearse, Rm, Moreno, Rp, Bauer, P, Pelosi, P, Metnitz, P, Spies, C, Vallet, B, Vincent, J, Hoeft, A, Rhodes, A, Galla, Amerigo, Mascia, Antonio, Primieri, Paolo, Mascia, Antonio (ORCID:0000-0002-4173-396X), and Primieri, Paolo (ORCID:0000-0001-6411-3125)

Abstract

Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.

Published
2012

41. Year in review in Intensive Care Medicine, 2008: III. Paediatrics, Ethics, outcome research and critical care organization, sedation, pharmacology and miscellanea

Author

Antonelli, Massimo, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), Conti, Giorgio (ORCID:0000-0002-8566-9365), Antonelli, Massimo, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, Giorgio, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, Salvatore Maurizio, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H., Antonelli, Massimo (ORCID:0000-0003-3007-1670), and Conti, Giorgio (ORCID:0000-0002-8566-9365)

Published
2009

42. Year in review in Intensive Care Medicine, 2008: I. Brain injury and neurology, renal failure and endocrinology, metabolism and nutrition, sepsis, infections and pneumonia

Author

Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, MacRae, D, Zhang, H., CITERIO, GIUSEPPE, Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, MacRae, D, Zhang, H., and CITERIO, GIUSEPPE

Published
2009

43. Year in review in Intensive Care Medicine, 2008: II. Experimental, acute respiratory failure and ARDS, mechanical ventilation and endotracheal intubation

Author

Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, MacRae, D, Zhang, H., CITERIO, GIUSEPPE, Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, MacRae, D, Zhang, H., and CITERIO, GIUSEPPE

Published
2009

44. Year in review in Intensive Care Medicine, 2008: III. Paediatrics, Ethics, outcome research and critical care organization, sedation, pharmacology and miscellanea

Author

Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, MacRae, D, Zhang, H., CITERIO, GIUSEPPE, Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, MacRae, D, Zhang, H., and CITERIO, GIUSEPPE

Published
2009

46. Year in review in Intensive Care Medicine, 2007. I. Experimental studies. Clinical studies: Brain injury and neurology, renal failure and endocrinology

Author

Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, Zhang, H., CITERIO, GIUSEPPE, Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, Zhang, H., and CITERIO, GIUSEPPE

Published
2008

47. Year in review in Intensive Care Medicine, 2007. II. Haemodynamics, pneumonia, infections and sepsis, invasive and non-invasive mechanical ventilation, acute respiratory distress syndrome

Author

Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, Zhang, H., CITERIO, GIUSEPPE, Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, Zhang, H., and CITERIO, GIUSEPPE

Published
2008

48. Year in review in Intensive Care Medicine, 2007. III. Ethics and legislation, health services research, pharmacology and toxicology, nutrition and paediatrics

Author

Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, Zhang, H., CITERIO, GIUSEPPE, Antonelli, M, Azoulay, E, Bonten, M, Chastre, J, Citerio, G, Conti, G, De Backer, D, Lemaire, F, Gerlach, H, Groeneveld, J, Hedenstierna, G, Macrae, D, Mancebo, J, Maggiore, S, Mebazaa, A, Metnitz, P, Pugin, J, Wernerman, J, Zhang, H, Zhang, H., and CITERIO, GIUSEPPE

Published
2008

49. Errors in administration of parenteral drugs in intensive care units: multinational prospective study

Author

Valentin, Andreas, Capuzzo, Maurizia, Guidet, Bertrand, Moreno, Rui, Metnitz, Barbara, Bauer, Peter, and Metnitz, Philipp

Abstract

OBJECTIVE: To assess on a multinational level the frequency, characteristics, contributing factors, and preventive measures of administration errors in parenteral medication in intensive care units. Design Observational, prospective, 24 hour cross sectional study with self reporting by staff. Setting 113 intensive care units in 27 countries. Participants 1328 adults in intensive care. MAIN OUTCOME MEASURES: Number of errors; impact of errors; distribution of error characteristics; distribution of contributing and preventive factors. RESULTS: 861 errors affecting 441 patients were reported: 74.5 (95% confidence interval 69.5 to 79.4) events per 100 patient days. Three quarters of the errors were classified as errors of omission. Twelve patients (0.9% of the study population) experienced permanent harm or died because of medication errors at the administration stage. In a multiple logistic regression with patients as the unit of analysis, odds ratios for the occurrence of at least one parenteral medication error were raised for number of organ failures (odds ratio per increase of one organ failure: 1.19, 95% confidence interval 1.05 to 1.34); use of any intravenous medication (yes v no: 2.73, 1.39 to 5.36); number of parenteral administrations (per increase of one parenteral administration: 1.06, 1.04 to 1.08); typical interventions in patients in intensive care (yes v no: 1.50, 1.14 to 1.96); larger intensive care unit (per increase of one bed: 1.01, 1.00 to 1.02); number of patients per nurse (per increase of one patient: 1.30, 1.03 to 1.64); and occupancy rate (per 10% increase: 1.03, 1.00 to 1.05). Odds ratios for the occurrence of parenteral medication errors were decreased for presence of basic monitoring (yes v no: 0.19, 0.07 to 0.49); an existing critical incident reporting system (yes v no: 0.69, 0.53 to 0.90); an established routine of checks at nurses’ shift change (yes v no: 0.68, 0.52 to 0.90); and an increased ratio of patient turnover to the size of the unit (per increase of one patient: 0.73, 0.57 to 0.93). CONCLUSIONS: Parenteral medication errors at the administration stage are common and a serious safety problem in intensive care units. With the increasing complexity of care in critically ill patients, organisational factors such as error reporting systems and routine checks can reduce the risk for such errors.

Published
2009

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