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Your search keyword '"Oppert, M."' showing total 5 results
Start Over Author "Oppert, M." Topic intensive care units
5 results on '"Oppert, M."'

1. [Patients with sepsis].

Author

Oppert M

Subjects
Anti-Bacterial Agents therapeutic use, Bacteriological Techniques, Early Diagnosis, Early Medical Intervention, Humans, Multiple Organ Failure diagnosis, Multiple Organ Failure therapy, Prognosis, Shock, Septic diagnosis, Shock, Septic therapy, Intensive Care Units, Sepsis diagnosis, Sepsis therapy
Abstract

Sepsis is still the leading cause of mortality in noncardiac intensive care units. The new definition of sepsis emphasizes the importance of organ dysfunction. The Sepsis-related Organ Failure Assessment (SOFA) score is an indicator for organ dysfunction. The diagnosis of sepsis is for the most part made on clinical parameters with an altered mental status being a very sensitive indicator. Microbiological work-up is essential and two sets of blood cultures are the recommended minimum. Management includes prompt initiation of adequate antibiotic treatment and swift fluid resuscitation. Overinfusion is to be avoided as this itself can have a negative impact on patient outcome.

Published
2016
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2. An outbreak of hospital-acquired Pseudomonas aeruginosa infection caused by contaminated bottled water in intensive care units.

Author

Eckmanns T, Oppert M, Martin M, Amorosa R, Zuschneid I, Frei U, Rüden H, and Weist K

Subjects
Germany epidemiology, Humans, Cross Infection epidemiology, Disease Outbreaks, Intensive Care Units, Pseudomonas Infections epidemiology, Pseudomonas aeruginosa isolation & purification, Water Microbiology, Water Supply
Abstract

This study describes an outbreak of Pseudomonas aeruginosa infections caused by contaminated bottled still water (BSW) in six intensive care units (ICUs) of a German university hospital. Clinical and environmental samples from these units were cultured and genotyped by amplified fragment-length polymorphism and pulsed-field gel electrophoresis analysis. Microbiological results were reviewed on a weekly basis to determine the number of P. aeruginosa infections and colonisations of ICU patients. Clinical specimens from 19 ICU patients--15 infections and four colonisations--yielded the same strain of P. aeruginosa. Furthermore, four of 103 environmental samples also yielded P. aeruginosa. However, only a P. aeruginosa strain isolated from unopened BSW was genetically identical to the P. aeruginosa strain isolated from the patients. In the 42-week period before the outbreak, the mean weekly number of new ICU patients infected or colonised with P. aeruginosa was 46.9 (95% CI 40.7-53.1)/1000 bed-days. During the 6-week period of the outbreak, the weekly number of new patients with P. aeruginosa was 88.9 (95% CI 54.3-122.2)/1000 bed-days. This number returned to the previous level after removal of the BSW. Thus, the microbiological and epidemiological findings revealed that the outbreak was related to BSW contaminated with P. aeruginosa. It was concluded that all untested BSW should be removed from ICUs.

Published
2008
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3. Mild therapeutic hypothermia shortens intensive care unit stay of survivors after out-of-hospital cardiac arrest compared to historical controls.

Author

Storm C, Steffen I, Schefold JC, Krueger A, Oppert M, Jörres A, and Hasper D

Subjects
APACHE, Aged, Case-Control Studies, Female, Germany, Humans, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Respiration, Artificial, Survivors, Heart Arrest therapy, Hypothermia, Induced, Intensive Care Units, Length of Stay statistics & numerical data
Abstract

Introduction: Persistent coma is a common finding after cardiac arrest and has profound ethical and economic implications. Evidence suggests that therapeutic hypothermia improves neurological outcome in these patients. In this analysis, we investigate whether therapeutic hypothermia influences the length of intensive care unit (ICU) stay and ventilator time in patients surviving out-of-hospital cardiac arrest., Methods: A prospective observational study with historical controls was conducted at our medical ICU. Fifty-two consecutive patients (median age 62.6 years, 43 males, 34 ventricular fibrillation) submitted to therapeutic hypothermia after out-of-hospital cardiac arrest were included. They were compared with a historical cohort (n = 74, median age 63.8 years, 53 males, 43 ventricular fibrillation) treated in the era prior to hypothermia treatment. All patients received the same standard of care. Neurological outcome was assessed using the Pittsburgh cerebral performance category (CPC) score. Univariate analyses and multiple regression models were used., Results: In survivors, therapeutic hypothermia and baseline disease severity (Acute Physiology and Chronic Health Evaluation II [APACHE II] score) were both found to significantly influence ICU stay and ventilator time (all P < 0.01). ICU stay was shorter in survivors receiving therapeutic hypothermia (median 14 days [interquartile range (IQR) 8 to 26] versus 21 days [IQR 15 to 30] in the control group; P = 0.017). ICU length of stay and time on ventilator were prolonged in patients with CPC 3 or 4 compared with patients with CPC 1 or 2 (P = 0.003 and P = 0.034, respectively). Kaplan-Meier analysis showed improved probability for 1-year survival in the hypothermia group compared with the controls (log-rank test P = 0.013)., Conclusion: Therapeutic hypothermia was found to significantly shorten ICU stay and time of mechanical ventilation in survivors after out-of-hospital cardiac arrest. Moreover, profound improvements in both neurological outcome and 1-year survival were observed.

Published
2008
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4. Resuscitation fluid use in critically ill adults: an international cross sectional study in 391 intensive care units

Author

Finfer, S, Liu, B, Taylor, C, Bellomo, R, Billot, L, Cook, D, Du, B, Mcarthur, C, Myburgh, J, Jacobs, S, Gazzard, R, Edington, J, Ghelani, D, Blythe, D, Richards, B, Mccalman, C, Parr, M, Walker, C, Seppelt, I, Cole, L, Stevens, D, Cade, J, Webb, S, Woolfe, C, van Heerden PV, Cooper, J, Mitchell, I, Peake, S, French, C, Playford, H, Bannerjee, A, Berwanger, O, da Silva, N, Mario Teles, J, Guimarães, H, Rocha, M, Piras, C, Mcintyre, L, Bagshaw, Sm, Stelfox, T, Green, R, Hall, R, Son, W, Meade, M, Kumar, A, Wittman, R, Martin, C, Leblanc, M, Lim, S, Keenan, S, Magder, S, Chittock, D, Wang, W, Dong, J, Chen, X, Li, A, Zhuang, H, Liu, W, Liu, Y, He, Q, Wang, J, Zhou, N, Bai, Y, Wang, L, Lu, F, Chen, W, Wang, S, Zhou, J, Zhang, Z, Xu, Y, Li, T, Sun, X, Wang, B, Zhao, C, Song, Q, Pan, L, Ma, P, Li, Q, Li, G, Chen, D, Liu, L, Gao, K, Han, S, Wan, X, Zhang, Y, Chao, Y, Xi, X, Jiang, L, Han, C, Qin, T, Jiang, W, Li, Y, Liu, X, Hu, Z, Ding, Y, Li, W, Wang, X, Weng, L, Wang, D, Li, S, An, Y, Zhang, W, Luo, H, Luo, Y, Zhu, X, Li, H, Li, C, Qu, H, Mao, E, Min, D, Wang, C, Zhang, J, Ren, H, Liu, H, Wang, M, Zhao, M, Fei, D, Qian, C, Liu, R, Shi, B, Guo, H, Guan, X, Wu, J, Zhou, L, Yu, K, Wang, H, Wang, Y, Li, D, Huang, Q, Su, M, Dong, C, Zhang, X, Wu, B, Qin, Y, Zhang, N, Kang, Y, Deng, Y, Ai, Y, Guo, Y, Cui, Q, Jia, J, Chen, H, Yan, J, Xu, Q, Sun, R, Hong, J, Fang, Q, Zheng, X, Qiu, H, Liu, S, Zhou, Q, Li, J, Schonemann, N, Bendtsen, A, Thornberg, K, Boensen, H, Tousi, H, Bestle, M, Pawlowicz, M, Høen Beck, D, Carl, P, Ronholm, E, Welling, K, Strelitz, J, Kancir, C, Hostrup, A, Perner, A, Jensen, R, Westergard Nielsen, J, Bennett, S, Ball, A, Becker, H, Desikan, S, Watson, N, Watson, D, Smith, I, Wright, M, Millo, J, Morris, J, Williams, A, Peebles Brown, A, Grainger, K, Marsh, R, Christmas, D, Harling, D, Boulanger, C, Davenport, A, Goldsmith, A, Cook, B, Drage, S, Goodall, J, Higgins, D, Price, J, Margarson, M, Sherry, T, Mcauley, F, Syndercombe, A, Jones, G, Reid, J, Andrivet, P, Jamali, S, Rigaud, J, Gaffine, A, Kerkeni, Mejean, C, Drault, J, Beuret, P, Bourffandeau, B, Gasselin, J, de Jonghe, B, Mercat, A, Quenot, J, Broux, C, Timsit, J, Mokhtar, H, Jacobs, F, Pease, S, Mourvillier, B, Lasocki, S, Clabault, K, Rahmani, H, Cariou, A, Guerin, C, Combes, A, Duguet, A, Thuong, M, Janvier, G, Schortgen, F, Icahai, C, Megarbane, B, Payen, D, Leon, R, Gruson, D, Guidet, B, Tardu, D, Roch, A, Ridel, C, Fartoukh, M, Mentec, H, Guitton, C, Blot, F, Oppert, M, Spies, C, Gründling, M, Friesecke, S, Meier, A, Martin, J, Jaschinski, U, Gärtner, R, Weyland, W, Wappler, F, Bromber, H, Welte, T, Hadem, J, Fiedler, F, Peckelsen, C, Fritz, H, Rensing, H, Ragaller, M, Reinhart, K, Brunkhorst, Fm, Riessen, R, Gerlach, H, Hoffmann, U, Chow, Fl, Cheng, C, Joynt, G, Buckley, T, Auyeung, Kw, Young, K, Ching, Ck, Sigurdsson, S, Sigvaldason, K, Hreinsson, K, Kapadia, F, Donnelly, M, Bailie, R, Breen, D, Bates, J, Marsh, B, Motherway, C, Mcauley, D, Trinder, J, Manzoni, A, Mottura, G, Bonaccorso, G, Luzzani, A, De Blasio, E, Bonanno, R, Cardarelli, N, De Cristofaro, M, Mazzola, E, Monfregola, M, Isetta, M, Franchi, F, Trisolino, F, Marchetti, G, Piga, G, Todesco, L, Perno, S, Bianchin, A, Blasetti, A, Rossi, S, Salcuni, R, Greco, M, Beck, E, Antonini, B, Malacarne, P, Prandi, E, Negro, G, Cubeddu, G, Pasquinucci, G, Ferrari, E, Rotelli, S, Savioli, M, Mediani, T, Tognoli, E, Ribola, A, Laperchia, L, Meinardi, S, Cancellieri, F, Mancosu, S, Segala, V, Gamberini, E, Garofalo, G, Dentini, N, Carnevale, L, Bilotta, F, Brunod, F, Casagrande, L, Riva, I, Osti, D, Sitta, V, Alleva, S, Becattini, G, Munaron, S, Cavallo, R, Marzullo, A, Ferrari, F, Calicchio, G, Sucre, M, Quattrocchi, L, Breschi, C, Gratarola, A, Sciacca, P, Postiglione, M, Barattini, M, Rossi, M, Falcelli, C, Coaloa, M, Cattin, S, Palmese, S, David, Antonio, Calabrese, P, Dote, K, Ohashi, I, Morimatsu, H, Goto, Y, Hagioka, S, Mcguiness, S, Gibson, A, Henderson, S, Freebairn, R, Williams, T, Liang, J, Van Haren, F, Dinsdale, D, Serra, I, Arabi, Y, Qushmaq, I, Abouchala, N, Kherallah, M, Mandourah, Y, Cuthbertson, B, Willis, P, Cole, S, Macdougall, M, Andrews, P, Alcorn, D, Carins, C, Digby, B, Tan, Ck, Lee, P, Chan, Y, Petersen, P, Albert, J, Guldbrand, P, Juhlin Dannfeldt, M, Nielsen, N, Hjelmqvist, H, Nordlund, P, Berkius, J, Oldner, A, Konrad, D, Zatterman, R, Metcalf, K, Friberg, H, Chew, M, Lindgren, K, Aneman, A, Gatz, R, Blomqvist, H, Wizelius, I, Andersson, M, Rodling Wahlstrom, M, Stiernstrom, H, Lindgren, P, Elvstad, T, Hyddmark, U, Merz, T, Laube, M, Haberthuer, C, Jaeggi, M, Maggiorini, M, Stover, J, Ahmed, R, Kellum, J, Murugan, R, Salmon, A, Vlahakis, N, Cohn, S, and Chung, K.

Subjects
Adult, Male, endocrine system, medicine.medical_specialty, Resuscitation, Internationality, Cross-sectional study, Critical Illness, Critical Care and Intensive Care Medicine, complex mixtures, Resuscitation fluid, Intensive care, medicine, Humans, Colloids, Medical prescription, Intensive care medicine, Generalized estimating equation, Aged, critically ill adults, business.industry, Research, digestive, oral, and skin physiology, Odds ratio, Middle Aged, Confidence interval, body regions, Intensive Care Units, Cross-Sectional Studies, intensive care units, Emergency medicine, Commentary, Fluid Therapy, Female, business, Perfusion
Abstract

Introduction Recent evidence suggests that choice of fluid used for resuscitation may influence mortality in critically ill patients. Methods We conducted a cross-sectional study in 391 intensive care units across 25 countries to describe the types of fluids administered during resuscitation episodes. We used generalized estimating equations to examine the association between patient, prescriber and geographic factors and the type of fluid administered (classified as crystalloid, colloid or blood products). Results During the 24-hour study period, 1,955 of 5,274 (37.1%) patients received resuscitation fluid during 4,488 resuscitation episodes. The main indications for administering crystalloid or colloid were impaired perfusion (1,526/3,419 (44.6%) of episodes), or to correct abnormal vital signs (1,189/3,419 (34.8%)). Overall, colloid was administered to more patients (1,234 (23.4%) versus 782 (14.8%)) and during more episodes (2,173 (48.4%) versus 1,468 (32.7%)) than crystalloid. After adjusting for patient and prescriber characteristics, practice varied significantly between countries with country being a strong independent determinant of the type of fluid prescribed. Compared to Canada where crystalloid, colloid and blood products were administered in 35.5%, 40.6% and 28.3% of resuscitation episodes respectively, odds ratios for the prescription of crystalloid in China, Great Britain and New Zealand were 0.46 (95% confidence interval (CI) 0.30 to 0.69), 0.18 (0.10 to 0.32) and 3.43 (1.71 to 6.84) respectively; odds ratios for the prescription of colloid in China, Great Britain and New Zealand were 1.72 (1.20 to 2.47), 4.72 (2.99 to 7.44) and 0.39 (0.21 to 0.74) respectively. In contrast, choice of fluid was not influenced by measures of illness severity (for example, Acute Physiology and Chronic Health Evaluation (APACHE) II score). Conclusions Administration of resuscitation fluid is a common intervention in intensive care units and choice of fluid varies markedly between countries. Although colloid solutions are more expensive and may possibly be harmful in some patients, they were administered to more patients and during more resuscitation episodes than crystalloids were.

Published
2010
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5. Both sides of the story - cerebral infarction after intra-abdominal bleeding.

Author

Hasper, D., Storm, C., Seehofer, D., Hoffmann, K., Oppert, M., Krüger, A., Hoffmann, K T, and Krüger, A

Subjects
ADULT respiratory distress syndrome, SARCOIDOSIS, WOMEN patients, HEMORRHAGIC shock, CEREBRAL infarction, MAGNETIC resonance imaging, HEMOPHILIACS, INTENSIVE care units, CRITICAL care medicine, RESEARCH, PATIENTS
Abstract

The article cites a case report about a 36-year-old female patient who was diagnosed with acute pulmonary sarcoidosis and liver infiltration. It was observed that the patient developed a hemorrhagic shock due to intra-abdominal bleeding. Cranial magnetic resonance imaging showed the bilateral cerebral infarction of the anterior and occipital lobes and ischemic lesions in both thalami. Recombinant factor VIIa was used for the treatment of bleeding in hemophilia patients.

Published
2006
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