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1. High expression of L-GILZ transcript variant 1 (GILZ TV 1) is associated with increased 30-day sepsis mortality, and a high expression ratio possibly contraindicates hydrocortisone administration

Author

Rusev, Stefan, Thon, Patrick, Dyck, Birte, Ziehe, Dominik, Rahmel, Tim, Marko, Britta, Palmowski, Lars, Nowak, Hartmuth, Ellger, Björn, Limper, Ulrich, Schwier, Elke, Henzler, Dietrich, Ehrentraut, Stefan Felix, Bergmann, Lars, Unterberg, Matthias, Adamzik, Michael, Koos, Björn, and Rump, Katharina

Published
2024
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4. The impact of the COVID-19 pandemic on non-COVID induced sepsis survival

Author

Unterberg, Matthias, Rahmel, Tim, Rump, Katharina, Wolf, Alexander, Haberl, Helge, von Busch, Alexander, Bergmann, Lars, Bracht, Thilo, Zarbock, Alexander, Ehrentraut, Stefan Felix, Putensen, Christian, Wappler, Frank, Köhler, Thomas, Ellger, Björn, Babel, Nina, Frey, Ulrich, Eisenacher, Martin, Kleefisch, Daniel, Marcus, Katrin, Sitek, Barbara, Adamzik, Michael, Koos, Björn, and Nowak, Hartmuth

Published
2022
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5. Fit-for-Future: Lessons Learned from the COVID-19 Pandemic in Primary Extracorporeal Membrane Oxygenation (ECMO) Transports of Acute Respiratory Distress Syndrome (ARDS) Patients.

Author

Muenster, Stefan, Schumacher, Silvia, Schmandt, Mathias, Kreyer, Stefan, Poth, Jens Martin, Putensen, Christian, Schewe, Jens-Christian, and Ehrentraut, Stefan Felix

Subjects
COVID-19 pandemic, ADULT respiratory distress syndrome, EXTRACORPOREAL membrane oxygenation, TREATMENT duration, PANDEMICS
Abstract

(1) Background: The COVID-19 pandemic presented significant challenges in managing acute respiratory distress syndrome (ARDS), with extracorporeal membrane oxygenation (ECMO) being a critical but resource-intensive intervention. (2) Methods: This retrospective study analyzed veno-venous (VV) ECMO therapy in ARDS patients before and during the pandemic at a high-volume ECMO center in Germany. The study used a reduced ECMO team (one medical and one nursing specialist) to optimize patient care with limited resources, aiming to offer insights for future pandemic management. Data from 181 adult patients (age ≥ 18) with severe ARDS were analyzed: 57 pre-pandemic and 124 during the pandemic. (3) Results: Despite increased isolation measures during the pandemic (25% pre-COVID-19 vs. 79% during COVID-19, p < 0.0001), there was no significant change in transportation mode (ground vs. air) or ECMO implantation times at local hospitals. Similarly, time and distance for primary ECMO transport remained unchanged between the two periods. Complication rates related to ECMO circuit placement and prolonged transport were also insignificant across groups. However, ECMO therapy duration (median 12 days pre-COVID-19 vs. 19 days during COVID-19, p < 0.0001) and hospital stays (median 3 days pre-COVID-19 vs. 7 days during COVID-19, p < 0.01) were longer during the pandemic. Mortality rates were also higher during the pandemic (49% pre-COVID-19 vs. 65% during COVID-19, p < 0.05). (4) Conclusions: In conclusion, a reduced ECMO team proved to be an effective resource-saving strategy that maintained high-quality care with low complication rates, despite the additional challenges posed by pandemic-related isolation measures. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Exploring the relationship between HCMV serostatus and outcomes in COVID-19 sepsis

Author

Ziehe, Dominik, primary, Wolf, Alexander, additional, Rahmel, Tim, additional, Nowak, Hartmuth, additional, Haberl, Helge, additional, Bergmann, Lars, additional, Rump, Katharina, additional, Dyck, Birte, additional, Palmowski, Lars, additional, Marko, Britta, additional, Witowski, Andrea, additional, Willemsen, Katrin Maria, additional, Pfaender, Stephanie, additional, Eisenacher, Martin, additional, Anft, Moritz, additional, Babel, Nina, additional, Bracht, Thilo, additional, Sitek, Barbara, additional, Bayer, Malte, additional, Zarbock, Alexander, additional, von Groote, Thilo, additional, Putensen, Christian, additional, Ehrentraut, Stefan Felix, additional, Weisheit, Christina, additional, Adamzik, Michael, additional, Unterberg, Matthias, additional, and Koos, Björn, additional

Published
2024
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10. Intracranial Hemorrhages on Extracorporeal Membrane Oxygenation: Differences Between COVID-19 and Other Viral Acute Respiratory Distress Syndrome

Author

Seeliger, Benjamin, Doebler, Michael, Hofmaenner, Daniel Andrea, Wendel-Garcia, Pedro D., Schuepbach, Reto A., Schmidt, Julius J., Welte, Tobias, Hoeper, Marius M., Gillmann, Hans-Jörg, Kuehn, Christian, Ehrentraut, Stefan Felix, Schewe, Jens-Christian, Putensen, Christian, Stahl, Klaus, Bode, Christian, and David, Sascha

Published
2022
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11. The Aquaporin 3 Polymorphism (rs17553719) Is Associated with Sepsis Survival and Correlated with IL-33 Secretion

Author

Ziehe, Dominik, primary, Marko, Britta, additional, Thon, Patrick, additional, Rahmel, Tim, additional, Palmowski, Lars, additional, Nowak, Hartmuth, additional, von Busch, Alexander, additional, Wolf, Alexander, additional, Witowski, Andrea, additional, Vonheder, Jolene, additional, Ellger, Björn, additional, Wappler, Frank, additional, Schwier, Elke, additional, Henzler, Dietrich, additional, Köhler, Thomas, additional, Zarbock, Alexander, additional, Ehrentraut, Stefan Felix, additional, Putensen, Christian, additional, Frey, Ulrich Hermann, additional, Anft, Moritz, additional, Babel, Nina, additional, Adamzik, Michael, additional, Koos, Björn, additional, Bergmann, Lars, additional, Unterberg, Matthias, additional, and Rump, Katharina, additional

Published
2024
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12. AQP3 and AQP9—Contrary Players in Sepsis?

Author

Thon, Patrick, primary, Rahmel, Tim, additional, Ziehe, Dominik, additional, Palmowski, Lars, additional, Marko, Britta, additional, Nowak, Hartmuth, additional, Wolf, Alexander, additional, Witowski, Andrea, additional, Orlowski, Jennifer, additional, Ellger, Björn, additional, Wappler, Frank, additional, Schwier, Elke, additional, Henzler, Dietrich, additional, Köhler, Thomas, additional, Zarbock, Alexander, additional, Ehrentraut, Stefan Felix, additional, Putensen, Christian, additional, Frey, Ulrich Hermann, additional, Anft, Moritz, additional, Babel, Nina, additional, Sitek, Barbara, additional, Adamzik, Michael, additional, Bergmann, Lars, additional, Unterberg, Matthias, additional, Koos, Björn, additional, and Rump, Katharina, additional

Published
2024
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13. The Association between the rs3747406 Polymorphism in the Glucocorticoid-Induced Leucine Zipper Gene and Sepsis Survivals Depends on the SOFA Score.

Author

Rusev, Stefan, Thon, Patrick, Rahmel, Tim, Ziehe, Dominik, Marko, Britta, Nowak, Hartmuth, Ellger, Björn, Limper, Ulrich, Schwier, Elke, Henzler, Dietrich, Ehrentraut, Stefan Felix, Bergmann, Lars, Unterberg, Matthias, Adamzik, Michael, Koos, Björn, and Rump, Katharina

Subjects
LEUCINE zippers, SEPSIS, SINGLE nucleotide polymorphisms, GENETIC variation, GENETIC polymorphisms, SOFAS
Abstract

The variability in mortality in sepsis could be a consequence of genetic variability. The glucocorticoid system and the intermediate TSC22D3 gene product—glucocorticoid-induced leucine zipper—are clinically relevant in sepsis, which is why this study aimed to clarify whether TSC22D3 gene polymorphisms contribute to the variance in sepsis mortality. Blood samples for DNA extraction were obtained from 455 patients with a sepsis diagnosis according to the Sepsis-III criteria and from 73 control subjects. A SNP TaqMan assay was used to detect single-nucleotide polymorphisms (SNPs) in the TSC22D3 gene. Statistical and graphical analyses were performed using the SPSS Statistics and GraphPad Prism software. C-allele carriers of rs3747406 have a 2.07-fold higher mortality rate when the sequential organ failure assessment (SOFA) score is higher than eight. In a multivariate COX regression model, the SNP rs3747406 with a SOFA score ≥ 8 was found to be an independent risk factor for 30-day survival in sepsis. The HR was calculated to be 2.12, with a p-value of 0.011. The wild-type allele was present in four out of six SNPs in our cohort. The promoter of TSC22D3 was found to be highly conserved. However, we discovered that the C-allele of rs3747406 poses a risk for sepsis mortality for SOFA Scores higher than 6. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Lung Ultrasound in Predicting Outcomes in Patients with COVID-19 Treated with Extracorporeal Membrane Oxygenation

Author

Schäfer, Valentin Sebastian, primary, Recker, Florian, additional, Kretschmer, Edgar, additional, Putensen, Christian, additional, Ehrentraut, Stefan Felix, additional, Staerk, Christian, additional, Fleckenstein, Tobias, additional, Mayr, Andreas, additional, Seibel, Armin, additional, Schewe, Jens-Christian, additional, and Petzinna, Simon Michael, additional

Published
2023
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15. COVID-19 Is an Independent Risk Factor for Detrimental Invasive Fungal Disease in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: A Retrospective Study

Author

Poth, Jens Martin, primary, Schewe, Jens-Christian, additional, Lehmann, Felix, additional, Weller, Johannes, additional, Schmandt, Mathias Willem, additional, Kreyer, Stefan, additional, Muenster, Stefan, additional, Putensen, Christian, additional, and Ehrentraut, Stefan Felix, additional

Published
2023
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16. Additive prognostic impact of the cerebrospinal fluid arginine/ornithine ratio to established clinical scores in aneurysmal subarachnoid hemorrhage

Author

Weller, Johannes, primary, Lampmann, Tim, additional, Asoglu, Harun, additional, Schneider, Matthias, additional, Ehrentraut, Stefan Felix, additional, Lehmann, Felix, additional, Güresir, Erdem, additional, Dorn, Franziska, additional, Petzold, Gabor C., additional, Vatter, Hartmut, additional, and Zimmermann, Julian, additional

Published
2023
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19. Interprofessional two-man team approach for interhospital transport of ARDS-patients under extracorporeal membrane oxygenation: a 10 years retrospective observational cohort study

Author

Ehrentraut, Stefan Felix, Schroll, Barbara, Lenkeit, Stefan, Ehrentraut, Heidi, Bode, Christian, Kreyer, Stefan, Kögl, Florian, Lehmann, Felix, Muders, Thomas, Scholz, Martin, Strater, Claudia, Steinhagen, Folkert, Theuerkauf, Nils Ulrich, Weißbrich, Carsten, Putensen, Christian, and Schewe, Jens-Christian

Published
2019
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21. Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage

Author

Lehmann, Felix, primary, Schneider, Matthias, additional, Bernstock, Joshua D., additional, Bode, Christian, additional, Borger, Valeri, additional, Ehrentraut, Stefan Felix, additional, Gessler, Florian, additional, Potthoff, Anna-Laura, additional, Putensen, Christian, additional, Schenk, Lorena M., additional, Zimmermann, Julian, additional, Vatter, Hartmut, additional, Schuss, Patrick, additional, and Hadjiathanasiou, Alexis, additional

Published
2022
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22. Intracranial Hemorrhages on Extracorporeal Membrane Oxygenation: Differences Between COVID-19 and Other Viral Acute Respiratory Distress Syndrome

Author

Seeliger, Benjamin; https://orcid.org/0000-0001-7373-752X, Doebler, Michael, Hofmaenner, Daniel Andrea; https://orcid.org/0000-0002-9334-7753, Wendel-Garcia, Pedro D; https://orcid.org/0000-0001-7775-3279, Schuepbach, Reto A; https://orcid.org/0000-0002-7058-4377, Schmidt, Julius J; https://orcid.org/0000-0002-0815-7788, Welte, Tobias; https://orcid.org/0000-0002-9947-7356, Hoeper, Marius M; https://orcid.org/0000-0001-9086-2293, Gillmann, Hans-Jörg, Kuehn, Christian, Ehrentraut, Stefan Felix, Schewe, Jens-Christian, Putensen, Christian, Stahl, Klaus; https://orcid.org/0000-0002-4833-6035, Bode, Christian; https://orcid.org/0000-0002-0830-870X, David, Sascha; https://orcid.org/0000-0002-8231-0461, Seeliger, Benjamin; https://orcid.org/0000-0001-7373-752X, Doebler, Michael, Hofmaenner, Daniel Andrea; https://orcid.org/0000-0002-9334-7753, Wendel-Garcia, Pedro D; https://orcid.org/0000-0001-7775-3279, Schuepbach, Reto A; https://orcid.org/0000-0002-7058-4377, Schmidt, Julius J; https://orcid.org/0000-0002-0815-7788, Welte, Tobias; https://orcid.org/0000-0002-9947-7356, Hoeper, Marius M; https://orcid.org/0000-0001-9086-2293, Gillmann, Hans-Jörg, Kuehn, Christian, Ehrentraut, Stefan Felix, Schewe, Jens-Christian, Putensen, Christian, Stahl, Klaus; https://orcid.org/0000-0002-4833-6035, Bode, Christian; https://orcid.org/0000-0002-0830-870X, and David, Sascha; https://orcid.org/0000-0002-8231-0461

Abstract

Objectives: Extracorporeal membrane oxygenation (ECMO) is a potentially lifesaving procedure in acute respiratory distress syndrome (ARDS) due to COVID-19. Previous studies have shown a high prevalence of clinically silent cerebral microbleeds in patients with COVID-19. Based on this fact, together with the hemotrauma and the requirement of therapeutic anticoagulation on ECMO support, we hypothesized an increased risk of intracranial hemorrhages (ICHs). We analyzed ICH occurrence rate, circumstances and clinical outcome in patients that received ECMO support due to COVID-19-induced ARDS in comparison to viral non-COVID-19-induced ARDS intracerebral hemorrhage. Design: Multicenter, retrospective analysis between January 2010 and May 2021. Setting: Three tertiary care ECMO centers in Germany and Switzerland. Patients: Two-hundred ten ARDS patients on ECMO support (COVID-19, n = 142 vs viral non-COVID, n = 68). Interventions: None. Measurements and main results: Evaluation of ICH occurrence rate, parameters of coagulation and anticoagulation strategies, inflammation, and ICU survival. COVID-19 and non-COVID-19 ARDS patients showed comparable disease severity regarding Sequential Organ Failure Assessment score, while the oxygenation index before ECMO cannulation was higher in the COVID group (82 vs 65 mm Hg). Overall, ICH of any severity occurred in 29 of 142 COVID-19 patients (20%) versus four of 68 patients in the control ECMO group (6%). Fifteen of those 29 ICH events in the COVID-19 group were classified as major (52%) including nine fatal cases (9/29, 31%). In the control group, there was only one major ICH event (1/4, 25%). The adjusted subhazard ratio for the occurrence of an ICH in the COVID-19 group was 5.82 (97.5% CI, 1.9-17.8; p = 0.002). The overall ICU mortality in the presence of ICH of any severity was 88%. Conclusions: This retrospective multicenter analysis showed a six-fold increased adjusted risk for ICH and a 3.5-fold increased incidence of ICH in CO

Published
2022

23. Monitoring of Cerebral Oxygen Saturation in Interhospital Transport of Patients Receiving Extracorporeal Membrane Oxygenation

Author

Schewe, Jens-Christian, primary, Schumacher, Silvia, additional, Erdfelder, Felix, additional, Ehrentraut, Stefan Felix, additional, Weißbrich, Carsten, additional, Lehmann, Felix, additional, Kögl, Florian, additional, Muders, Thomas, additional, Thudium, Marcus, additional, Putensen, Christian, additional, and Kreyer, Stefan, additional

Published
2022
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27. Extensive Therapeutic Drug Monitoring of Colistin in Critically Ill Patients Reveals Undetected Risks

Author

Ehrentraut, Stefan Felix, primary, Muenster, Stefan, additional, Kreyer, Stefan, additional, Theuerkauf, Nils Ulrich, additional, Bode, Christian, additional, Steinhagen, Folkert, additional, Ehrentraut, Heidi, additional, Schewe, Jens-Christian, additional, Weber, Matthias, additional, Putensen, Christian, additional, and Muders, Thomas, additional

Published
2020
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29. Tlr2 deficiency does not limit the development of left ventricular hypertrophy in a model of transverse aortic constriction induced pressure overload.

Author

Tippaporn Bualeong, Kebir, Sied, Hof, Dorothea, Goelz, Lina, Graewe, Mathias, Ehrentraut, Stefan Felix, Knuefermann, Pascal, Baumgarten, Georg, Meyer, Rainer, and Ehrentraut, Heidi

Subjects
TOLL-like receptors, CARDIAC hypertrophy, NATURAL immunity, CARDIOVASCULAR diseases risk factors, ISCHEMIA, HEART failure
Abstract

Background: Toll-like receptors (TLRs) are involved in a variety of cardiovascular disorders, including septic cardiomyopathy, ischemia/reperfusion, heart failure, and cardiac hypertrophy. Previous research revealed that TLR4 promotes cardiac hypertrophy in vivo. Therefore, we investigated whether TLR2 is also involved in the development of cardiac hypertrophy. Methods: Tlr2 deficient and wild type mice were subjected to transverse aortic constriction (TAC) or sham operation procedure. Left ventricular, heart and lung weights as well as hemodynamic parameters were determined after 3, 14 or 28 days. Real-time RT PCR was used to evaluate left ventricular gene expression. Protein content was determined via ELISA. Results: TAC increased systolic left ventricular pressure, contraction and relaxations velocities as well as the heart weight in both genotypes. Tlr2 deficiency significantly enhanced cardiac hypertrophy after 14 and 28 days of TAC. Left ventricular end-diastolic pressure and heart rate increased in Tlr2-/- TAC mice only. Fourteen days of TAC led to a significant elevation of ANP, BNP, TGFβ and TLR4 mRNA levels in Tlr2-/- left ventricular tissue. Conclusion: These data suggest that Tlr2 deficiency may promote the development of cardiac hypertrophy and ventricular remodeling after transverse aortic constriction. [ABSTRACT FROM AUTHOR]

Published
2016
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31. Estimation of Cardiac Output Under Veno-Venous Extracorporeal Membrane Oxygenation: Comparing Thermodilution Methods to 3D Echocardiography.

Author

Linden K, Schmandt M, Muders T, Theuerkauf N, Schewe JC, Herberg U, Putensen C, Ehrentraut SF, and Kreyer S

Abstract

Thermodilution methods to determine cardiac output (CO) may be affected by veno-venous extracorporeal membrane oxygenation (ECMO). We compared CO estimations by pulmonary arterial thermodilution using a pulmonary arterial catheter (COPAC), transpulmonary thermodilution (COTPTD), and three-dimensional echocardiography (3DEcho) (CO3DEcho) in 18 patients under veno-venous ECMO. Comparisons between CO3DEcho and COPAC, and COTPTD were performed using correlation statistics and Bland-Altman analysis. Blood flow on ECMO support ranged from 4.3 to 5.8 L/min (median 4.9 L/min). Cardiac output measured with three-dimensional echocardiography was 5.2 L/min (3.8/5.9), COPAC was 7.3 L/min (5.9/7.9), and COTPTD was 7.3 L/min (6/8.2) (median [25%/75% percentile]). Bland-Altman analysis of CO3DEcho and COPAC revealed a mean bias of -2.06 L/min, with limits of agreement from -4.16 to 0.04 L/min. Bland-Altman analysis of CO3DEcho and COTPTD revealed a mean bias of -2.22 L/min, with limits of agreement from -4.18 to -0.25 L/min. We found a negative mean bias and negative limits of agreement between CO3DEcho and COPAC/COTPTD. We concluded an influence on the estimation of CO by thermodilution under ECMO most likely due to loss of indicator resulting in an overestimation of CO. Clinicians should consider this when monitoring thermodilution-based CO under ECMO., Competing Interests: Disclosure: The authors have no conflicts of interest to report., (Copyright © ASAIO 2024.)

Published
2024
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