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365 results on '"Moerer, O."'

4. Acute renal response to changes in carbon dioxide in mechanically ventilated female pigs.

Author

Pozzi, T., Nicolardi, R. V., Fioccola, A., Fratti, I., Romitti, F., Busana, M., Collino, F., Gattarello, S., Wieditz, J., Caironi, P., Moerer, O., Quintel, M., Meissner, K., Camporota, L., and Gattinoni, L.

Subjects
ARTIFICIAL respiration, MECHANICAL models, CARBON dioxide, VENTILATION, HEMODYNAMICS
Abstract

Kidney response to acute and mechanically induced variation in ventilation associated with different levels of PEEP has not been investigated. We aimed to quantify the effect of ventilatory settings on renal acid–base compensation. Forty‐one pigs undergoing hypo‐ (<0.2 Lkg−1 min−1, PEEP 25 cmH2O), intermediate (0.2–0.4 Lkg−1 min−1 with either PEEP 5 or 25 cmH2O), or hyper‐ventilation (>0.4 Lkg−1 min−1, PEEP 5 cmH2O) for 48 h were retrospectively included. The decrease in pH paralleled the decrease in plasma strong ion difference (SID) in hyper‐ and intermediately ventilated groups with lower PEEP. In contrast, the plasma SID remained nearly constant in hypo‐ and intermediately ventilated groups with higher PEEP. Changes in plasma chloride concentration accounted for the changes in plasma SID (conditional R2 = 0.86). The plasma SID changes were paralleled by mirror changes in urinary SID. Higher PEEP (25 cmH2O), compared to lower PEEP (5 cmH2O) dampened or abolished the renal compensation through its effect on hemodynamics (higher central venous and mean pulmonary pressures), irrespective of minute ventilation. During mechanical ventilation, the compensatory renal response to respiratory derangement is immediate and progressive but can be dampened by high PEEP levels. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Zertifikat „Intensivmedizin“ der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin – ein Update.

Author

Bickenbach, J., Moerer, O., Dembinski, R., Weig, T., Heim, M., Putensen, C., Herbstreit, F., Suchodolski, K., Trommler, P., Weber-Carstens, S., and Marx, G.

Subjects
WOUNDS & injuries, PATIENT safety, MEDICAL education, EXTRACORPOREAL membrane oxygenation, BURNS & scalds, TRANSPLANTATION of organs, tissues, etc., MEDICAL care, CERTIFICATION, SUBACUTE care, INTENSIVE care units, MEDICAL research, ANESTHESIOLOGY, QUALITY assurance, PHYSICIANS, CHANGE management, VENTILATOR weaning, CRITICAL care medicine, CARDIOVASCULAR system
Abstract

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2024
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8. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Author

Pham, T, Heunks, L, Bellani, G, Madotto, F, Aragao, I, Beduneau, G, Goligher, E, Grasselli, G, Laake, J, Mancebo, J, Penuelas, O, Piquilloud, L, Pesenti, A, Wunsch, H, van Haren, F, Brochard, L, Laffey, J, Abrough, F, Acharya, S, Amin, P, Arabi, Y, Bauer, P, Beitler, J, Berkius, J, Bugedo, G, Camporota, L, Cerny, V, Cho, Y, Clarkson, K, Estenssoro, E, Gritsan, A, Hashemian, S, Hermans, G, Jovanovic, B, Kurahashi, K, Matamis, D, Moerer, O, Molnar, Z, Ozyilmaz, E, Panka, B, Papali, A, Perbet, S, Qiu, H, Razek, A, Rittayamai, N, Roldan, R, Serpa Neto, A, Szuldrzynski, K, Talmor, D, Tomescu, D, Villagomez, A, Zeggwagh, A, Abe, T, Aboshady, A, Acampo-de Jong, M, Adderley, J, Adiguzel, N, Agrawal, V, Aguilar, G, Aguirre, G, Aguirre-Bermeo, H, Ahlstrom, B, Akbas, T, Akker, M, Al Sadeh, G, Alamri, S, Algaba, A, Ali, M, Aliberti, A, Allegue, J, Alvarez, D, Amador, J, Andersen, F, Ansari, S, Apichatbutr, Y, Apostolopoulou, O, Arellano, D, Arica, M, Arikan, H, Arinaga, K, Arnal, J, Asano, K, Asin-Corrochano, M, Avalos Cabrera, J, Avila Fuentes, S, Aydemir, S, Aygencel, G, Azevedo, L, Bacakoglu, F, Badie, J, Baedorf Kassis, E, Bai, G, Balaraj, G, Ballico, B, Banner-Goodspeed, V, Banwarie, P, Barbieri, R, Baronia, A, Barrett, J, Barrot, L, Barrueco-Francioni, J, Barry, J, Bawangade, H, Beavis, S, Beck, E, Beehre, N, Belenguer Muncharaz, A, Belliato, M, Bellissima, A, Beltramelli, R, Ben Souissi, A, Benitez-Cano, A, Benlamin, M, Benslama, A, Bento, L, Benvenuti, D, Bernabe, L, Bersten, A, Berta, G, Bertini, P, Bertram-Ralph, E, Besbes, M, Bettini, L, Beuret, P, Bewley, J, Bezzi, M, Bhakhtiani, L, Bhandary, R, Bhowmick, K, Bihari, S, Bissett, B, Blythe, D, Bocher, S, Boedjawan, N, Bojanowski, C, Boni, E, Boraso, S, Borelli, M, Borello, S, Borislavova, M, Bosma, K, Bottiroli, M, Boyd, O, Bozbay, S, Briva, A, Bruel, C, Bruni, A, Buehner, U, Bulpa, P, Burt, K, Buscot, M, Buttera, S, Cabrera, J, Caccese, R, Caironi, P, Canchos Gutierrez, I, Canedo, N, Cani, A, Cappellini, I, Carazo, J, Cardonnet, L, Carpio, D, Carriedo, D, Carrillo, R, Carvalho, J, Caser, E, Castelli, A, Castillo Quintero, M, Castro, H, Catorze, N, Cengiz, M, Cereijo, E, Ceunen, H, Chaintoutis, C, Chang, Y, Chaparro, G, Chapman, C, Chau, S, Chavez, C, Chelazzi, C, Chelly, J, Chemouni, F, Chen, K, Chena, A, Chiarandini, P, Chilton, P, Chiumello, D, Chou-Lie, Y, Chudeau, N, Cinel, I, Cinnella, G, Clark, M, Clark, T, Clementi, S, Coaguila, L, Codecido, A, Collins, A, Colombo, R, Conde, J, Consales, G, Cook, T, Coppadoro, A, Cornejo, R, Cortegiani, A, Coxo, C, Cracchiolo, A, Crespo Ramirez, M, Crova, P, Cruz, J, Cubattoli, L, Cukurova, Z, Curto, F, Czempik, P, D'Andrea, R, da Silva Ramos, F, Dangers, L, Danguy des Deserts, M, Danin, P, Dantas, F, Daubin, C, Dawei, W, de Haro, C, de Jesus Montelongo, F, De Mendoza, D, de Pablo, R, De Pascale, G, De Rosa, S, Decavele, M, Declercq, P, Deicas, A, del Carmen Campos Moreno, M, Dellamonica, J, Delmas, B, Demirkiran, O, Demirkiran, H, Dendane, T, di Mussi, R, Diakaki, C, Diaz, A, Diaz, W, Dikmen, Y, Dimoula, A, Doble, P, Doha, N, Domingos, G, Dres, M, Dries, D, Duggal, A, Duke, G, Dunts, P, Dybwik, K, Dykyy, M, Eckert, P, Efe, S, Elatrous, S, Elay, G, Elmaryul, A, Elsaadany, M, Elsayed, H, Elsayed, S, Emery, M, Ena, S, Eng, K, Englert, J, Erdogan, E, Ergin Ozcan, P, Eroglu, E, Escobar, M, Esen, F, Esen Tekeli, A, Esquivel, A, Esquivel Gallegos, H, Ezzouine, H, Facchini, A, Faheem, M, Fanelli, V, Farina, M, Fartoukh, M, Fehrle, L, Feng, F, Feng, Y, Fernandez, I, Fernandez, B, Fernandez-Rodriguez, M, Ferrando, C, Ferreira da Silva, M, Ferreruela, M, Ferrier, J, Flamm Zamorano, M, Flood, L, Floris, L, Fluckiger, M, Forteza, C, Fortunato, A, Frans, E, Frattari, A, Fredes, S, Frenzel, T, Fumagalli, R, Furche, M, Fusari, M, Fysh, E, Galeas-Lopez, J, Galerneau, L, Garcia, A, Garcia, M, Garcia, E, Garcia Olivares, P, Garlicki, J, Garnero, A, Garofalo, E, Gautam, P, Gazenkampf, A, Gelinotte, S, Gelormini, D, Ghrenassia, E, Giacomucci, A, Giannoni, R, Gigante, A, Glober, N, Gnesin, P, Gollo, Y, Gomaa, D, Gomero Paredes, R, Gomes, R, Gomez, R, Gomez, O, Gomez, A, Gondim, L, Gonzalez, M, Gonzalez, I, Gonzalez-Castro, A, Gordillo Romero, O, Gordo, F, Gouin, P, Graf Santos, J, Grainne, R, Grando, M, Granov Grabovica, S, Grasso, S, Grasso, R, Grimmer, L, Grissom, C, Gu, Q, Guan, X, Guarracino, F, Guasch, N, Guatteri, L, Gueret, R, Guerin, C, Guerot, E, Guitard, P, Gul, F, Gumus, A, Gurjar, M, Gutierrez, P, Hachimi, A, Hadzibegovic, A, Hagan, S, Hammel, C, Han Song, J, Hanlon, G, Heines, S, Henriksson, J, Herbrecht, J, Heredia Orbegoso, G, Hermon, A, Hernandez, R, Hernandez, C, Herrera, L, Herrera-Gutierrez, M, Hidalgo, J, Hill, D, Holmquist, D, Homez, M, Hongtao, X, Hormis, A, Horner, D, Hornos, M, Hou, M, House, S, Housni, B, Hugill, K, Humphreys, S, Humbert, L, Hunter, S, Hwa Young, L, Iezzi, N, Ilutovich, S, Inal, V, Innes, R, Ioannides, P, Iotti, G, Ippolito, M, Irie, H, Iriyama, H, Itagaki, T, Izura, J, Izza, S, Jabeen, R, Jamaati, H, Jamadarkhana, S, Jamoussi, A, Jankowski, M, Jaramillo, L, Jeon, K, Jeong Lee, S, Jeswani, D, Jha, S, Jiang, L, Jing, C, Jochmans, S, Johnstad, B, Jongmin, L, Joret, A, Junhasavasdikul, D, Jurado, M, Kam, E, Kamohara, H, Kane, C, Kara, I, Karakurt, S, Karnjanarachata, C, Kataoka, J, Katayama, S, Kaushik, S, Kelebek Girgin, N, Kerr, K, Kerslake, I, Khairnar, P, Khalid, A, Khan, A, Khanna, A, Khorasanee, R, Kienhorst, D, Kirakli, C, Knafelj, R, Kol, M, Kongpolprom, N, Kopitko, C, Korkmaz Ekren, P, Kubisz-Pudelko, A, Kulcsar, Z, Kumasawa, J, Kuriyama, A, Kutchak, F, Labarca, E, Labat, F, Laborda, C, Laca Barrera, M, Lagache, L, Landaverde Lopez, A, Lanspa, M, Lascari, V, Le Meur, M, Lee, S, Lee, Y, Lee, J, Lee, W, Legernaes, T, Leiner, T, Lemiale, V, Leonor, T, Lepper, P, Li, D, Li, H, Li, O, Lima, A, Lind, D, Litton, E, Liu, N, Liu, L, Liu, J, Llitjos, J, Llorente, B, Lopez, R, Lopez, C, Lopez Nava, C, Lovazzano, P, Lu, M, Lucchese, F, Lugano, M, Lugo Goytia, G, Luo, H, Lynch, C, Macheda, S, Madrigal Robles, V, Maggiore, S, Magret Iglesias, M, Malaga, P, Mallapura Maheswarappa, H, Malpartida, G, Malyarchikov, A, Mansson, H, Manzano, A, Marey, I, Marin, N, Marin, M, Markman, E, Martin, F, Martin, A, Martin Dal Gesso, C, Martinez, F, Martinez-Fidalgo, C, Martin-Loeches, I, Mas, A, Masaaki, S, Maseda, E, Massa, E, Mattsson, A, Maugeri, J, Mccredie, V, Mccullough, J, Mcguinness, S, Mckown, A, Medve, L, Mei, C, Mellado Artigas, R, Mendes, V, Mervat, M, Michaux, I, Mikhaeil, M, Milagros, O, Milet, I, Millan, M, Minwei, Z, Mirabella, L, Mishra, S, Mistraletti, G, Mochizuki, K, Moghal, A, Mojoli, F, Molin, A, Montiel, R, Montini, L, Monza, G, Mora Aznar, M, Morakul, S, Morales, M, Moreno Torres, D, Morocho Tutillo, D, Motherway, C, Mouhssine, D, Mouloudi, E, Munoz, T, Munoz de Cabo, C, Mustafa, M, Muthuchellappan, R, Muthukrishnan, M, Muttini, S, Nagata, I, Nahar, D, Nakanishi, M, Nakayama, I, Namendys-Silva, S, Nanchal, R, Nandakumar, S, Nasi, A, Nasir, K, Navalesi, P, Naz Aslam, T, Nga Phan, T, Nichol, A, Niiyama, S, Nikolakopoulou, S, Nikolic, E, Nitta, K, Noc, M, Nonas, S, Nseir, S, Nur Soyturk, A, Obata, Y, Oeckler, R, Oguchi, M, Ohshimo, S, Oikonomou, M, Ojados, A, Oliveira, M, Oliveira Filho, W, Oliveri, C, Olmos, A, Omura, K, Orlandi, M, Orsenigo, F, Ortiz-Ruiz De Gordoa, L, Ota, K, Ovalle Olmos, R, Oveges, N, Oziemski, P, Ozkan Kuscu, O, Pachas Alvarado, F, Pagella, G, Palaniswamy, V, Palazon Sanchez, E, Palmese, S, Pan, G, Pan, W, Papanikolaou, M, Papavasilopoulou, T, Parekh, A, Parke, R, Parrilla, F, Parrilla, D, Pasha, T, Pasin, L, Patao, L, Patel, M, Patel, G, Pati, B, Patil, J, Pattnaik, S, Paul, D, Pavesi, M, Pavlotsky, V, Paz, G, Paz, E, Pecci, E, Pellegrini, C, Pena Padilla, A, Perchiazzi, G, Pereira, T, Pereira, V, Perez, M, Perez Calvo, C, Perez Cheng, M, Perez Maita, R, Perez-Araos, R, Perez-Teran, P, Perez-Torres, D, Perkins, G, Persona, P, Petnak, T, Petrova, M, Philippart, F, Picetti, E, Pierucci, E, Piervincenzi, E, Pinciroli, R, Pintado, M, Piraino, T, Piras, S, Piras, C, Pirompanich, P, Pisani, L, Platas, E, Plotnikow, G, Porras, W, Porta, V, Portilla, M, Portugal, J, Povoa, P, Prat, G, Pratto, R, Preda, G, Prieto, I, Prol-Silva, E, Pugh, R, Qi, Y, Qian, C, Qin, T, Qu, H, Quintana, T, Quispe Sierra, R, Quispe Soto, R, Rabbani, R, Rabee, M, Rabie, A, Rahe Pereira, M, Rai, A, Raj Ashok, S, Rajab, M, Ramdhani, N, Ramey, E, Ranieri, M, Rathod, D, Ray, B, Redwanul Huq, S, Regli, A, Reina, R, Resano Sarmiento, N, Reynaud, F, Rialp, G, Ricart, P, Rice, T, Richardson, A, Rieder, M, Rinket, M, Rios, F, Risso Vazquez, A, Riva, I, Rivette, M, Roca, O, Roche-Campo, F, Rodriguez, C, Rodriguez, G, Rodriguez Gonzalez, D, Rodriguez Tucto, X, Rogers, A, Romano, M, Rortveit, L, Rose, A, Roux, D, Rouze, A, Rubatto Birri, P, Ruilan, W, Ruiz Robledo, A, Ruiz-Aguilar, A, Sadahiro, T, Saez, I, Sagardia, J, Saha, R, Saiphoklang, N, Saito, S, Salem, M, Sales, G, Salgado, P, Samavedam, S, Sami Mebazaa, M, Samuelsson, L, San Juan Roman, N, Sanchez, P, Sanchez-Ballesteros, J, Sandoval, Y, Sani, E, Santos, M, Santos, C, Sanui, M, Saravanabavan, L, Sari, S, Sarkany, A, Sauneuf, B, Savioli, M, Sazak, H, Scano, R, Schneider, F, Schortgen, F, Schultz, M, Schwarz, G, Seckin Yucesoy, F, Seely, A, Seiler, F, Seker Tekdos, Y, Seok Chan, K, Serano, L, Serednicki, W, Setten, M, Shah, A, Shah, B, Shang, Y, Shanmugasundaram, P, Shapovalov, K, Shebl, E, Shiga, T, Shime, N, Shin, P, Short, J, Shuhua, C, Siddiqui, S, Silesky Jimenez, J, Silva, D, Silva Sales, B, Simons, K, Sjobo, B, Slessor, D, Smiechowicz, J, Smischney, N, Smith, P, Smith, T, Smith, M, Snape, S, Snyman, L, Soetens, F, Sook Hong, K, Sosa Medellin, M, Soto, G, Souloy, X, Sousa, E, Sovatzis, S, Sozutek, D, Spadaro, S, Spagnoli, M, Spangfors, M, Spittle, N, Spivey, M, Stapleton, A, Stefanovic, B, Stephenson, L, Stevenson, E, Strand, K, Strano, M, Straus, S, Sun, C, Sun, R, Sundaram, V, Sunpark, T, Surlemont, E, Sutherasan, Y, Szabo, Z, Tainter, C, Takaba, A, Tallott, M, Tamasato, T, Tang, Z, Tangsujaritvijit, V, Taniguchi, L, Taniguchi, D, Tarantino, F, Teerapuncharoen, K, Temprano, S, Terragni, P, Terzi, N, Thakur, A, Theerawit, P, Thille, A, Thomas, M, Thungtitigul, P, Thyrault, M, Tilouch, N, Timenetsky, K, Tirapu, J, Todeschini, M, Tomas, R, Tomaszewski, C, Tonetti, T, Tonnelier, A, Trinder, J, Trongtrakul, K, Truwit, J, Tsuei, B, Tulaimat, A, Turan, S, Turkoglu, M, Tyagi, S, Ubeda, A, Vagginelli, F, Valenti, M, Vallverdu, I, Van Axel, A, van den Hul, I, van der Hoeven, H, Van Der Meer, N, Vanhoof, M, Vargas-Ordonez, M, Vaschetto, R, Vascotto, E, Vatsik, M, Vaz, A, Vazquez-Sanchez, A, Ventura, S, Vermeijden, J, Vidal, A, Vieira, J, Vilela Costa Pinto, B, Villagra, A, Villegas Succar, C, Vinorum, O, Vitale, G, Vj, R, Vochin, A, Voiriot, G, Volta, C, von Seth, M, Wajdi, M, Walsh, D, Wang, S, Wardi, G, Ween-Velken, N, Wei, B, Weller, D, Welsh, D, Welters, I, Wert, M, Whiteley, S, Wilby, E, Williams, E, Williams, K, Wilson, A, Wojtas, J, Won Huh, J, Wrathall, D, Wright, C, Wu, J, Xi, G, Xing, Z, Xu, H, Yamamoto, K, Yan, J, Yanez, J, Yang, X, Yates, E, Yazicioglu Mocin, O, Ye, Z, Yildirim, F, Yoshida, N, Yoshido, H, Young Lee, B, Yu, R, Yu, G, Yu, T, Yuan, B, Yuangtrakul, N, Yumoto, T, Yun, X, Zakalik, G, Zaki, A, Zalba-Etayo, B, Zambon, M, Zang, B, Zani, G, Zarka, J, Zerbi, S, Zerman, A, Zetterquist, H, Zhang, J, Zhang, H, Zhang, W, Zhang, G, Zhao, H, Zheng, J, Zhu, B, Zumaran, R, Pham T., Heunks L., Bellani G., Madotto F., Aragao I., Beduneau G., Goligher E. C., Grasselli G., Laake J. H., Mancebo J., Penuelas O., Piquilloud L., Pesenti A., Wunsch H., van Haren F., Brochard L., Laffey J. G., Abrough F., Acharya S. P., Amin P., Arabi Y., Bauer P., Beitler J., Berkius J., Bugedo G., Camporota L., Cerny V., Cho Y. -J., Clarkson K., Estenssoro E., Goligher E., Gritsan A., Hashemian S. M., Hermans G., Heunks L. M., Jovanovic B., Kurahashi K., Matamis D., Moerer O., Molnar Z., Ozyilmaz E., Panka B., Papali A., Perbet S., Qiu H., Razek A. A., Rittayamai N., Roldan R., Serpa Neto A., Szuldrzynski K., Talmor D., Tomescu D., Villagomez A., Zeggwagh A. A., Abe T., Aboshady A., Acampo-de Jong M., Acharya S., Adderley J., Adiguzel N., Agrawal V. K., Aguilar G., Aguirre G., Aguirre-Bermeo H., Ahlstrom B., Akbas T., Akker M., Al Sadeh G., Alamri S., Algaba A., Ali M., Aliberti A., Allegue J. M., Alvarez D., Amador J., Andersen F. H., Ansari S., Apichatbutr Y., Apostolopoulou O., Arellano D., Arica M., Arikan H., Arinaga K., Arnal J. -M., Asano K., Asin-Corrochano M., Avalos Cabrera J. M., Avila Fuentes S., Aydemir S., Aygencel G., Azevedo L., Bacakoglu F., Badie J., Baedorf Kassis E., Bai G., Balaraj G., Ballico B., Banner-Goodspeed V., Banwarie P., Barbieri R., Baronia A., Barrett J., Barrot L., Barrueco-Francioni J. E., Barry J., Bawangade H., Beavis S., Beck E., Beehre N., Belenguer Muncharaz A., Belliato M., Bellissima A., Beltramelli R., Ben Souissi A., Benitez-Cano A., Benlamin M., Benslama A., Bento L., Benvenuti D., Bernabe L., Bersten A., Berta G., Bertini P., Bertram-Ralph E., Besbes M., Bettini L. R., Beuret P., Bewley J., Bezzi M., Bhakhtiani L., Bhandary R., Bhowmick K., Bihari S., Bissett B., Blythe D., Bocher S., Boedjawan N., Bojanowski C. M., Boni E., Boraso S., Borelli M., Borello S., Borislavova M., Bosma K. J., Bottiroli M., Boyd O., Bozbay S., Briva A., Bruel C., Bruni A., Buehner U., Bulpa P., Burt K., Buscot M., Buttera S., Cabrera J., Caccese R., Caironi P., Canchos Gutierrez I., Canedo N., Cani A., Cappellini I., Carazo J., Cardonnet L. P., Carpio D., Carriedo D., Carrillo R., Carvalho J., Caser E., Castelli A., Castillo Quintero M., Castro H., Catorze N., Cengiz M., Cereijo E., Ceunen H., Chaintoutis C., Chang Y., Chaparro G., Chapman C., Chau S., Chavez C. E., Chelazzi C., Chelly J., Chemouni F., Chen K., Chena A., Chiarandini P., Chilton P., Chiumello D., Chou-Lie Y., Chudeau N., Cinel I., Cinnella G., Clark M., Clark T., Clementi S., Coaguila L., Codecido A. J., Collins A., Colombo R., Conde J., Consales G., Cook T., Coppadoro A., Cornejo R., Cortegiani A., Coxo C., Cracchiolo A. N., Crespo Ramirez M., Crova P., Cruz J., Cubattoli L., Cukurova Z., Curto F., Czempik P., D'Andrea R., da Silva Ramos F., Dangers L., Danguy des Deserts M., Danin P. -E., Dantas F., Daubin C., Dawei W., de Haro C., de Jesus Montelongo F., De Mendoza D., de Pablo R., De Pascale G., De Rosa S., Decavele M., Declercq P. -L., Deicas A., del Carmen Campos Moreno M., Dellamonica J., Delmas B., Demirkiran O., Demirkiran H., Dendane T., di Mussi R., Diakaki C., Diaz A., Diaz W., Dikmen Y., Dimoula A., Doble P., Doha N., Domingos G., Dres M., Dries D., Duggal A., Duke G., Dunts P., Dybwik K., Dykyy M., Eckert P., Efe S., Elatrous S., Elay G., Elmaryul A. S., Elsaadany M., Elsayed H., Elsayed S., Emery M., Ena S., Eng K., Englert J. A., Erdogan E., Ergin Ozcan P., Eroglu E., Escobar M., Esen F., Esen Tekeli A., Esquivel A., Esquivel Gallegos H., Ezzouine H., Facchini A., Faheem M., Fanelli V., Farina M. F., Fartoukh M., Fehrle L., Feng F., Feng Y., Fernandez I., Fernandez B., Fernandez-Rodriguez M. L., Ferrando C., Ferreira da Silva M. J., Ferreruela M., Ferrier J., Flamm Zamorano M. J., Flood L., Floris L., Fluckiger M., Forteza C., Fortunato A., Frans E., Frattari A., Fredes S., Frenzel T., Fumagalli R., Furche M. A., Fusari M., Fysh E., Galeas-Lopez J. L., Galerneau L. -M., Garcia A., Garcia M. F., Garcia E., Garcia Olivares P., Garlicki J., Garnero A., Garofalo E., Gautam P., Gazenkampf A., Gelinotte S., Gelormini D., Ghrenassia E., Giacomucci A., Giannoni R., Gigante A., Glober N., Gnesin P., Gollo Y., Gomaa D., Gomero Paredes R., Gomes R., Gomez R. A., Gomez O., Gomez A., Gondim L., Gonzalez M., Gonzalez I., Gonzalez-Castro A., Gordillo Romero O., Gordo F., Gouin P., Graf Santos J., Grainne R., Grando M., Granov Grabovica S., Grasso S., Grasso R., Grimmer L., Grissom C., Gu Q., Guan X. -D., Guarracino F., Guasch N., Guatteri L., Gueret R., Guerin C., Guerot E., Guitard P. -G., Gul F., Gumus A., Gurjar M., Gutierrez P., Hachimi A., Hadzibegovic A., Hagan S., Hammel C., Han Song J., Hanlon G., Heines S., Henriksson J., Herbrecht J. -E., Heredia Orbegoso G. O., Hermon A., Hernandez R., Hernandez C., Herrera L., Herrera-Gutierrez M., Hidalgo J., Hill D., Holmquist D., Homez M., Hongtao X., Hormis A., Horner D., Hornos M. C., Hou M., House S., Housni B., Hugill K., Humphreys S., Humbert L., Hunter S., Hwa Young L., Iezzi N., Ilutovich S., Inal V., Innes R., Ioannides P., Iotti G. A., Ippolito M., Irie H., Iriyama H., Itagaki T., Izura J., Izza S., Jabeen R., Jamaati H., Jamadarkhana S., Jamoussi A., Jankowski M., Jaramillo L. A., Jeon K., Jeong Lee S., Jeswani D., Jha S., Jiang L., Jing C., Jochmans S., Johnstad B. A., Jongmin L., Joret A., Junhasavasdikul D., Jurado M. T., Kam E., Kamohara H., Kane C., Kara I., Karakurt S., Karnjanarachata C., Kataoka J., Katayama S., Kaushik S., Kelebek Girgin N., Kerr K., Kerslake I., Khairnar P., Khalid A., Khan A., Khanna A. K., Khorasanee R., Kienhorst D., Kirakli C., Knafelj R., Kol M. K., Kongpolprom N., Kopitko C., Korkmaz Ekren P., Kubisz-Pudelko A., Kulcsar Z., Kumasawa J., Kuriyama A., Kutchak F., Labarca E., Labat F., Laborda C., Laca Barrera M. A., Lagache L., Landaverde Lopez A., Lanspa M., Lascari V., Le Meur M., Lee S. H., Lee Y. J., Lee J., Lee W. -Y., Legernaes T., Leiner T., Lemiale V., Leonor T., Lepper P. M., Li D., Li H., Li O., Lima A. R., Lind D., Litton E., Liu N., Liu L., Liu J., Llitjos J. -F., Llorente B., Lopez R., Lopez C. E., Lopez Nava C., Lovazzano P., Lu M., Lucchese F., Lugano M., Lugo Goytia G., Luo H., Lynch C., Macheda S., Madrigal Robles V. H., Maggiore S. M., Magret Iglesias M., Malaga P., Mallapura Maheswarappa H., Malpartida G., Malyarchikov A., Mansson H., Manzano A., Marey I., Marin N., Marin M. D. C., Markman E., Martin F., Martin A., Martin Dal Gesso C., Martinez F., Martinez-Fidalgo C., Martin-Loeches I., Mas A., Masaaki S., Maseda E., Massa E., Mattsson A., Maugeri J., McCredie V., McCullough J., McGuinness S., McKown A., Medve L., Mei C., Mellado Artigas R., Mendes V., Mervat M. K. E., Michaux I., Mikhaeil M., Milagros O., Milet I., Millan M. T., Minwei Z., Mirabella L., Mishra S., Mistraletti G., Mochizuki K., Moghal A., Mojoli F., Molin A., Montiel R., Montini L., Monza G., Mora Aznar M., Morakul S., Morales M., Moreno Torres D., Morocho Tutillo D. R., Motherway C., Mouhssine D., Mouloudi E., Munoz T., Munoz de Cabo C., Mustafa M., Muthuchellappan R., Muthukrishnan M., Muttini S., Nagata I., Nahar D., Nakanishi M., Nakayama I., Namendys-Silva S. A., Nanchal R., Nandakumar S., Nasi A., Nasir K., Navalesi P., Naz Aslam T., Nga Phan T., Nichol A., Niiyama S., Nikolakopoulou S., Nikolic E., Nitta K., Noc M., Nonas S., Nseir S., Nur Soyturk A., Obata Y., Oeckler R., Oguchi M., Ohshimo S., Oikonomou M., Ojados A., Oliveira M. T., Oliveira Filho W., Oliveri C., Olmos A., Omura K., Orlandi M. C., Orsenigo F., Ortiz-Ruiz De Gordoa L., Ota K., Ovalle Olmos R., Oveges N., Oziemski P., Ozkan Kuscu O., Pachas Alvarado F., Pagella G., Palaniswamy V., Palazon Sanchez E. L., Palmese S., Pan G., Pan W., Papanikolaou M., Papavasilopoulou T., Parekh A., Parke R., Parrilla F. J., Parrilla D., Pasha T., Pasin L., Patao L., Patel M., Patel G., Pati B. K., Patil J., Pattnaik S., Paul D., Pavesi M., Pavlotsky V. A., Paz G., Paz E., Pecci E., Pellegrini C., Pena Padilla A. G., Perchiazzi G., Pereira T., Pereira V., Perez M., Perez Calvo C., Perez Cheng M., Perez Maita R., Perez-Araos R., Perez-Teran P., Perez-Torres D., Perkins G., Persona P., Petnak T., Petrova M., Philippart F., Picetti E., Pierucci E., Piervincenzi E., Pinciroli R., Pintado M. -C., Piraino T., Piras S., Piras C., Pirompanich P., Pisani L., Platas E., Plotnikow G., Porras W., Porta V., Portilla M., Portugal J., Povoa P., Prat G., Pratto R., Preda G., Prieto I., Prol-Silva E., Pugh R., Qi Y., Qian C., Qin T., Qu H., Quintana T., Quispe Sierra R., Quispe Soto R., Rabbani R., Rabee M., Rabie A., Rahe Pereira M. A., Rai A., Raj Ashok S., Rajab M., Ramdhani N., Ramey E., Ranieri M., Rathod D., Ray B., Redwanul Huq S. M., Regli A., Reina R., Resano Sarmiento N., Reynaud F., Rialp G., Ricart P., Rice T., Richardson A., Rieder M., Rinket M., Rios F., Risso Vazquez A., Riva I., Rivette M., Roca O., Roche-Campo F., Rodriguez C., Rodriguez G., Rodriguez Gonzalez D., Rodriguez Tucto X. Y., Rogers A., Romano M. E., Rortveit L., Rose A., Roux D., Rouze A., Rubatto Birri P. N., Ruilan W., Ruiz Robledo A., Ruiz-Aguilar A. L., Sadahiro T., Saez I., Sagardia J., Saha R., Saiphoklang N., Saito S., Salem M., Sales G., Salgado P., Samavedam S., Sami Mebazaa M., Samuelsson L., San Juan Roman N., Sanchez P., Sanchez-Ballesteros J., Sandoval Y., Sani E., Santos M., Santos C., Sanui M., Saravanabavan L., Sari S., Sarkany A., Sauneuf B., Savioli M., Sazak H., Scano R., Schneider F., Schortgen F., Schultz M. J., Schwarz G. L., Seckin Yucesoy F., Seely A., Seiler F., Seker Tekdos Y., Seok Chan K., Serano L., Serednicki W., Setten M., Shah A., Shah B., Shang Y., Shanmugasundaram P., Shapovalov K., Shebl E., Shiga T., Shime N., Shin P., Short J., Shuhua C., Siddiqui S., Silesky Jimenez J. I., Silva D., Silva Sales B., Simons K., Sjobo B. A., Slessor D., Smiechowicz J., Smischney N., Smith P., Smith T., Smith M., Snape S., Snyman L., Soetens F., Sook Hong K., Sosa Medellin M. A., Soto G., Souloy X., Sousa E., Sovatzis S., Sozutek D., Spadaro S., Spagnoli M., Spangfors M., Spittle N., Spivey M., Stapleton A., Stefanovic B., Stephenson L., Stevenson E., Strand K., Strano M. T., Straus S., Sun C., Sun R., Sundaram V., SunPark T., Surlemont E., Sutherasan Y., Szabo Z., Tainter C., Takaba A., Tallott M., Tamasato T., Tang Z., Tangsujaritvijit V., Taniguchi L., Taniguchi D., Tarantino F., Teerapuncharoen K., Temprano S., Terragni P., Terzi N., Thakur A., Theerawit P., Thille A. W., Thomas M., Thungtitigul P., Thyrault M., Tilouch N., Timenetsky K., Tirapu J., Todeschini M., Tomas R., Tomaszewski C., Tonetti T., Tonnelier A., Trinder J., Trongtrakul K., Truwit J., Tsuei B., Tulaimat A., Turan S., Turkoglu M., Tyagi S., Ubeda A., Vagginelli F., Valenti M. F., Vallverdu I., Van Axel A., van den Hul I., van der Hoeven H., Van Der Meer N., Vanhoof M., Vargas-Ordonez M., Vaschetto R., Vascotto E., Vatsik M., Vaz A., Vazquez-Sanchez A., Ventura S., Vermeijden J. W., Vidal A., Vieira J., Vilela Costa Pinto B., Villagra A., Villegas Succar C., Vinorum O. G., Vitale G., Vj R., Vochin A., Voiriot G., Volta C. A., von Seth M., Wajdi M., Walsh D., Wang S., Wardi G., Ween-Velken N. 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A., Gomez O., Gomez A., Gondim L., Gonzalez M., Gonzalez I., Gonzalez-Castro A., Gordillo Romero O., Gordo F., Gouin P., Graf Santos J., Grainne R., Grando M., Granov Grabovica S., Grasso S., Grasso R., Grimmer L., Grissom C., Gu Q., Guan X. -D., Guarracino F., Guasch N., Guatteri L., Gueret R., Guerin C., Guerot E., Guitard P. -G., Gul F., Gumus A., Gurjar M., Gutierrez P., Hachimi A., Hadzibegovic A., Hagan S., Hammel C., Han Song J., Hanlon G., Heines S., Henriksson J., Herbrecht J. -E., Heredia Orbegoso G. O., Hermon A., Hernandez R., Hernandez C., Herrera L., Herrera-Gutierrez M., Hidalgo J., Hill D., Holmquist D., Homez M., Hongtao X., Hormis A., Horner D., Hornos M. C., Hou M., House S., Housni B., Hugill K., Humphreys S., Humbert L., Hunter S., Hwa Young L., Iezzi N., Ilutovich S., Inal V., Innes R., Ioannides P., Iotti G. A., Ippolito M., Irie H., Iriyama H., Itagaki T., Izura J., Izza S., Jabeen R., Jamaati H., Jamadarkhana S., Jamoussi A., Jankowski M., Jaramillo L. A., Jeon K., Jeong Lee S., Jeswani D., Jha S., Jiang L., Jing C., Jochmans S., Johnstad B. A., Jongmin L., Joret A., Junhasavasdikul D., Jurado M. T., Kam E., Kamohara H., Kane C., Kara I., Karakurt S., Karnjanarachata C., Kataoka J., Katayama S., Kaushik S., Kelebek Girgin N., Kerr K., Kerslake I., Khairnar P., Khalid A., Khan A., Khanna A. K., Khorasanee R., Kienhorst D., Kirakli C., Knafelj R., Kol M. K., Kongpolprom N., Kopitko C., Korkmaz Ekren P., Kubisz-Pudelko A., Kulcsar Z., Kumasawa J., Kuriyama A., Kutchak F., Labarca E., Labat F., Laborda C., Laca Barrera M. A., Lagache L., Landaverde Lopez A., Lanspa M., Lascari V., Le Meur M., Lee S. H., Lee Y. J., Lee J., Lee W. -Y., Legernaes T., Leiner T., Lemiale V., Leonor T., Lepper P. M., Li D., Li H., Li O., Lima A. R., Lind D., Litton E., Liu N., Liu L., Liu J., Llitjos J. -F., Llorente B., Lopez R., Lopez C. E., Lopez Nava C., Lovazzano P., Lu M., Lucchese F., Lugano M., Lugo Goytia G., Luo H., Lynch C., Macheda S., Madrigal Robles V. H., Maggiore S. M., Magret Iglesias M., Malaga P., Mallapura Maheswarappa H., Malpartida G., Malyarchikov A., Mansson H., Manzano A., Marey I., Marin N., Marin M. D. C., Markman E., Martin F., Martin A., Martin Dal Gesso C., Martinez F., Martinez-Fidalgo C., Martin-Loeches I., Mas A., Masaaki S., Maseda E., Massa E., Mattsson A., Maugeri J., McCredie V., McCullough J., McGuinness S., McKown A., Medve L., Mei C., Mellado Artigas R., Mendes V., Mervat M. K. E., Michaux I., Mikhaeil M., Milagros O., Milet I., Millan M. T., Minwei Z., Mirabella L., Mishra S., Mistraletti G., Mochizuki K., Moghal A., Mojoli F., Molin A., Montiel R., Montini L., Monza G., Mora Aznar M., Morakul S., Morales M., Moreno Torres D., Morocho Tutillo D. R., Motherway C., Mouhssine D., Mouloudi E., Munoz T., Munoz de Cabo C., Mustafa M., Muthuchellappan R., Muthukrishnan M., Muttini S., Nagata I., Nahar D., Nakanishi M., Nakayama I., Namendys-Silva S. A., Nanchal R., Nandakumar S., Nasi A., Nasir K., Navalesi P., Naz Aslam T., Nga Phan T., Nichol A., Niiyama S., Nikolakopoulou S., Nikolic E., Nitta K., Noc M., Nonas S., Nseir S., Nur Soyturk A., Obata Y., Oeckler R., Oguchi M., Ohshimo S., Oikonomou M., Ojados A., Oliveira M. T., Oliveira Filho W., Oliveri C., Olmos A., Omura K., Orlandi M. C., Orsenigo F., Ortiz-Ruiz De Gordoa L., Ota K., Ovalle Olmos R., Oveges N., Oziemski P., Ozkan Kuscu O., Pachas Alvarado F., Pagella G., Palaniswamy V., Palazon Sanchez E. L., Palmese S., Pan G., Pan W., Papanikolaou M., Papavasilopoulou T., Parekh A., Parke R., Parrilla F. J., Parrilla D., Pasha T., Pasin L., Patao L., Patel M., Patel G., Pati B. K., Patil J., Pattnaik S., Paul D., Pavesi M., Pavlotsky V. A., Paz G., Paz E., Pecci E., Pellegrini C., Pena Padilla A. G., Perchiazzi G., Pereira T., Pereira V., Perez M., Perez Calvo C., Perez Cheng M., Perez Maita R., Perez-Araos R., Perez-Teran P., Perez-Torres D., Perkins G., Persona P., Petnak T., Petrova M., Philippart F., Picetti E., Pierucci E., Piervincenzi E., Pinciroli R., Pintado M. -C., Piraino T., Piras S., Piras C., Pirompanich P., Pisani L., Platas E., Plotnikow G., Porras W., Porta V., Portilla M., Portugal J., Povoa P., Prat G., Pratto R., Preda G., Prieto I., Prol-Silva E., Pugh R., Qi Y., Qian C., Qin T., Qu H., Quintana T., Quispe Sierra R., Quispe Soto R., Rabbani R., Rabee M., Rabie A., Rahe Pereira M. A., Rai A., Raj Ashok S., Rajab M., Ramdhani N., Ramey E., Ranieri M., Rathod D., Ray B., Redwanul Huq S. M., Regli A., Reina R., Resano Sarmiento N., Reynaud F., Rialp G., Ricart P., Rice T., Richardson A., Rieder M., Rinket M., Rios F., Risso Vazquez A., Riva I., Rivette M., Roca O., Roche-Campo F., Rodriguez C., Rodriguez G., Rodriguez Gonzalez D., Rodriguez Tucto X. Y., Rogers A., Romano M. E., Rortveit L., Rose A., Roux D., Rouze A., Rubatto Birri P. N., Ruilan W., Ruiz Robledo A., Ruiz-Aguilar A. L., Sadahiro T., Saez I., Sagardia J., Saha R., Saiphoklang N., Saito S., Salem M., Sales G., Salgado P., Samavedam S., Sami Mebazaa M., Samuelsson L., San Juan Roman N., Sanchez P., Sanchez-Ballesteros J., Sandoval Y., Sani E., Santos M., Santos C., Sanui M., Saravanabavan L., Sari S., Sarkany A., Sauneuf B., Savioli M., Sazak H., Scano R., Schneider F., Schortgen F., Schultz M. J., Schwarz G. L., Seckin Yucesoy F., Seely A., Seiler F., Seker Tekdos Y., Seok Chan K., Serano L., Serednicki W., Setten M., Shah A., Shah B., Shang Y., Shanmugasundaram P., Shapovalov K., Shebl E., Shiga T., Shime N., Shin P., Short J., Shuhua C., Siddiqui S., Silesky Jimenez J. I., Silva D., Silva Sales B., Simons K., Sjobo B. A., Slessor D., Smiechowicz J., Smischney N., Smith P., Smith T., Smith M., Snape S., Snyman L., Soetens F., Sook Hong K., Sosa Medellin M. A., Soto G., Souloy X., Sousa E., Sovatzis S., Sozutek D., Spadaro S., Spagnoli M., Spangfors M., Spittle N., Spivey M., Stapleton A., Stefanovic B., Stephenson L., Stevenson E., Strand K., Strano M. T., Straus S., Sun C., Sun R., Sundaram V., SunPark T., Surlemont E., Sutherasan Y., Szabo Z., Tainter C., Takaba A., Tallott M., Tamasato T., Tang Z., Tangsujaritvijit V., Taniguchi L., Taniguchi D., Tarantino F., Teerapuncharoen K., Temprano S., Terragni P., Terzi N., Thakur A., Theerawit P., Thille A. W., Thomas M., Thungtitigul P., Thyrault M., Tilouch N., Timenetsky K., Tirapu J., Todeschini M., Tomas R., Tomaszewski C., Tonetti T., Tonnelier A., Trinder J., Trongtrakul K., Truwit J., Tsuei B., Tulaimat A., Turan S., Turkoglu M., Tyagi S., Ubeda A., Vagginelli F., Valenti M. F., Vallverdu I., Van Axel A., van den Hul I., van der Hoeven H., Van Der Meer N., Vanhoof M., Vargas-Ordonez M., Vaschetto R., Vascotto E., Vatsik M., Vaz A., Vazquez-Sanchez A., Ventura S., Vermeijden J. W., Vidal A., Vieira J., Vilela Costa Pinto B., Villagra A., Villegas Succar C., Vinorum O. G., Vitale G., Vj R., Vochin A., Voiriot G., Volta C. A., von Seth M., Wajdi M., Walsh D., Wang S., Wardi G., Ween-Velken N. C., Wei B. -L., Weller D., Welsh D., Welters I., Wert M., Whiteley S., Wilby E., Williams E., Williams K., Wilson A., Wojtas J., Won Huh J., Wrathall D., Wright C., Wu J. -F., Xi G., Xing Z. -J., Xu H., Yamamoto K., Yan J., Yanez J., Yang X., Yates E., Yazicioglu Mocin O., Ye Z., Yildirim F., Yoshida N., Yoshido H. H. L., Young Lee B., Yu R., Yu G., Yu T., Yuan B., Yuangtrakul N., Yumoto T., Yun X., Zakalik G., Zaki A., Zalba-Etayo B., Zambon M., Zang B., Zani G., Zarka J., Zerbi S. M., Zerman A., Zetterquist H., Zhang J., Zhang H., Zhang W., Zhang G., Zhao H., Zheng J., Zhu B., and Zumaran R.

Abstract

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 d

Published
2023

10. „Neurally adjusted ventilatory assist“ (NAVA)

Author

Moerer, O., Barwing, J., and Quintel, M.

Abstract

Zusammenfassung: Ziele einer maschinellen Beatmung sind die Sicherung des Gasaustausches und die ausreichende Entlastung der Atemmuskulatur. Moderne lungenprotektive Beatmungskonzepte beinhalten die Applikation niedriger Tidalvolumen und den Erhalt der Spontanatmung des Patienten, die sich positiv auf die Rekrutierung atelektatischer Lungenareale und die Oxygenierung auswirken. Ein Problem konventioneller, assistierender Beatmungsverfahren resultiert aus der schlechten Interaktion zwischen Patient und Beatmungsgerät. „Neurally adjusted ventilator assist“ (NAVA) ist ein neues assistierendes Beatmungsverfahren, bei dem das Beatmungsgerät über die elektrische Aktivierung des Zwerchfells („electrical activation of diaphragm“, EAdi) gesteuert wird. Erste Untersuchungen belegen eine verbesserte Synchronisierung zwischen Patient und Beatmungsgerät sowie eine effiziente Entlastung der Atemmuskulatur. Zukünftige Studien müssen zeigen, ob NAVA einen klinischen Vorteil im Vergleich zu bislang verfügbaren assistierenden Beatmungsmodi aufweist. Ziel dieser Übersicht ist die Vorstellung von NAVA vor dem Hintergrund bisheriger Studien.

Published
2024
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12. Role of Fluid and Sodium Retention in Experimental Ventilator-Induced Lung Injury

Author

Gattarello, S, Pasticci, I, Busana, M, Lazzari, S, Palermo, P, Palumbo, M, Romitti, F, Steinberg, I, Collino, F, Vassalli, F, Langer, T, Moerer, O, Saager, L, Herrmann, P, Cadringher, P, Meissner, K, Quintel, M, Gattinoni, L, Gattarello S., Pasticci I., Busana M., Lazzari S., Palermo P., Palumbo M. M., Romitti F., Steinberg I., Collino F., Vassalli F., Langer T., Moerer O., Saager L., Herrmann P., Cadringher P., Meissner K., Quintel M., Gattinoni L., Gattarello, S, Pasticci, I, Busana, M, Lazzari, S, Palermo, P, Palumbo, M, Romitti, F, Steinberg, I, Collino, F, Vassalli, F, Langer, T, Moerer, O, Saager, L, Herrmann, P, Cadringher, P, Meissner, K, Quintel, M, Gattinoni, L, Gattarello S., Pasticci I., Busana M., Lazzari S., Palermo P., Palumbo M. M., Romitti F., Steinberg I., Collino F., Vassalli F., Langer T., Moerer O., Saager L., Herrmann P., Cadringher P., Meissner K., Quintel M., and Gattinoni L.

Abstract

Background: Ventilator-induced lung injury (VILI) via respiratory mechanics is deeply interwoven with hemodynamic, kidney and fluid/electrolyte changes. We aimed to assess the role of positive fluid balance in the framework of ventilation-induced lung injury. Methods: Post-hoc analysis of seventy-eight pigs invasively ventilated for 48 h with mechanical power ranging from 18 to 137 J/min and divided into two groups: high vs. low pleural pressure (10.0 ± 2.8 vs. 4.4 ± 1.5 cmH2O; p < 0.01). Respiratory mechanics, hemodynamics, fluid, sodium and osmotic balances, were assessed at 0, 6, 12, 24, 48 h. Sodium distribution between intracellular, extracellular and non-osmotic sodium storage compartments was estimated assuming osmotic equilibrium. Lung weight, wet-to-dry ratios of lung, kidney, liver, bowel and muscle were measured at the end of the experiment. Results: High pleural pressure group had significant higher cardiac output (2.96 ± 0.92 vs. 3.41 ± 1.68 L/min; p < 0.01), use of norepinephrine/epinephrine (1.76 ± 3.31 vs. 5.79 ± 9.69 mcg/kg; p < 0.01) and total fluid infusions (3.06 ± 2.32 vs. 4.04 ± 3.04 L; p < 0.01). This hemodynamic status was associated with significantly increased sodium and fluid retention (at 48 h, respectively, 601.3 ± 334.7 vs. 1073.2 ± 525.9 mmol, p < 0.01; and 2.99 ± 2.54 vs. 6.66 ± 3.87 L, p < 0.01). Ten percent of the infused sodium was stored in an osmotically inactive compartment. Increasing fluid and sodium retention was positively associated with lung-weight (R2 = 0.43, p < 0.01; R2 = 0.48, p < 0.01) and with wet-to-dry ratio of the lungs (R2 = 0.14, p < 0.01; R2 = 0.18, p < 0.01) and kidneys (R2 = 0.11, p = 0.02; R2 = 0.12, p = 0.01). Conclusion: Increased mechanical power and pleural pressures dictated an increase in hemodynamic support resulting in proportionally increased sodium and fluid retention and pulmonary edema.

Published
2021

15. Ökonomie und Vergütung

Author

Moerer, O., Burchardi, H., Burchardi, Hilmar, editor, Larsen, Reinhard, editor, Kuhlen, Ralf, editor, Jauch, Karl-Walter, editor, and Schölmerich, Jürgen, editor

Published
2008
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17. Ventilator-related causes of lung injury: the mechanical power

Author

Gattinoni, L., Tonetti, T., Cressoni, M., Cadringher, P., Herrmann, P., Moerer, O., and Protti, A.

Subjects
Lung diseases, Health care industry
Abstract

Purpose We hypothesized that the ventilator-related causes of lung injury may be unified in a single variable: the mechanical power. We assessed whether the mechanical power measured by the pressure-volume loops can be computed from its components: tidal volume (TV)/driving pressure (âP.sub.aw), flow, positive end-expiratory pressure (PEEP), and respiratory rate (RR). If so, the relative contributions of each variable to the mechanical power can be estimated. Methods We computed the mechanical power by multiplying each component of the equation of motion by the variation of volume and RR: Powerrs=RR·[DELTA]V2·12·ELrs+RR·1+I:E60·I:E·Raw+[DELTA]V·PEEP,where âV is the tidal volume, EL.sub.rs is the elastance of the respiratory system, I:E is the inspiratory-to-expiratory time ratio, and R.sub.aw is the airway resistance. In 30 patients with normal lungs and in 50 ARDS patients, mechanical power was computed via the power equation and measured from the dynamic pressure-volume curve at 5 and 15 cmH.sub.2O PEEP and 6, 8, 10, and 12 ml/kg TV. We then computed the effects of the individual component variables on the mechanical power. Results Computed and measured mechanical powers were similar at 5 and 15 cmH.sub.2O PEEP both in normal subjects and in ARDS patients (slopes = 0.96, 1.06, 1.01, 1.12 respectively, R.sup.2 > 0.96 and p < 0.0001 for all). The mechanical power increases exponentially with TV, âP.sub.aw, and flow (exponent = 2) as well as with RR (exponent = 1.4) and linearly with PEEP. Conclusions The mechanical power equation may help estimate the contribution of the different ventilator-related causes of lung injury and of their variations. The equation can be easily implemented in every ventilator's software., Author(s): L. Gattinoni [sup.1], T. Tonetti [sup.1], M. Cressoni [sup.2], P. Cadringher [sup.3], P. Herrmann [sup.1], O. Moerer [sup.1], A. Protti [sup.3], M. Gotti [sup.2], C. Chiurazzi [sup.2], E. Carlesso [...]

Published
2016
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18. ESICM LIVES 2016: part three: Milan, Italy. 1–5 October 2016

Author

Velasquez, T., Mackey, G., Lusk, J., Kyle, U. G., Fontenot, T., Marshall, P., Shekerdemian, L. S., Coss-Bu, J. A., Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., Yokoyama, M., Ruiz-Rodriguez, J. C., Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Riveiro, M., Baena, J., Sanchez, A., Bañeras, J., Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Riera, J., Serra, J., Rutten, A. M. F., van Ieperen, S. N. M., Der Kinderen, E. P. H. M., Van Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Kyle, U. G., Akcan-Arikan, A., Silva, J. C., Mackey, G., Lusk, J., Goldsworthy, M., Shekerdemian, L. S., Coss-Bu, J. A., Wood, D., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano’, S. M., De Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Nomura, T., Yamamoto, N., Sakai, Y., Yoshida, T., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T., Longani, N., Medar, S., Abdel-Aal, I. R., El Adawy, A. S., Mohammed, H. M. E. H., Mohamed, A. N., Parry, S. M., Knight, L. D., Denehy, L., De Morton, N., Baldwin, C. E., Sani, D., Kayambu, G., da Silva, V. Z. M., Phongpagdi, P., Puthucheary, Z. A., Granger, C. L., Rydingsward, J. E., Horkan, C. M., Christopher, K. B., McWilliams, D., Jones, C., Reeves, E., Atkins, G., Snelson, C., Aitken, L. M., Rattray, J., Kenardy, J., Hull, A. M., Ullman, A., Le Brocque, R., Mitchell, M., Davis, C., Macfarlane, B., Azevedo, J. C., Rocha, L. L., De Freitas, F. F. M., Cavalheiro, A. M., Lucinio, N. M., Lobato, M. S., Ebeling, G., Kraegpoeth, A., Laerkner, E., De Brito-Ashurst, I., White, C., Gregory, S., Forni, L. 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Iglesias, Sáez, V. Chica, Ruiz-Ruano, R. de la Chica, González, A. Sánchez, Kunze-Szikszay, N., Wand, S., Klapsing, P., Wetz, A., Heyne, T., Schwerdtfeger, K., Troeltzsch, M., Bauer, M., Quintel, M., Moerer, O., Cook, D. J., Rutherford, W. B., Scales, D. C., Adhikari, N. K., Cuthbertson, B. H., Suzuki, T., Takei, T., Fushimi, K., Iwamoto, M., Nakagawa, S., Mendsaikhan, N., Begzjav, T., Lundeg, G., Dünser, M. W., Romero, D. González, Cabrera, J. L. Santana, Santana, J. D. Martín, Padilla, Y. Santana, Pérez, H. Rodríguez, Torrent, R. Lorenzo, Kleinpell, R., Chouris, I., Radu, V., Stougianni, M., Lavrentieva, A., Lagonidis, D., Price, R. D. T., Day, A., Arora, N., Henderson, M. A., Hickey, S., Costa, M. I. Almeida, Carvalho, J. P., Gomes, A. A., Mergulhão, P. J., Chan, K. K. C., Shum, H. P., Yan, W. W., Maghsoudi, B., Tabei, S. H., Masjedi, M., Sabetian, G., Tabatabaei, H. R., Akbarzadeh, A., Saigal, S., Pakhare, A., Joshi, R., Pattnaik, S. K., Ray, B., Rousseau, A. F., Michel, L., Bawin, M., Cavalier, E., Reginster, J. Y., Damas, P., Bruyere, O., Zhou, J. C., Cauwenberghs, H., De Backer, A., Neels, H., Deblier, I., Berghmans, J., Himpe, D., Barea-Mendoza, J. A., Portillo, I. Prieto, Fernández, M. Valiente, Gigorro, R. Garcia, Vela, J. L. Perez, Mateos, H. Marín, Alves, S. Chacón, Varas, G. Morales, Rodriguez-Biendicho, A., Carreño, E. Renes, González, J. C. Montejo, Yang, J. S., Chiang, C. H., Hung, W. T., Huang, W. C., Cheng, C. C., Lin, K. C., Lin, S. C., Chiou, K. R., Wann, S. R., Lin, K. L., Kang, P. L., Mar, G. Y., Liu, C. P., Zhou, J. C., Choi, Y. J., Yoon, S. Z., Gordillo-Brenes, A., Fernandez-Zamora, M. D., Perez-Borrero, L., Arias-Verdu, M. D., Aguilar-Alonso, E., Herruzo-Aviles, A., Garcia-Delgado, M., Hinojosa-Perez, R., Curiel-Balsera, E., Rivera-Fernandez, R., Lesmes, S. P. Gómez, Rosario, L. E. De la Cruz, Hernández, A. Ansotegui, Herrera, A. N. García, Sanz, E. Regidor, Sánchez, M. J. Gómez, Hualde, J. Barado, Pascual, O. Agudo, León, J. P. Tirapu, Irazabal, J. M. Guergue, Pérez, A. González, Fernández, P. Alvarez, Amor, L. Lopéz, Albaiceta, G. Muñiz, Lesmes, S. P. Gómez, Rosario, L. E. De la Cruz, Hernández, A. Ansotegui, Sanz, E. Regidor, Sánchez, M. J. Gómez, Calvo, S. Aldunate, Herrera, A. N. García, Hualde, J. Barado, Pascual, O. Agudo, León, J. P. Tirapu, Corona, A., Ruffini, C., Spazzadeschi, A., Marrazzo, F., Gandola, A., Sciurti, R., Savi, C., Catena, E., Ke, M. W., Cheng, C. C., Huang, W. C., Chiang, C. H., Hung, W. T., Lin, K. C., Lin, S. C., Wann, S. R., Chiou, K. R., Tseng, C. J., Kang, P. L., Mar, G. Y., Liu, C. P., Bertini, P., De Sanctis, F., Guarracino, F., Bertini, P., Baldassarri, R., Guarracino, F., Buitinck, S. H., van der Voort, P. H. J., Oto, J., Nakataki, E., Tsunano, Y., Izawa, M., Tane, N., Onodera, M., Nishimura, M., Ghosh, S., Gupta, A., De Gasperi, A., Mazza, E., Limuti, R., Prosperi, M., Bissenova, N., Yergaliyeva, A., Talan, L., Yılmaz, G., Güven, G., Yoruk, F., Altıntas, N. D., Mukherjee, D. N., Agarwal, L. K., Mandal, K., Palomar, M., Balsera, B., Vallverdu, M., Martinez, M., Garcia, M., Castellana, D., Lopez, R., Barcenilla, F., Kaminsky, G. E., Carreño, R., Escribá, A., Fuentes, M., Gálvez, V., Del Olmo, R., Nieto, B., Vaquerizo, C., Alvarez, J., De la Torre, M. A., Torres, E., Bogossian, E., Nouer, S. Aranha, Salgado, D. Ribeiro, Brugger, S. Carvalho, Jiménez, G. Jiménez, Torner, M. Miralbés, Vidal, M. Vallverdú, Garrido, B. Balsera, Casals, X. Nuvials, Gaite, F. Barcenilla, Cabello, J. Trujillano, Martínez, M. Palomar, Doganci, M., Izdes, S., Besevli, S. Guzeldag, Alkan, A., Kayaaslan, B., Ramírez, C. Sánchez, Balcázar, L. Caipe, Santana, M. Cabrera, Viera, M. A. Hernández, Escalada, S. Hípola, Vázquez, C. F. Lübbe, Penichet, S. M. Marrero, Campelo, F. Artiles, López, M. A. De La Cal, Santana, P. Saavedra, Santana, S. Ruíz, Repessé, X., Artiguenave, M., Paktoris-Papine, S., Espinasse, F., Dinh, A., El Sayed, F., Charron, C., Géri, G., Vieillard-Baron, A., Marmanidou, K., Oikonomou, M., Nouris, C., Dimitroulakis, K., Soilemezi, E., Matamis, D., Ferré, A., Guillot, M., Teboul, J. L., Lichtenstein, D., Mézière, G., Richard, C., Monnet, X., Pham, T., Beduneau, G., Schortgen, F., Piquilloud, L., Zogheib, E., Jonas, M., Grelon, F., Runge, I., Terzi, N., Grangé, S., Barberet, G., Guitard, P. G., Frat, J. P., Constan, A., Chrétien, J. M., Mancebo, J., Mercat, A., Richard, J. C. M., Brochard, L., Prīdāne, S., Sabeļņikovs, O., Mojoli, F., Orlando, A., Bianchi, I., Torriglia, F., Bianzina, S., Pozzi, M., Iotti, G. A., Braschi, A., Beduneau, G., Pham, T., Schortgen, F., Piquilloud, L., Zogheib, E., Jonas, M., Grelon, F., Runge, I., Terzi, N., Grangé, S., Barberet, G., Guitard, P. G., Frat, J. P., Constan, A., Chrétien, J. M., Mancebo, J., Mercat, A., Richard, J. C. M., Brochard, L., Kondili, E., Psarologakis, C., Kokkini, S., Amargianitakis, V., Babalis, D., Chytas, A., Chouvarda, I., Vaporidi, K., Georgopoulos, D., Trapp, O., Kalenka, A., Mojoli, F., Orlando, A., Bianchi, I., Torriglia, F., Bianzina, S., Pozzi, M., Iotti, G. A., Braschi, A., Lozano, J. A. Benítez, Sánchez, P. Carmona, Francioni, J. E. Barrueco, Ferrón, F. Ruiz, Simón, J. M. Serrano, Spadaro, S., Karbing, D. S., Gioia, A., Moro, F., Corte, F. Dalla, Mauri, T., Volta, C. A., Rees, S. E., Petrova, M. V., Mohan, R., Butrov, A. V., Beeharry, S. D., Vatsik, M. V., Sakieva, F. I., Gobert, F., Yonis, H., Tapponnier, R., Fernandez, R., Labaune, M. A., Burle, J. F., Barbier, J., Vincent, B., Cleyet, M., Richard, J. C., Guérin, C., Shinotsuka, C. Righy, Creteur, J., Taccone, F. S., Törnblom, S., Nisula, S., Vaara, S., Poukkanen, M., Andersson, S., Pettilä, V., Pesonen, E., Xie, Z., Liao, X., Kang, Y., Zhang, J., Kubota, K., Egi, M., Mizobuchi, S., Hegazy, S., El-Keraie, A., El Sayed, E., El Hamid, M. Abd, Rodrigues, N. J., Pereira, M., Godinho, I., Gameiro, J., Neves, M., Gouveia, J., e Silva, Z. Costa, Lopes, J. A., Mckinlay, J., Kostalas, M., Kooner, G., Dudas, G., Horton, A., Kerr, C., Karanjia, N., Creagh-Brown, B., Forni, L., Yamazaki, A., Ganuza, M. Sanz, Molina, J. A. Martinez, Martinez, F. Hidalgo, Freile, M. T. Chiquito, Fernandez, N. Garcia, Travieso, P. Medrano, Bandert, A., Frithiof, R., Lipcsey, M., Smekal, D., Schlaepfer, P., Durovray, J. D., Plouhinec, V., Chiappa, C., Bellomo, R., Schneider, A. G., Mitchell, S., Durrant, J., Street, H., Dunthorne, E., Shears, J., Caballero, C. Hernandez, Hutchison, R., Schwarze, S., Ghabina, S., Thompson, E., Prowle, J. R., Kirwan, C. J., Gonzalez, C. A., Pinto, J. L., Orozco, V., Patiño, J. A., Garcia, P. K., Contreras, K. M., Rodriguez, P., Echeverri, J. E., GETGAG Working Group, JSEPTIC (Japanese Society of Education for Physicians and Trainees in Intensive Care) Clinical Trial Group, CAPCRI Study, for the ReVA Research Network and the PROVE Network Investigators, from the FROG ICU Investigators, The WIND study group, Plug Working Group, GETGAG/SEMICYUC, AKI Research Group, St George’s University of London, IPREA Study Group, FINNRESUSCI Study Group, PICS- HCPA: Programa Intrahospitalar de Combate à Sepse do Hospital de Clínicas de Porto Alegre, ENVIN-HELICS Study Group, ARIAM registry of adult cardiac surgery, The Rapid Diagnosis of Infections in the Critically Ill Team, Tokyo Womens Medical University, PLUG working group, PLUG Working Group, On behalf of Okayama Research Investigation Organizing Network (ORION)investigators, PS-ICU Group, Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group, Student Research Committee - Shiraz University of Medical Sciences, ARIAM-ANDALUCIA, The WIND study group, PLUG Working Group, The WIND study group, PLUG Working Group, and Plug working group

Published
2016
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23. Infection control, prophylactic antibiotics, and testing for SARS-CoV-2 and PPE on German intensive care units: results from a national mixed methods survey

Author

Dickel, S, Grimm, C, Popp, M, Struwe, C, Sachkova, A, Golinski, M, Seeber, C, Fichtner, F, Heise, D, Kranke, P, Meissner, W, Laudi, S, Voigt-Radloff, S, Meerpohl, JJ, Jabs, J, Mutters, NT, Moerer, O, and German CEOsys Study Group

Subjects
Antibiotikaprophylaxe, Variants of concern, PSA, ddc: 610, cohort isolation, COVID-19, PPE, Kohortenisolation, prophylactic antibiotics
Abstract

Aim: Recommendations on hygiene measures, personal protective equipment (PPE), isolation, and antibiotic prophylaxis were developed during the coronavirus 2019 disease (COVID-19) pandemic and have been revised several times to date. Some of the underlying literature indicates a large evidence gap. We suspect that this leads to a large variance of measures on German intensive care units (ICU).Methods: A mixed methods online survey among intensive-care specialists in Germany caring for COVID-19 patients was conducted in December 2020.Results: We received responses from 205 German ICUs that had treated COVID-19 patients to date. There was wide variation in the use of PPE. Polymerase Chain reaction (PCR) testing for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) was used by 94.8% of the units, with an average waiting time of 12 hours for the result. 18.7% of the respondents prescribed antibiotic prophylaxis in COVID-19 patients.Conclusion: We found a high variance in essential care strategies for COVID-19 patients on German intensive care units. This included differences in infection prophylaxis, personal protective equipment, and the indication of prophylactic antibiotic therapy. Based on our results, we recommend further studies to quantify and improve guideline adherence. Zielsetzung: Empfehlungen zu Hygienemaßnahmen, persönlicher Schutzausrüstung (PSA), Isolierung und Antibiotikaprophylaxe wurden während der COVID-19 Pandemie entwickelt und bis heute mehrfach überarbeitet. Ein Teil der zugrundeliegenden Literatur weist eine große Evidenzlücke auf. Wir vermuten, dass dies zu einer großen Varianz der Maßnahmen auf deutschen Intensivstationen führt.Methoden: Mixed-methods-Onlineumfrage unter leitenden Intensivmedizinern in Deutschland, die COVID-19-Patienten betreuen, durchgeführt im Dezember 2020.Ergebnisse: Wir erhielten Antworten von 205 deutschen Intensivstationen, die bis zu diesem Zeitpunkt COVID-19-Patienten behandelt hatten. Es gab eine große Variation in der Verwendung von PSA. Die Polymerase-Kettenreaktion (PCR) zum Nachweis von SARS-CoV-2 wurde von 94,8% der Stationen verwendet, wobei die durchschnittliche Wartezeit auf das Ergebnis 12 Stunden betrug. 18,7% der Befragten begannen bei COVID-19-Patienten mit einer Antibiotikaprophylaxe.Schlussfolgerung: Wir konnten eine hohe Versorgungsvarianz in Hinblick auf essentielle Versorgungsstrategien von COVID-19 Patienten auf deutschen Intensivstationen feststellen. Hierzu zählten Unterschiede im Bereich der Infektionsprophylaxe, persönlicher Schutzausrüstung und der Indikationsstellung einer prophylaktischen Antibiotikatherapie. Auf Basis unserer Ergebnisse empfehlen wir weitere Untersuchungen zur Quantifizierung und Verbesserung der Leitlinienadhärenz.

Published
2021

24. ESICM LIVES 2016: part one: Milan, Italy. 1-5 October 2016

Author

Bos, L., Schouten, L., van Vught, L., Wiewel, M., Ong, D., Cremer, O., Artigas, A., Martin-Loeches, I., Hoogendijk, A., van der Poll, T., Horn, J., Juffermans, N., Schultz, M., de Prost, N., Pham, T., Carteaux, G., Dessap, A. Mekontso, Brun-Buisson, C., Fan, E., Bellani, G., Laffey, J., Mercat, A., Brochard, L., Maitre, B., Howells, P. A., Thickett, D. R., Knox, C., Park, D. P., Gao, F., Tucker, O., Whitehouse, T., McAuley, D. F., Perkins, G. D., Pham, T., Laffey, J., Bellani, G., Fan, E., Pisani, L., Roozeman, J. P., Simonis, F. D., Giangregorio, A., Schouten, L. R., Van der Hoeven, S. M., Horn, J., Neto, A. Serpa, Festic, E., Dondorp, A. M., Grasso, S., Bos, L. D., Schultz, M. J., Koster-Brouwer, M., Verboom, D., Scicluna, B., van de Groep, K., Frencken, J., Schultz, M., van der Poll, T., Bonten, M., Cremer, O., Ko, J. I., Kim, K. S., Suh, G. J., Kwon, W. Y., Kim, K., Shin, J. H., Ranzani, O. T., Prina, E., Menendez, R., Ceccato, A., Mendez, R., Cilloniz, C., Gabarrus, A., Ferrer, M., Torres, A., Urbano, A., Zhang, L. A., Swigon, D., Pike, F., Parker, R. S., Clermont, G., Scheer, C., Kuhn, S. O., Modler, A., Vollmer, M., Fuchs, C., Hahnenkamp, K., Rehberg, S., Gründling, M., Taggu, A., Darang, N., Öveges, N., László, I., Tánczos, K., Németh, M., Lebák, G., Tudor, B., Érces, D., Kaszaki, J., Huber, W., Trásy, D., Molnár, Z., Ferrara, G., Edul, V. S. Kanoore, Canales, H. S., Martins, E., Canullán, C., Murias, G., Pozo, M. O., Eguillor, J. F. Caminos, Buscetti, M. G., Ince, C., Dubin, A., Aya, H. D., Rhodes, A., Fletcher, N., Grounds, R. M., Cecconi, M., Jacquet-Lagrèze, M., Riche, M., Schweizer, R., Portran, P., Fornier, W., Lilot, M., Neidecker, J., Fellahi, J. L., Escoresca-Ortega, A., Gutiérrez-Pizarraya, A., Charris-Castro, L., Corcia-Palomo, Y., Fernandez-Delgado, E., Garnacho-Montero, J., Roger, C., Muller, L., Elotmani, L., Lipman, J., Lefrant, J. Y., Roberts, J. A., Muñoz-Bermúdez, R., Samper, M., Climent, C., Vasco, F., Sara, V., Luque, S., Campillo, N., Cerrato, S. Grau, Masclans, J. R., Alvarez-Lerma, F., Brugger, S. Carvalho, Jimenez, G. Jimenez, Torner, M. Miralbés, Cabello, J. Trujillano, Garrido, B. Balsera, Casals, X. Nuvials, Gaite, F. Barcenilla, Vidal, M. Vallverdú, Martínez, M. Palomar, Gusarov, V., Shilkin, D., Dementienko, M., Nesterova, E., Lashenkova, N., Kuzovlev, A., Zamyatin, M., Demoule, A., Carreira, S., Lavault, S., Palancca, O., Morawiec, E., Mayaux, J., Arnulf, I., Similowski, T., Rasmussen, B. S., Maltesen, R. G., Hanifa, M., Pedersen, S., Kristensen, S. R., Wimmer, R., Panigada, M., Bassi, G. Li, Ranzani, O. T., Kolobow, T., Zanella, A., Cressoni, M., Berra, L., Parrini, V., Kandil, H., Salati, G., Livigni, S., Amatu, A., Andreotti, A., Tagliaferri, F., Moise, G., Mercurio, G., Costa, A., Vezzani, A., Lindau, S., Babel, J., Cavana, M., Consonni, D., Pesenti, A., Gattinoni, L., Torres, A., Mansouri, P., Zand, F., Zahed, L., Dehghanrad, F., Bahrani, M., Ghorbani, M., Cambiaghi, B., Moerer, O., Mauri, T., Kunze-Szikszay, N., Ritter, C., Pesenti, A., Quintel, M., Vilander, L. M., Kaunisto, M. A., Vaara, S. T., Pettilä, V., Mulier, J. L. G. Haitsma, Rozemeijer, S., Spoelstra-de Man, A. M. E., Elbers, P. E., Tuinman, P. R., de Waard, M. C., Oudemans-van Straaten, H. M., Liberatore, A. M. A., Souza, R. B., Martins, A. M. C. R. P. F., Vieira, J. C. F., Koh, I. H. J., Martínez, M. Galindo, Sánchez, R. Jiménez, Gascón, L. Martínez, Mulero, M. D. Rodríguez, Freire, A. Ortín, Muñoz, A. Ojados, Acebes, S. Rebollo, Martínez, Á. Fernández, Aliaga, S. Moreno, Para, L. Herrera, Payá, J. Murcia, Mulero, F. 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L., Mebazaa, A., Hartmann, J., Harm, S., and Weber, V.

Published
2016
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27. CEOsys: ein lebendiges Ökosystem für Evidenz zu COVID-19

Author

Meerpohl, J, Voigt-Radloff, S, Spies, C, Rehfuess, E, Moerer, O, Rüschemeyer, G, and Wipplinger, J

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund/Fragestellung: Schon früh im Verlauf der COVID-19-Pandemie wurde klar, dass die vorhandenen Strukturen nur eingeschränkt in der Lage sind, zeitnah die beste verfügbare Evidenz als Basis für Entscheidungen bereitzustellen. CEOsys zielt als lebendiges Evidenz-Ökosystem[zum vollständigen Text gelangen Sie über die oben angegebene URL], Who cares? – EbM und Transformation im Gesundheitswesen; 22. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Published
2021
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31. Determinants of the effect of extracorporeal carbon dioxide removal in the SUPERNOVA trial: implications for trial design

Author

Goligher, E. C., Combes, A., Brodie, D., Ferguson, N. D., Pesenti, A. M., Ranieri, V. M., Slutsky, A. S., Beale, R., Brochard, L., Chiche, J. -D., Fan, E., de Backer, D., Francois, G., Laffey, J., Mercat, A., Mcauley, D. F., Muller, T., Quintel, M., Vincent, J. -L., Taccone, F. S., Peperstraete, H., Morimont, P., Schmidt, M., Levy, B., Diehl, J. -L., Guervilly, C., Capelier, G., Vieillard-Baron, A., Messika, J., Karagiannidis, C., Moerer, O., Urbino, R., Antonelli, M., Mojoli, F., Alessandri, F., Grasselli, G., Donker, D., Ferrer, R., Mancebo, J., Fanelli, V., Pham, T., Goligher E.C., Combes A., Brodie D., Ferguson N.D., Pesenti A.M., Ranieri V.M., Slutsky A.S., Beale R., Brochard L., Chiche J.-D., Fan E., de Backer D., Francois G., Laffey J., Mercat A., McAuley D.F., Muller T., Quintel M., Vincent J.-L., Taccone F.S., Peperstraete H., Morimont P., Schmidt M., Levy B., Diehl J.-L., Guervilly C., Capelier G., Vieillard-Baron A., Messika J., Karagiannidis C., Moerer O., Urbino R., Antonelli M., Mojoli F., Alessandri F., Grasselli G., Donker D., Ferrer R., Mancebo J., Fanelli V., and Pham T.

Subjects
Artificial ventilation, Adult, Male, medicine.medical_specialty, Extracorporeal Circulation, Organ Dysfunction Scores, medicine.medical_treatment, Acute respiratory distress syndrome, Extracorporeal carbon dioxide removal, Predictive enrichment, Ventilator-induced lung injury, Pilot Projects, Aged, Blood Gas Analysis, Carbon Dioxide, Extracorporeal Membrane Oxygenation, Female, Humans, Linear Models, Middle Aged, ROC Curve, Simplified Acute Physiology Score, Treatment Outcome, Critical Care and Intensive Care Medicine, Hypoxemia, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Linear regression, Extracorporeal membrane oxygenation, medicine, Journal Article, Respiratory system, Tidal volume, business.industry, Extracorporeal circulation, 030208 emergency & critical care medicine, respiratory system, 030228 respiratory system, Sample size determination, Cardiology, medicine.symptom, business
Abstract

Purpose To describe the variability and determinants of the effect of extracorporeal CO2 removal (ECCO2R) on tidal volume (V-t), driving pressure (Delta P), and mechanical power (Power(RS)) and to determine whether highly responsive patients can be identified for the purpose of predictive enrichment in ECCO2R trial design. Methods Using data from the SUPERNOVA trial (95 patients with early moderate acute respiratory distress syndrome), the independent effects of alveolar dead space fraction (ADF), respiratory system compliance (Crs), hypoxemia (PaO2/FiO(2)), and device performance (higher vs lower CO2 extraction) on the magnitude of reduction in V-t, Delta P, and Power(RS) permitted by ECCO2R were assessed by linear regression. Predicted and observed changes in Delta P were compared by Bland-Altman analysis. Hypothetical trials of ECCO2R, incorporating predictive enrichment and different target CO2 removal rates, were simulated in the SUPERNOVA study population. Results Changes in V-t permitted by ECCO2R were independently associated with ADF and device performance but not PaO2/FiO(2). Changes in Delta P and Power(RS) were independently associated with ADF, Crs, and device performance but not PaO2/FiO(2). The change in Delta P predicted from ADF and Crs was moderately correlated with observed change in Delta P (R-2 0.32, p < 0.001); limits of agreement between observed and predicted changes in Delta P were +/- 3.9 cmH(2)O. In simulated trials, restricting enrollment to patients with a larger predicted decrease in Delta P enhanced the average reduction in Delta P, increased predicted mortality benefit, and reduced sample size and screening size requirements. The increase in statistical power obtained by restricting enrollment based on predicted Delta P response varied according to device performance as specified by the target CO2 removal rate. Conclusions The lung-protective benefits of ECCO2R increase with higher alveolar dead space fraction, lower respiratory system compliance, and higher device performance. ADF and Crs, rather than severity of hypoxemia, should be the primary factors determining whether to enroll patients in clinical trials of ECCO2R.

Published
2019

33. Studienprotokoll der VISEP-Studie: Entgegnung der SepNet-Studiengruppe

Author

Reinhart, K., Brunkhorst, F.M., Engel, C., Bloos, F., Meier-Hellmann, A., Ragaller, M., Weiler, N., Moerer, O., Gruendling, M., Oppert, M., Grond, S., Olthoff, D., Jaschinski, U., John, S., Rossaint, R., Welte, T., Schaefer, M., Kern, P., Kuhnt, E., Kiehntopf, M., Deufel, T., Hartog, C., Gerlach, H., Stüber, F., Volk, H.-D., Quintel, M., Loeffler, M., and für die Deutsche Studiengruppe Kompetenznetzwerk Sepsis (SepNet)

Published
2008
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34. Noninvasive Neurally Adjusted Ventilator Assist Ventilation in the Postoperative Period Produces Better Patient-Ventilator Synchrony but Not Comfort

Author

Harnisch, Lars-Olav, Olgemoeller, U., Mann, Jana, Quintel, M., and Moerer, O.

Subjects
Diseases of the respiratory system, Article Subject, RC705-779
Abstract

Background. Noninvasive neurally adjusted ventilatory assist (NAVA) has been shown to improve patient-ventilator interaction in many settings. There is still scarce data with regard to postoperative patients indicated for noninvasive ventilation (NIV) which this study elates. The purpose of this trial was to evaluate postoperative patients for synchrony and comfort in noninvasive pressure support ventilation (NIV-PSV) vs. NIV-NAVA. Methods. Twenty-two subjects received either NIV-NAVA or NIV-PSV in an object-blind, prospective, randomized, crossover fashion (observational trial). We evaluated blood gases and ventilator tracings throughout as well as comfort of ventilation at the end of each ventilation phase. Results. There was an effective reduction in ventilator delays (p

Published
2020

43. Feasibility and safety of extracorporeal CO 2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study

Author

Combes, A, Fanelli, V, Pham, T, Ranieri, Vm, Goligher, Ec, Brodie, D, Pesenti, A, Beale, R, Brochard, L, Chiche, Jd, Fan, E, de Backer, D, Francois, G, Ferguson, N, Laffey, J, Mercat, A, Mcauley, Df, Muller, T, Quintel, M, Vincent, Jl, Taccone, Fs, Peperstraete, H, Morimont, P, Schmidt, M, Levy, B, Diehl, Jl, Guervilly, C, Capelier, G, Vieillard-Baron, A, Messika, J, Karagiannidis, C, Moerer, O, Urbino, R, Antonelli, Massimo, Mojoli, F, Alessandri, F, Grasselli, G, Donker, D, Ferrer, R, Mancebo, J, Slutsky, As, Combes, Alain, Fanelli, Vito, Pham, Tai, and Ranieri, V Marco

Subjects
Male, Adult, Canada, ARDS, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Extracorporeal, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Mechanical ventilation, Settore MED/41 - ANESTESIOLOGIA, Extracorporeal carbon dioxide removal, Journal Article, Extracorporeal membrane oxygenation, medicine, Humans, Prospective Studies, Adverse effect, Acute respiratory distress syndrome, Ventilator-induced lung injury, Acidosis, Respiratory, Aged, Analysis of Variance, Carbon Dioxide, Europe, Feasibility Studies, Female, Middle Aged, Respiration, Artificial, Respiratory Distress Syndrome, Adult, Respiratory Distress Syndrome, business.industry, Respiration, 030208 emergency & critical care medicine, medicine.disease, Confidence interval, 030228 respiratory system, Pneumothorax, Anesthesia, Artificial, Respiratory, Breathing, Acidosis, business
Abstract

Purpose: We assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO 2 R) to facilitate ultra-protective ventilation (V T 4 mL/kg and P PLAT ≤ 25 cmH 2 O) in patients with moderate acute respiratory distress syndrome (ARDS). Methods: Prospective multicenter international phase 2 study. Primary endpoint was the proportion of patients achieving ultra-protective ventilation with PaCO 2 not increasing more than 20% from baseline, and arterial pH > 7.30. Severe adverse events (SAE) and ECCO 2 R-related adverse events (ECCO 2 R-AE) were reported to an independent data and safety monitoring board. We used lower CO 2 extraction and higher CO 2 extraction devices (membrane lung cross-sectional area 0.59 vs. 1.30 m 2 ; flow 300–500 mL/min vs. 800–1000 mL/min, respectively). Results: Ninety-five patients were enrolled. The proportion of patients who achieved ultra-protective settings by 8 h and 24 h was 78% (74 out of 95 patients; 95% confidence interval 68–89%) and 82% (78 out of 95 patients; 95% confidence interval 76–88%), respectively. ECCO 2 R was maintained for 5 [3–8] days. Six SAEs were reported; two of them were attributed to ECCO 2 R (brain hemorrhage and pneumothorax). ECCO 2 R-AEs were reported in 39% of the patients. A total of 69 patients (73%) were alive at day 28. Fifty-nine patients (62%) were alive at hospital discharge. Conclusions: Use of ECCO 2 R to facilitate ultra-protective ventilation was feasible. A randomized clinical trial is required to assess the overall benefits and harms. Clinicaltrials.gov: NCT02282657.

Published
2019

45. Noninvasive Ventilation: Education and Training. A Narrative Analysis and an International Consensus Document

Author

Karim, H, Burns, K, Ciobanu, L, El-Khatib, M, Nicolini, A, Vargas, N, Hernández-Gilsoul, T, Skoczyński, S, Falcone, V, Arnal, J, Bach, J, De Santo, L, Lucchini, A, Steier, J, Purro, A, Petroianni, A, Sassoon, C, Bambi, S, Aguiar, M, Soubani, A, Taniguchi, C, Mollica, C, Berlin, D, Piervincenzi, E, Rao, F, Luigi, F, Ferrari, R, Garuti, G, Laier-Groeneveld, G, Fiorentino, G, Ho, K, Alqahtani, J, Luján, M, Moerer, O, Resta, O, Pierucci, P, Papadakos, P, Steiner, S, Stieglitz, S, Dikmen, Y, Duan, J, Bhakta, P, Iglesias, A, Corcione, N, Caldeira, V, Karakurt, Z, Valli, G, Kondili, E, Ruggieri, M, Raposo, M, Bottino, F, Soler-González, R, Gurjar, M, Sandoval-Gutierrez, J, Jafari, B, Arroyo-Cozar, M, Noval, A, Esquinas, A, Karim, Habib Md Reazaul, Burns, Karen E A, Ciobanu, Laura D, El-Khatib, Mohamad, Nicolini, Antonello, Vargas, Nicola, Hernández-Gilsoul, Thierry, Skoczyński, Szymon, Falcone, Vito Antonio, Arnal, Jean-Michel, Bach, John, De Santo, Luca Salvatore, Lucchini, Alberto, Steier, Joerg, Purro, Andrea, Petroianni, Angelo, Sassoon, Catherine S, Bambi, Stefano, Aguiar, Margarida, Soubani, Ayman O, Taniguchi, Corinne, Mollica, Corrado, Berlin, David A, Piervincenzi, Edoardo, Rao, Fabrizio, Luigi, Ferini-Strambi, Ferrari, Rodolfo, Garuti, Giancarlo, Laier-Groeneveld, Gerhard, Fiorentino, Giuseppe, Ho, Kwok M, Alqahtani, Jaber Saud, Luján, Manuel, Moerer, Onnen, Resta, Onofrio, Pierucci, Paola, Papadakos, Peter, Steiner, Stephan, Stieglitz, Sven, Dikmen, Yalim, Duan, Jun, Bhakta, Pradipta, Iglesias, Alejandro Ubeda, Corcione, Nadia, Caldeira, Vânia, Karakurt, Zuhal, Valli, Gabriele, Kondili, Eumorfia, Ruggieri, Maria Pia, Raposo, Margarida Simões, Bottino, Fabrizio, Soler-González, Rafael, Gurjar, Mohan, Sandoval-Gutierrez, José Luis, Jafari, Behrouz, Arroyo-Cozar, Marta, Noval, Ana Roca, Esquinas, Antonio M, Karim, H, Burns, K, Ciobanu, L, El-Khatib, M, Nicolini, A, Vargas, N, Hernández-Gilsoul, T, Skoczyński, S, Falcone, V, Arnal, J, Bach, J, De Santo, L, Lucchini, A, Steier, J, Purro, A, Petroianni, A, Sassoon, C, Bambi, S, Aguiar, M, Soubani, A, Taniguchi, C, Mollica, C, Berlin, D, Piervincenzi, E, Rao, F, Luigi, F, Ferrari, R, Garuti, G, Laier-Groeneveld, G, Fiorentino, G, Ho, K, Alqahtani, J, Luján, M, Moerer, O, Resta, O, Pierucci, P, Papadakos, P, Steiner, S, Stieglitz, S, Dikmen, Y, Duan, J, Bhakta, P, Iglesias, A, Corcione, N, Caldeira, V, Karakurt, Z, Valli, G, Kondili, E, Ruggieri, M, Raposo, M, Bottino, F, Soler-González, R, Gurjar, M, Sandoval-Gutierrez, J, Jafari, B, Arroyo-Cozar, M, Noval, A, Esquinas, A, Karim, Habib Md Reazaul, Burns, Karen E A, Ciobanu, Laura D, El-Khatib, Mohamad, Nicolini, Antonello, Vargas, Nicola, Hernández-Gilsoul, Thierry, Skoczyński, Szymon, Falcone, Vito Antonio, Arnal, Jean-Michel, Bach, John, De Santo, Luca Salvatore, Lucchini, Alberto, Steier, Joerg, Purro, Andrea, Petroianni, Angelo, Sassoon, Catherine S, Bambi, Stefano, Aguiar, Margarida, Soubani, Ayman O, Taniguchi, Corinne, Mollica, Corrado, Berlin, David A, Piervincenzi, Edoardo, Rao, Fabrizio, Luigi, Ferini-Strambi, Ferrari, Rodolfo, Garuti, Giancarlo, Laier-Groeneveld, Gerhard, Fiorentino, Giuseppe, Ho, Kwok M, Alqahtani, Jaber Saud, Luján, Manuel, Moerer, Onnen, Resta, Onofrio, Pierucci, Paola, Papadakos, Peter, Steiner, Stephan, Stieglitz, Sven, Dikmen, Yalim, Duan, Jun, Bhakta, Pradipta, Iglesias, Alejandro Ubeda, Corcione, Nadia, Caldeira, Vânia, Karakurt, Zuhal, Valli, Gabriele, Kondili, Eumorfia, Ruggieri, Maria Pia, Raposo, Margarida Simões, Bottino, Fabrizio, Soler-González, Rafael, Gurjar, Mohan, Sandoval-Gutierrez, José Luis, Jafari, Behrouz, Arroyo-Cozar, Marta, Noval, Ana Roca, and Esquinas, Antonio M

Abstract

Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients’ lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated. Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries

Published
2019

46. Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study

Author

Combes, A, Fanelli, V, Pham, T, Ranieri, Vm, Goligher, Ec, Brodie, D, Pesenti, A, Beale, R, Brochard, L, Chiche, Jd, Fan, E, de Backer, D, Francois, G, Ferguson, N, Laffey, J, Mercat, A, McAuley, Df, Muller, T, Quintel, M, Vincent, Jl, Taccone, F, Peperstraete, H, Morimont, P, Schmidt, M, Levy, B, Diehl, Jl, Guervilly, C, Capelier, G, Vieillard-Baron, A, Messika, J, Karagiannidis, C, Moerer, O, Urbino, R, Antonelli, M, Mojoli, F, Alessandri, F, Grasselli, G, Donker, D, Ferrer, R, Mancebo, J, Slutsky, As, Antonelli, M (ORCID:0000-0003-3007-1670), Combes, A, Fanelli, V, Pham, T, Ranieri, Vm, Goligher, Ec, Brodie, D, Pesenti, A, Beale, R, Brochard, L, Chiche, Jd, Fan, E, de Backer, D, Francois, G, Ferguson, N, Laffey, J, Mercat, A, McAuley, Df, Muller, T, Quintel, M, Vincent, Jl, Taccone, F, Peperstraete, H, Morimont, P, Schmidt, M, Levy, B, Diehl, Jl, Guervilly, C, Capelier, G, Vieillard-Baron, A, Messika, J, Karagiannidis, C, Moerer, O, Urbino, R, Antonelli, M, Mojoli, F, Alessandri, F, Grasselli, G, Donker, D, Ferrer, R, Mancebo, J, Slutsky, As, and Antonelli, M (ORCID:0000-0003-3007-1670)

Abstract

PurposeWe assessed feasibility and safety of extracorporeal carbon dioxide removal (ECCO2R) to facilitate ultra-protective ventilation (V-T 4mL/kg and P(PLAT)25cmH(2)O) in patients with moderate acute respiratory distress syndrome (ARDS).MethodsProspective multicenter international phase 2 study. Primary endpoint was the proportion of patients achieving ultra-protective ventilation with PaCO2 not increasing more than 20% from baseline, and arterial pH>7.30. Severe adverse events (SAE) and ECCO2R-related adverse events (ECCO2R-AE) were reported to an independent data and safety monitoring board. We used lower CO2 extraction and higher CO2 extraction devices (membrane lung cross-sectional area 0.59 vs. 1.30m(2); flow 300-500mL/min vs. 800-1000mL/min, respectively).ResultsNinety-five patients were enrolled. The proportion of patients who achieved ultra-protective settings by 8h and 24h was 78% (74 out of 95 patients; 95% confidence interval 68-89%) and 82% (78 out of 95 patients; 95% confidence interval 76-88%), respectively. ECCO2R was maintained for 5 [3-8]days. Six SAEs were reported; two of them were attributed to ECCO2R (brain hemorrhage and pneumothorax). ECCO2R-AEs were reported in 39% of the patients. A total of 69 patients (73%) were alive at day 28. Fifty-nine patients (62%) were alive at hospital discharge.ConclusionsUse of ECCO2R to facilitate ultra-protective ventilation was feasible. A randomized clinical trial is required to assess the overall benefits and harms.Clinicaltrials.govNCT02282657

Published
2019

50. Kosten der Sepsis

Author

Moerer, O. and Burchardi, H.

Abstract

Zusammenfassung: In den letzten Jahren wurden auf dem Gebiet der Sepsisforschung große Fortschritte gemacht. Trotz des wachsenden Verständnisses für die pathophysiologischen Zusammenhänge und neuer therapeutischer Optionen, stellt die Sepsis allerdings weiterhin ein erhebliches Problem dar. Pro Jahr erkranken in Deutschland zwischen 45.000 und 90.000 Patienten an einer schweren Sepsis; in den USA sind es bis zu 750.000. Die Kosten der Intensivtherapie sind bei diesem Patientengut aufgrund langer Verweildauern und aufwändiger Therapien außerordentlich hoch. Ergänzt man die indirekten Kosten, die der Gesellschaft z. B. durch den Krankheitsausfall entstehen, dann resultiert infolge der hohen Inzidenz insgesamt eine beachtliche sozioökonomische Belastung. In Deutschland betragen die jährlichen Kosten der Sepsis für die Gesellschaft schätzungsweise zwischen EUR 3,6 und 7,8 Mrd. Die schwere Sepsis ist somit nicht nur aus der Perspektive der Intensivstation oder des Krankenhauses, sondern auch aus gesundheitsökonomischer Sicht von beträchtlicher Relevanz. Neue Medikamente, wie aktiviertes Protein C, und therapeutische Strategien, wie die intensivierte Insulintherapie, sind erfolgversprechend und werden in Zukunft wahrscheinlich eine wichtige Rolle in der Behandlung der schweren Sepsis spielen. Obwohl ihre Kosteneffektivität teilweise erwiesen scheint, stellen sie den Intensivmediziner jedoch vor eine nicht unerhebliche ökonomische Belastung. In der folgenden Übersicht werden Studien, die sich mit den direkten oder indirekten Kosten der Sepsis beschäftigen, vorgestellt, und die Kosteneffektivität innovativer Therapien wird diskutiert.

Published
2024
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