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21 results on '"Okrojek, Rainer"'

2. Percutaneous dilatational tracheotomy in high-risk ICU patients

Author

Lüsebrink, Enzo, Krogmann, Alexander, Tietz, Franziska, Riebisch, Matthias, Okrojek, Rainer, Peltz, Friedhelm, Skurk, Carsten, Hullermann, Carsten, Sackarnd, Jan, Wassilowsky, Dietmar, Toischer, Karl, Scherer, Clemens, Preusch, Michael, Testori, Christoph, Flierl, Ulrike, Peterss, Sven, Hoffmann, Sabine, Kneidinger, Nikolaus, Hagl, Christian, Massberg, Steffen, Zimmer, Sebastian, Luedike, Peter, Rassaf, Tienush, Thiele, Holger, Schäfer, Andreas, and Orban, Martin

Subjects
Anticoagulation, Research, Percutaneous dilatational tracheotomy, Dual antiplatelet therapy, Bleeding, Airway management
Abstract

Background Percutaneous dilatational tracheotomy (PDT) has become an established procedure in intensive care units (ICU). However, the safety of this method has been under debate given the growing number of critically ill patients with high bleeding risk receiving anticoagulation, dual antiplatelet therapy (DAPT) or even a combination of both, i.e. triple therapy. Therefore, the purpose of this study, including such a high proportion of patients on antithrombotic therapy, was to investigate whether PDT in high-risk ICU patients is associated with elevated procedural complications and to analyse the risk factors for bleeding occurring during and after PDT. Methods PDT interventions conducted in ICUs at 12 European sites between January 2016 and October 2019 were retrospectively analysed for procedural complications. For subgroup analyses, patient stratification into clinically relevant risk groups based on anticoagulation and antiplatelet treatment regimens was performed and the predictors of bleeding occurrence were analysed. Results In total, 671 patients receiving PDT were included and stratified into four clinically relevant antithrombotic treatment groups: (1) intravenous unfractionated heparin (iUFH, prophylactic dosage) (n = 101); (2) iUFH (therapeutic dosage) (n = 131); (3) antiplatelet therapy (aspirin and/or P2Y12 receptor inhibitor) with iUFH (prophylactic or therapeutic dosage) except for triple therapy (n = 290) and (4) triple therapy (DAPT with iUFH in therapeutic dosage) (n = 149). Within the whole cohort, 74 (11%) bleedings were reported to be procedure-related. Bleeding occurrence during and after PDT was independently associated with low platelet count (OR 0.73, 95% CI [0.56, 0.92], p = 0.009), chronic kidney disease (OR 1.75, 95% CI [1.01, 3.03], p = 0.047) and previous stroke (OR 2.13, 95% CI [1.1, 3.97], p = 0.02). Conclusion In this international, multicenter study bronchoscopy-guided PDT was a safe and low-complication airway management option, even in a cohort of high risk for bleeding on cardiovascular ICUs. Low platelet count, chronic kidney disease and previous stroke were identified as independent risk factors of bleeding during and after PDT but not triple therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-021-00906-5.

Published
2021

3. Early Bronchoscopy Improves Extubation Rates after Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Analysis

Author

Zimmermann, Gregor S., primary, Palm, Jana, additional, Lahmann, Anna Lena, additional, Peltz, Friedhelm, additional, Okrojek, Rainer, additional, Weis, Florian, additional, Müller, Arne, additional, Ziegler, Tilman, additional, Steger, Alexander, additional, Haller, Bernhard, additional, Hoppmann, Petra, additional, Laugwitz, Karl-Ludwig, additional, and Hautmann, Hubert, additional

Published
2021
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4. Efficacy and Safety of Revacept, a Novel Lesion-Directed Competitive Antagonist to Platelet Glycoprotein VI, in Patients Undergoing Elective Percutaneous Coronary Intervention for Stable Ischemic Heart Disease

Author

Mayer, Katharina, primary, Hein-Rothweiler, Ralph, additional, Schüpke, Stefanie, additional, Janisch, Marion, additional, Bernlochner, Isabell, additional, Ndrepepa, Gjin, additional, Sibbing, Dirk, additional, Gori, Tommaso, additional, Borst, Oliver, additional, Holdenrieder, Stefan, additional, Kupka, Danny, additional, Petzold, Tobias, additional, Bradaric, Christian, additional, Okrojek, Rainer, additional, Leistner, David M., additional, Trippel, Tobias D., additional, Münzel, Thomas, additional, Landmesser, Ulf, additional, Pieske, Burkert, additional, Zeiher, Andreas M., additional, Gawaz, Meinrad P., additional, Hapfelmeier, Alexander, additional, Laugwitz, Karl-Ludwig, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, and Massberg, Steffen, additional

Published
2021
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5. Additional file 1 of Percutaneous dilatational tracheotomy in high-risk ICU patients

Author

Lüsebrink, Enzo, Krogmann, Alexander, Tietz, Franziska, Riebisch, Matthias, Okrojek, Rainer, Peltz, Friedhelm, Skurk, Carsten, Hullermann, Carsten, Sackarnd, Jan, Wassilowsky, Dietmar, Toischer, Karl, Scherer, Clemens, Preusch, Michael, Testori, Christoph, Flierl, Ulrike, Peterss, Sven, Hoffmann, Sabine, Kneidinger, Nikolaus, Hagl, Christian, Massberg, Steffen, Zimmer, Sebastian, Luedike, Peter, Rassaf, Tienush, Thiele, Holger, Schäfer, Andreas, and Orban, Martin

Abstract

Additional file 1: Table S1. Complications during and after PDT differentiated by body mass index (BMI). p-values 40 kg/m2 who were not included. Table S2. Baseline characteristics (based on seven treatment groups): I) Intravenous unfractionated heparin (iUFH) (prophylactic dosage), II) iUFH (therapeutic dosage), III) aspirin (100 mg/day) and iUFH (prophylactic dosage) IV) aspirin (100 mg/day) and iUFH (therapeutic dosage), V) P2Y12 receptor inhibitor, i.e. clopidogrel (75 mg/day), prasugrel (10 mg/day) or ticagrelor (90 mg twice daily) with iUFH (therapeutic dosage), VI) DAPT including aspirin (100 mg/day) and a P2Y12 receptor inhibitor with iUFH (prophylactic dosage) and VII) DAPT with iUFH (therapeutic dosage), i.e. triple therapy. All displayed laboratory values were recorded on the day of PDT 4 h prior to procedure. ARDS, acute respiratory distress syndrome; COPD, chronic obstructive pulmonary disease; INR, International Normalized Ratio; aPTT, activated Partial Thromboplastin Time; SD, standard deviation. Table S3. Procedural related complications during and after PDT (based on seven treatment groups). p-values

Published
2021
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7. Percutaneous dilatational tracheotomy in high-risk ICU patients

Author

Lüsebrink, Enzo, Krogmann, Alexander, Tietz, Franziska, Riebisch, Matthias, Okrojek, Rainer, Peltz, Friedhelm, Skurk, Carsten, Hullermann, Carsten, Sackarnd, Jan, Wassilowsky, Dietmar, Toischer, Karl, Scherer, Clemens, Preusch, Michael, Testori, Christoph, Flierl, Ulrike, Peterss, Sven, Hoffmann, Sabine, Kneidinger, Nikolaus, Hagl, Christian, Massberg, Steffen, Zimmer, Sebastian, Luedike, Peter, Rassaf, Tienush, Thiele, Holger, Schäfer, Andreas, Orban, Martin, Kääb, Stefan, Brunner, Stefan, Orban, Mathias, Petzold, Tobias, Kehar, Saliha, Würbel, Sara, Stemmler, Hans-Joachim, Binzenhöfer, Leonhard, Kleeberger, Jan, and Kellnar, Antonia

Subjects
Research, Percutaneous dilatational tracheotomy, Airway management, Anticoagulation, Dual antiplatelet therapy, Bleeding, ddc
Published
2020

10. Prediction of outcome in patients with ARDS: A prospective cohort study comparing ARDS-definitions and other ARDS-associated parameters, ratios and scores at intubation and over time

Author

Huber, Wolfgang, primary, Findeisen, Michael, additional, Lahmer, Tobias, additional, Herner, Alexander, additional, Rasch, Sebastian, additional, Mayr, Ulrich, additional, Hoppmann, Petra, additional, Jaitner, Juliane, additional, Okrojek, Rainer, additional, Brettner, Franz, additional, Schmid, Roland, additional, and Schmidle, Paul, additional

Published
2020
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11. Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – A propensity score-matched analysis

Author

Lahmann, Anna Lena, primary, Bongiovanni, Dario, additional, Berkefeld, Anna, additional, Kettern, Maximilian, additional, Martinez, Lucas, additional, Okrojek, Rainer, additional, Hoppmann, Petra, additional, Laugwitz, Karl-Ludwig, additional, Mayr, Patrick, additional, Cassese, Salvatore, additional, Byrne, Robert, additional, Kufner, Sebastian, additional, Xhepa, Erion, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, and Joner, Michael, additional

Published
2020
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14. Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes

Author

Schüpke, Stefanie, primary, Neumann, Franz-Josef, additional, Menichelli, Maurizio, additional, Mayer, Katharina, additional, Bernlochner, Isabell, additional, Wöhrle, Jochen, additional, Richardt, Gert, additional, Liebetrau, Christoph, additional, Witzenbichler, Bernhard, additional, Antoniucci, David, additional, Akin, Ibrahim, additional, Bott-Flügel, Lorenz, additional, Fischer, Marcus, additional, Landmesser, Ulf, additional, Katus, Hugo A., additional, Sibbing, Dirk, additional, Seyfarth, Melchior, additional, Janisch, Marion, additional, Boncompagni, Duino, additional, Hilz, Raphaela, additional, Rottbauer, Wolfgang, additional, Okrojek, Rainer, additional, Möllmann, Helge, additional, Hochholzer, Willibald, additional, Migliorini, Angela, additional, Cassese, Salvatore, additional, Mollo, Pasquale, additional, Xhepa, Erion, additional, Kufner, Sebastian, additional, Strehle, Axel, additional, Leggewie, Stefan, additional, Allali, Abdelhakim, additional, Ndrepepa, Gjin, additional, Schühlen, Helmut, additional, Angiolillo, Dominick J., additional, Hamm, Christian W., additional, Hapfelmeier, Alexander, additional, Tölg, Ralph, additional, Trenk, Dietmar, additional, Schunkert, Heribert, additional, Laugwitz, Karl-Ludwig, additional, and Kastrati, Adnan, additional

Published
2019
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15. Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – a propensity score-matched analysis

Author

Lahmann, Anna Lena, primary, Bongiovanni, Dario, additional, Berkefeld, Anna, additional, Kettern, Maximilian, additional, Martinez, Lucas, additional, Okrojek, Rainer, additional, Hoppmann, Petra, additional, Laugwitz, Karl-Ludwig, additional, Kasel, Markus, additional, Cassese, Salvatore, additional, Byrne, Robert, additional, Kufner, Sebastian, additional, Xhepa, Erion, additional, Schunkert, Heribert, additional, Kastrati, Adnan, additional, and Joner, Michael, additional

Published
2019
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16. Platelet dysfunction and inhibition of multiple electrode platelet aggregometry caused by penicillin

Author

von Beckerath Nicolas, Okrojek Rainer, von Beckerath Olga, Schulz Christian, and Massberg Steffen

Subjects
Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Abstract Beta-lactam antibiotics, e.g. penicillin, may inhibit platelet function and lead to reduced response in light transmission aggregometry and adhesion. However, influence on platelet function tests more commonly used in clinical practice, such as multiple electrode platelet aggregometry (MEA), have not been described so far. We report a case of a patient with local streptococcus infection. Treatment with penicillin resulted in mild bleeding tendency after 3 days. While coagulation parameters were normal, assessment of platelet function by MEA revealed strong platelet inhibition of both ADP and arachidonic acid induced platelet aggregation comparable to normal responders to antiplatelet therapy. Change of antibiotic regime resulted in recovery of platelet function. Thus, penicillin therapy may impact on platelet function and consecutively commonly used platelet function assays, e.g. MEA.

Published
2010
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20. Platelet dysfunction and inhibition of multipleelectrode platelet aggregometry caused bypenicillin.

Author

Schulz, Christian, Beckerath, Olga von, Okrojek, Rainer, von Beckerath, Nicolas, and Massberg, Steffen

Subjects
BETA lactam antibiotics, BLOOD platelet aggregation, PENICILLIN, ELECTROSTATIC adhesion, STREPTOCOCCUS
Abstract

Beta-lactam antibiotics, e.g. penicillin, may inhibit platelet function and lead to reduced response in light transmission aggregometry and adhesion. However, influence on platelet function tests more commonly used in clinical practice, such as multiple electrode platelet aggregometry (MEA), have not been described so far. We report a case of a patient with local streptococcus infection. Treatment with penicillin resulted in mild bleeding tendency after 3 days. While coagulation parameters were normal, assessment of platelet function by MEA revealed strong platelet inhibition of both ADP and arachidonic acid induced platelet aggregation comparable to normal responders to antiplatelet therapy. Change of antibiotic regime resulted in recovery of platelet function. Thus, penicillin therapy may impact on platelet function and consecutively commonly used platelet function assays, e.g. MEA. [ABSTRACT FROM AUTHOR]

Published
2010
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