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335 results on '"Roedl, Kevin"'

8. Association of early changes in arterial carbon dioxide with acute brain injury in adult patients with extracorporeal membrane oxygenation: A ten-year retrospective study in a German tertiary care hospital

Author

Yu, Yuanyuan, Lettow, Iris, Roedl, Kevin, Jarczak, Dominik, Pinnschmidt, Hans, Reichenspurner, Hermann, Bernhardt, Alexander M., Söffker, Gerold, Schrage, Benedikt, Haar, Markus, Weber, Theresa, Frings, Daniel, Kluge, Stefan, and Fischer, Marlene

Published
2024
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12. Comparative analysis of characteristics and outcomes in hospitalized COVID-19 patients infected with different SARS-CoV-2 variants between January 2020 and April 2022 – A retrospective single-center cohort study

Author

Brehm, Thomas Theo, Heyer, Andreas, Woo, Marcel S., Fischer, Marlene, van der Meirschen, Marc, Wichmann, Dominic, Jarczak, Dominik, Roedl, Kevin, Schmiedel, Stefan, Addo, Marylyn M., Lütgehetmann, Marc, Christner, Martin, Huber, Samuel, Lohse, Ansgar W., Kluge, Stefan, and Schulze zur Wiesch, Julian

Published
2023
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17. Molecular consequences of SARS-CoV-2 liver tropism

Author

Wanner, Nicola, Andrieux, Geoffroy, Badia-i-Mompel, Pau, Edler, Carolin, Pfefferle, Susanne, Lindenmeyer, Maja T., Schmidt-Lauber, Christian, Czogalla, Jan, Wong, Milagros N., Okabayashi, Yusuke, Braun, Fabian, Lütgehetmann, Marc, Meister, Elisabeth, Lu, Shun, Noriega, Maria L. M., Günther, Thomas, Grundhoff, Adam, Fischer, Nicole, Bräuninger, Hanna, Lindner, Diana, Westermann, Dirk, Haas, Fabian, Roedl, Kevin, Kluge, Stefan, Addo, Marylyn M., Huber, Samuel, Lohse, Ansgar W., Reiser, Jochen, Ondruschka, Benjamin, Sperhake, Jan P., Saez-Rodriguez, Julio, Boerries, Melanie, Hayek, Salim S., Aepfelbacher, Martin, Scaturro, Pietro, Puelles, Victor G., and Huber, Tobias B.

Published
2022
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18. Glucocorticoids induce a maladaptive epithelial stress response to aggravate acute kidney injury.

Author

Zhou, Luping, Pereiro, Marc Torres, Li, Yanqun, Derigs, Marcus, Kuenne, Carsten, Hielscher, Thomas, Huang, Wei, Kränzlin, Bettina, Tian, Gang, Kobayashi, Kazuhiro, Lu, Gia-Hue Natalie, Roedl, Kevin, Schmidt, Claudia, Günther, Stefan, Looso, Mario, Huber, Johannes, Xu, Yong, Wiech, Thorsten, Sperhake, Jan-Peter, and Wichmann, Dominic

Subjects
COVID-19, GLUCOCORTICOID receptors, DOUBLE-strand DNA breaks, ACUTE kidney failure, RENAL biopsy
Abstract

Acute kidney injury (AKI) is a frequent and challenging clinical condition associated with high morbidity and mortality and represents a common complication in critically ill patients with COVID-19. In AKI, renal tubular epithelial cells (TECs) are a primary site of damage, and recovery from AKI depends on TEC plasticity. However, the molecular mechanisms underlying adaptation and maladaptation of TECs in AKI remain largely unclear. Here, our study of an autopsy cohort of patients with COVID-19 provided evidence that injury of TECs by myoglobin, released as a consequence of rhabdomyolysis, is a major pathophysiological mechanism for AKI in severe COVID-19. Analyses of human kidney biopsies, mouse models of myoglobinuric and gentamicin-induced AKI, and mouse kidney tubuloids showed that TEC injury resulted in activation of the glucocorticoid receptor by endogenous glucocorticoids, which aggravated tubular damage. The detrimental effect of endogenous glucocorticoids on injured TECs was exacerbated by the administration of a widely clinically used synthetic glucocorticoid, dexamethasone, as indicated by experiments in mouse models of myoglobinuric- and folic acid–induced AKI, human and mouse kidney tubuloids, and human kidney slice cultures. Mechanistically, studies in mouse models of AKI, mouse tubuloids, and human kidney slice cultures demonstrated that glucocorticoid receptor signaling in injured TECs orchestrated a maladaptive transcriptional program to hinder DNA repair, amplify injury-induced DNA double-strand break formation, and dampen mTOR activity and mitochondrial bioenergetics. This study identifies glucocorticoid receptor activation as a mechanism of epithelial maladaptation, which is functionally important for AKI. Editor's summary: Acute kidney injury (AKI) is a complication of critically ill patients with COVID-19. Dexamethasone is a synthetic glucocorticoid used to treat severe COVID-19. Zhou et al. combined data from patients who died in association with COVID-19, human tissue, and mouse models of AKI and found that renal tubular epithelial cell (TEC) damage from myoglobinuria resulted in glucocorticoid receptor activation and worse injury. Mice given myoglobinuric injury and dexamethasone treatment had exacerbated TEC damage. Human kidney slices and TEC organoids from both humans and mice corroborated this exacerbated damage. Inhibiting endogenous glucocorticoid production or inactivating the glucocorticoid receptor ameliorated TEC damage in these models. TEC damage was linked to DNA damage and mitochondrial impairment. These data suggest that glucocorticoid receptor activation aggravates renal injury. —Brandon Berry [ABSTRACT FROM AUTHOR]

Published
2024
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22. Multi-dimensional and longitudinal systems profiling reveals predictive pattern of severe COVID-19

Author

Woo, Marcel S., Haag, Friedrich, Nierhaus, Axel, Jarczak, Dominik, Roedl, Kevin, Mayer, Christina, Brehm, Thomas T., van der Meirschen, Marc, Hennigs, Annette, Christopeit, Maximilian, Fiedler, Walter, Karagiannis, Panagiotis, Burdelski, Christoph, Schultze, Alexander, Huber, Samuel, Addo, Marylyn M., Schmiedel, Stefan, Friese, Manuel A., Kluge, Stefan, and Schulze zur Wiesch, Julian

Published
2021
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23. Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany

Author

Roedl, Kevin, Jarczak, Dominik, Thasler, Liina, Bachmann, Martin, Schulte, Frank, Bein, Berthold, Weber, Christian Friedrich, Schäfer, Ulrich, Veit, Carsten, Hauber, Hans-Peter, Kopp, Sebastian, Sydow, Karsten, de Weerth, Andreas, Bota, Marc, Schreiber, Rüdiger, Detsch, Oliver, Rogmann, Jan-Peer, Frings, Daniel, Sensen, Barbara, Burdelski, Christoph, Boenisch, Olaf, Nierhaus, Axel, de Heer, Geraldine, and Kluge, Stefan

Published
2021
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24. SOP Postreanimationsbehandlung

Author

Metelmann, Camilla, additional, Katzenschlager, Stephan, additional, Roedl, Kevin, additional, Seewald, Stephan, additional, and Wnent, Jan, additional

Published
2023
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37. Incidence of hypoxic hepatitis in patients with cardiogenic shock and association with mortality

Author

Beer, Benedikt N, primary, Besch, Lisa, additional, Weimann, Jessica, additional, Surendra, Kishore, additional, Roedl, Kevin, additional, Grensemann, Jörn, additional, Sundermeyer, Jonas, additional, Dettling, Angela, additional, Kluge, Stefan, additional, Kirchhof, Paulus, additional, Blankenberg, Stefan, additional, Scherer, Clemens, additional, and Schrage, Benedikt, additional

Published
2023
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41. Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest

Author

Chudeau, Nicolas, Guitton, Christophe, Cariou, Alain, Roedl, Kevin, Kluge, Stefan, Kjaergaard, Jesper, Møller, Jacob E., Hassager, Christian, Chudeau, Nicolas, Guitton, Christophe, Cariou, Alain, Roedl, Kevin, Kluge, Stefan, Kjaergaard, Jesper, Møller, Jacob E., and Hassager, Christian

Published
2023

44. Outcomes of critically ill coronavirus disease 2019 patients requiring kidney replacement therapy: A retrospective cohort study

Author

Braunsteiner, Josephine, primary, Jarczak, Dominik, additional, Schmidt-Lauber, Christian, additional, Boenisch, Olaf, additional, de Heer, Geraldine, additional, Burdelski, Christoph, additional, Frings, Daniel, additional, Sensen, Barbara, additional, Nierhaus, Axel, additional, Hoxha, Elion, additional, Huber, Tobias B., additional, Wichmann, Dominic, additional, Kluge, Stefan, additional, Fischer, Marlene, additional, and Roedl, Kevin, additional

Published
2022
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45. Thromboembolic events in deceased patients with proven SARS-CoV-2 infection: Frequency, characteristics and risk factors

Author

Voigtlaender, Minna, primary, Edler, Carolin, additional, Gerling, Moritz, additional, Schädler, Julia, additional, Ondruschka, Benjamin, additional, Schröder, Ann Sophie, additional, Sperhake, Jan, additional, Ehrhardt, Stephan, additional, Wang, Lin, additional, Haddad, Munif, additional, Kiencke, Verena, additional, Renné, Thomas, additional, Roedl, Kevin, additional, Kluge, Stefan, additional, Wichmann, Dominic, additional, and Langer, Florian, additional

Published
2022
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46. Effect of Hemadsorption Therapy in Critically Ill Patients with COVID-19 (CYTOCOV-19): A Prospective Randomized Controlled Pilot Trial

Author

Jarczak, Dominik, primary, Roedl, Kevin, additional, Fischer, Marlene, additional, de Heer, Geraldine, additional, Burdelski, Christoph, additional, Frings, Daniel Peter, additional, Sensen, Barbara, additional, Boenisch, Olaf, additional, Tariparast, Pischtaz Adel, additional, Kluge, Stefan, additional, and Nierhaus, Axel, additional

Published
2022
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48. Occurrence, Characteristics, and Outcome of Hypoxic Liver Injury among Patients Aged ≥90 Years Admitted to the Intensive Care Unit: A Retrospective Cohort Study.

Author

Roedl, Kevin, Daniels, Rikus, Theile, Pauline, Fuhrmann, Valentin, Kluge, Stefan, and Müller, Jakob

Subjects
*CRITICALLY ill children, *INTENSIVE care units, *LIVER injuries, *HOSPITAL mortality, *CARDIOGENIC shock, *COHORT analysis
Abstract

Introduction: Hypoxic liver injury (HLI) is a frequent and life-threatening complication occurring in up to 10% of critically ill patients. Heart failure and age were previously identified as risk factors for occurrence of HLI. However, there is lack of data on incidence of HLI and its clinical implications on outcome in very old (≥90 years) patients. The aim of this study was to investigate occurrence, clinical characteristics, and outcome of HLI in critically ill patients ≥90 years. Methods: This is a retrospective analysis of all consecutive critically ill patients ≥90 years admitted to the intensive care unit (ICU) of a tertiary care university hospital in Hamburg, Germany. Clinical course and laboratory data were analyzed for all patients. HLI was defined according to established criteria as elevation of aminotransferase levels (>20-fold upper limit of normal). Predictors of HLI occurrence, clinical course, and outcome were assessed and compared to those of patients without HLI. Results: In total, 1,065 critically ill patients ≥90 years were included. During the ICU stay, 3% (n = 35) developed HLI. Main causes of HLI were cardiogenic shock (51%, n = 18), septic shock (23%, n = 8), and cardiac arrest (20%, n = 7). Presenting characteristics including age, gender, and BMI were comparable between patients with and without HLI. The admission cause was primary medical (HLI: 49% vs. No-HLI: 34%, p = 0.07), surgical – planned (9% vs. 38%, p < 0.001), and surgical – emergency (43% vs. 28%, p = 0.06). The median Charlson Comorbidity Index (CCI) and the median updated CCI were 2 (1–3) and 2 (1–2) points in patients with HLI and 1 (0–2) and 1 (0–2) in patients without HLI (p < 0.01 and p = 0.08). Patients with HLI presented with higher SAPS II (55 vs. 36 points p < 0.001) score on admission and required mechanical ventilation (66% vs. 34%, p < 0.001), vasopressor therapy (91% vs. 40%, p < 0.001), renal replacement therapy (20% vs. 2%, p < 0.001), and parenteral nutrition (29% vs. 7%, p < 0.001). The ICU mortality and hospital mortality in patients with HLI were 66% (n = 23) and 83% (n = 29) compared with 17% (n = 170) and 28% (n = 292) in patients without HLI, respectively (both p < 0.001). Regression analysis identified SAPS II (OR 1.05, 95% CI: [1.02–1.07]; p < 0.001) and vasopressor therapy (OR 9.21, 95% CI: [2.58–32.86]; p < 0.01) as factors significantly associated with new onset of HLI. Occurrence of HLI was independently associated with mortality (HR 2.23, 95% CI: [1.50–3.30]; p < 0.001). Conclusion: HLI is an uncommon but not rare condition in critically ill patients aged ≥90 years. Occurrence of HLI is associated with high mortality and is mainly caused by cardiogenic or septic shock. HLI may serve as early prognostic marker in critically ill patients aged ≥90 years. [ABSTRACT FROM AUTHOR]

Published
2023
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