[S3 guidelines on intensive care medicine following polytrauma : Aspects regarding definitive surgical treatment].

The treatment of polytraumatized patients is challenging. Intensive efforts and interdisciplinary teamwork have improved survival rates of severely injured patients over the last decades. High quality guideline recommendations focusing on the prehospital setting, emergency room management and also the initial surgical phase have been published and are frequently updated.

[S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].

Background: Sepsis is an acute, life-threatening multiple organ dysfunction triggered by an infection.

Methods: This guideline is an update of the S3 guideline "Sepsis-prevention, diagnosis, therapy, and follow-up care" (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaft [AMWF] Registry No. 079-001) of the German Sepsis Society (DSG) dated 31 December 2018.

Efficacy and Safety of a Balanced Gelatine Solution for Fluid Resuscitation in Sepsis: A Prospective, Randomised, Controlled, Double-Blind Trial-GENIUS Trial.

: Sepsis is a leading cause of death in noncoronary intensive care units (ICUs). Fluids for intravascular resuscitation include crystalloids and colloids. There is extensive clinical evidence on colloid use, but large trials comparing gelatine with crystalloid regimens in ICU and septic patients are lacking.

Crystalloid vs colloid fluid resuscitation in polytrauma patients: a systematic review.

Purpose: The question of whether crystalloid or colloid fluid yields better outcomes in the treatment of polytrauma patients has recently garnered significant interest. This systematic review aims to comprehensively compare the effects of crystalloid versus colloid fluid resuscitation on treatment outcomes in polytrauma patients.

Methods: We searched PubMed, Cochrane Central Register of Controlled Trials and Web of Science to identify completed and ongoing studies from inception of each database to August 9, 2022.

[Survey of staffing structures and equipment in 176 German emergency departments].

Background And Research Question: Adequate staffing, especially with physicians and emergency nursing staff, is essential for high-quality emergency care. The aim of this study was to compare the current staffing situation in German emergency departments with recommended standards.

Methods: A questionnaire was developed based on the minimum standards of the German Interdisciplinary Association for Intensive and Emergency Medicine and the German Society for Interdisciplinary Emergency and Acute Medicine.

Extubation in the operating room after elective on-pump CABG surgery: impact on patient outcome and clinical practice during the COVID-19 pandemic.

Purpose: Coronary artery bypass graft (CABG) surgery is the standard treatment for advanced coronary artery disease. Despite evidence supporting enhanced recovery after surgery (ERAS) programs, many hospitals continue to keep patients intubated following on-pump CABG surgery. The coronavirus disease 2019 (COVID-19) pandemic further strained intensive care unit (ICU) capacities, leading to the consideration of immediate extubation after elective surgeries like CABG surgeries.

[Telemonitoring for chronically ill patients with multimorbidity is technically feasible!].

The German healthcare system is facing challenges of an aging population with an increasing number of chronically ill patients with multimorbidity. Some of these are in need of nursing care, but there is a limited supply of care due to continuing shortage of personnel. The project, Telemedizin@NRW, funded by the Europäischen Fonds für regionale Entwicklung (EFRE NRW), addresses these challenges and pursues a holistic concept - including a technical review - for the care of chronically ill patients with multimorbidity by focusing on cross-indication telemonitoring.

Critically ill patients undergoing interhospital transportation: a prospective multicentre cohort study in the Euregio Meuse-Rhine.

Objective: The principal aim of this study was to investigate differences in the characteristics and physiological parameters of critically ill patients who underwent interhospital transportation.

Design: Prospective observational cohort study.

Setting: Multicentre study within the Euregio Meuse-Rhine, including Dutch and German hospitals.

Intensive Care Patient Usability Assessment in mHealth: A Survey-Study.

Patient participation is critical for the success and acceptance of mHealth applications. Many digital health solutions lack sufficient patient input, often resulting in limited use and effectiveness. As part of a project funded by the German Federal Ministry of Education and Research (BMBF), an mHealth app was developed for former intensive care patients at risk for Post Intensive Care Syndrome (PICS).

[Prognostic parameters in patients with prolonged weaning from mechanical ventilation: a retrospective analysis].

Weaning from mechanical ventilation of patients treated in an intensive care unit can be difficult and requires transfer to a specialised weaning unit. So far, only limited data are available on parameters associated with survival and successful weaning in this patient group.A retrospective analysis of patients (n=659) treated in the specialised weaning unit at the University Hospital RWTH Aachen during a time period of 8 years was conducted.

Leveraging electronic medical records to evaluate a computerized decision support system for staphylococcus bacteremia.

Infectious disease specialists (IDS) improve outcomes of patients with Staphylococcus bacteremia, but immediate IDS access is not always guaranteed. We investigated whether a care-integrated computerized decision support system (CDSS) can safely enhance the standard of care (SOC) for these patients. We conducted a multicenter, noninferiority, interventional stepped-wedge cluster randomized controlled trial relying on the data integration centers at five university hospitals.

Implementation and One-Year Evaluation of Proenkephalin A in Critical Care.

Proenkephalin A 119-159 (PENK) is a promising functional kidney biomarker, evaluated in various clinical settings. In critical care medicine, early diagnosis of acute kidney injury (AKI) is crucial; however, to date, the diagnosis and the assessment of kidney function is still based on serum creatinine (sCr) and urine output, both associated with several limitations. Between November 2020 and March 2022, we implemented PENK in our daily practice on our intensive care units (ICU).

[Recommendations and Innovations in Nutritional Medicine in Critically Ill Patients].

Medical Nutrition Therapy (MNT) is a key component of treatment in intensive care units (ICU) and plays a crucial role in the prognosis of critically ill patients. An individualized nutrition strategy is essential to meet the specific needs of critically ill patients and to minimize potential complications.Recommendations for MNT differ between the guidelines of the German Society for Nutritional Medicine (DGEM), the European Society for Clinical Nutrition and Metabolism (ESPEN), and the American Society for Parenteral and Enteral Nutrition (A.

Impact of dysglycemia during the ebb and flow phases of critically ill burn patients: An observational study.

Background: Critically ill burn patients face severe metabolic stress, divided into early ebb and late flow phases, causing dysglycemia. While detrimental effects of hyper- and hypoglycemia in burn patients have been reported over the entire stay, its impact during the ebb and flow phases remains unexplored. This study is the first to investigate phase-separated dysglycemia for outcome prediction.

Examining the impact of validated handover protocols on treatment outcomes in polytrauma patients: a systematic review.

Purpose: Effective patient handovers in healthcare settings are critical for ensuring patient safety and care quality. Handover tools have gained prominence as potential aids in improving these transitions. This systematic review seeks to answer the question if the use of validated handover protocols leads to better treatment outcomes in polytrauma patients compared to no use of validated handover protocols.

Mobile Applications for Longitudinal Data Collection: Web-based Survey Study of Former Intensive Care Patients.

Purpose: Mobile health plays an important role in providing individualized information about the health status of patients. Limited information exists on intensive care unit (ICU) patients with the risk of suffering from the post-intensive care syndrome (PICS), summarizing long-term physical, mental and cognitive impairment. This web-based survey study aims to identify specific needs of former ICU patients for utilizing a newly developed, so called Post-Intensive Care Outcome Surveillance (PICOS) app to collect relevant PICS-related parameters.

Boosting the accuracy of existing models by updating and extending: using a multicenter COVID-19 ICU cohort as a proxy.

Most published prediction models for Coronavirus Disease 2019 (COVID-19) were poorly reported, at high risk of bias, and heterogeneous in model performance. To tackle methodological challenges faced in previous prediction studies, we investigated whether model updating and extending improves mortality prediction, using the Intensive Care Unit (ICU) as a proxy. All COVID-19 patients admitted to seven ICUs in the Euregio-Meuse Rhine during the first pandemic wave were included.

Value of Glycemic Indices for Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage: A Retrospective Single-Center Study.

Delayed cerebral ischemia (DCI) is a severe complication following aneurysmal subarachnoid hemorrhage (aSAH), linked to poor functional outcomes and prolonged intensive care unit (ICU) stays. Timely DCI diagnosis is crucial but remains challenging. Dysregulated blood glucose, commonly observed after aSAH, may impair the constant glucose supply that is vital for brain function, potentially contributing to DCI.

Early extubation after elective surgical aortic valve replacement during the COVID-19 pandemic.

Background: Surgical aortic valve replacement (SAVR) is an established therapy for severe calcific aortic stenosis. Enhanced recovery after cardiac surgery (ERACS) protocols have been shown to improve outcomes for elective cardiac procedures. The COVID-19 pandemic prompted early extubation post-elective surgeries to preserve critical care resources.

Online Survey Study on the Needs of Former Intensive-Care Patients for the Development of a User-Friendly App.

The aim of this online-survey study is the development and evaluation of a mobile health application specifically designed to meet the needs of individuals who have previously undergone intensive-care treatment. User acceptance and perception play a crucial role in refining and optimizing the app's features and functionalities. By actively incorporating suggestions and insights from users, the goal is to enhance the overall usability and better cater to the diverse needs of individuals in post-intensive care recovery.

[Potential of a Telemedical, Inpatient-Outpatient Care Concept to Improve the Quality of Healthcare from the User's Perspective - An Acceptance Analysis of the TELnet@NRW Study].

Objective: The aim of this study was to measure the acceptance of a telemedical, inpatient-outpatient care concept by physicians, patients and the relatives of patients. Based on a quantitative survey of acceptance, both the potential and success factors influencing the use of telemedicine were to be highlighted.

Methods: The TELnet@NRW study is a national, multicenter, cluster-randomized study in stepped-wedge design conducted from February 2017 to January 2020 for the purpose of documenting changes in the quality of care through telemedicine in an inpatient-outpatient network.

Observational study of missing SOFA score data frequency in RCTs relative to ICU length of stay.

The Sequential Organ Failure Assessment, also known as SOFA score, was introduced to assess organ dysfunction of critical ill patients. However, understanding the impact of missing SOFA scores in randomized controlled trials and how this affect the validity and applicability of the SOFA score as a surrogate endpoint for predicting mortality has been a matter of interest. To address this, a secondary analysis of a systematic review was conducted to quantify the relationship between SOFA scores and the prediction of mortality in critically ill adults in randomized controlled trials (RCTs).

Ribonuclease inhibitor 1 emerges as a potential biomarker and modulates inflammation and iron homeostasis in sepsis.

Sepsis, marked by organ dysfunction, necessitates reliable biomarkers. Ribonuclease inhibitor 1 (RNH1), a ribonuclease (RNase) inhibitor, emerged as a potential biomarker for acute kidney injury and mortality in thoracoabdominal aortic aneurysm patients. Our study investigates RNH1 dynamics in sepsis, its links to mortality and organ dysfunction, and the interplay with RNase 1 and RNase 5.