Prospective Evaluation of Thrombotic Complications After Internal Jugular Vein Cannulation for External Bypass.

Objectives: To determine the incidence and subsequent complications of internal jugular vein (IJV) thrombosis after cannulation performed during cardiopulmonary bypass (CPB) to ensure adequate venous drainage during minimally invasive cardiac surgery.

Design: Single-center observational trial SETTINGS: Intensive care postoperative monitoring of cardiac surgery patients and diagnosis of IJV thrombi at a university tertiary hospital during the 13-month study period from December 1, 2022, to January 11, 2024.

Participants: 44 patients undergoing catheterization of the IJV for total CPB.

Removal of EpCAM-positive tumor cells during intraoperative blood salvage- A pivotal multicenter clinical study (REMOVE).

Background: Intraoperative blood salvage can reduce the need for allogeneic blood transfusions, minimizing immunological risks and infection by reusing the patient's own blood. However, in cancer surgery, a key concern limiting its use is the potential reintroduction of viable cancer cells. Additional risks, such as infection and coagulopathy, have also contributed to its limited adoption.

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.

Critical risks of haemoadsorption for COVID-19 patients and directions for future evaluations: a nationwide propensity score matched cohort study.

Haemoadsorption has been suggested as treatment adjunct for sepsis and septic shock, cardiac surgery, acute respiratory distress syndrome, and coronavirus disease 2019 (COVID-19). Randomised clinical trials did not provide conclusive evidence for benefits and even suggest risks in COVID-19 patients. Retrospective observational cohort study based on hospital remuneration data from all COVID-19 patients treated in intensive care units in Germany between 01/01/2020 and 12/31/2021.

Comparative analysis of large language models and clinician responses in patient blood management knowledge.

Background: Large language models (LLMs) are increasingly used in the medical field and have the potential to reduce workload and improve treatment procedures in clinical practice. This study evaluates the capabilities of LLMs to answer common questions related to patient blood management (PBM) and compares their performance to the expertise of clinicians from two university hospitals.

Methods: To evaluate the performance of ChatGPT-3.

The fibrin-derived peptide FX06 protects human pulmonary endothelial cells against the COVID-19-triggered cytokine storm.

Introduction: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a major health emergency since its emergence in late 2019. Endothelial dysfunction is a hallmark of COVID-19, leading to severe illness, i.e.

Systemic role of orexin A, substance P, bradykinin, and DABK in severe COVID-19 and 2.5-yr follow-ups: an observational study.

Background: Orexin A regulates sleep-wake cycles, arousal, and energy homeostasis, linking it to the renin-angiotensin system and substance P. Dysfunction in these pathways occurs in acute and long-term COVID-19, including post-COVID syndrome.

Methods: This observational study analysed plasma orexin A, substance P, bradykinin, and des-Arg-bradykinin (DABK) in 78 ICU COVID-19 patients, 14 survivors of severe COVID-19 (2.

Glibenclamide Serves as a Potent Vasopressor to Treat Vasoplegia After Cardiopulmonary Bypass and Reperfusion in a Porcine Model.

The hemodynamic stabilization of patients after complex cardiac surgery is a daily challenge. The use of high doses of catecholamines is common but has potential adverse effects. Glibenclamide, a K blocker, seems to attenuate vasoplegia in different animal models of septic shock.

Sex- and age-related differences in LPS-induced lung injury: establishing a mouse intensive care unit.

Background: Mouse models are widely used to establish new therapy concepts for acute lung injury, but the transfer of therapeutic approaches into the intensive care unit often failed. To establish a mouse intensive care unit to adequately reflect the patient's situation and to investigate sex- and age-related differences in response to lipopolysaccharide.

Methods: For the establishment of a mouse intensive care unit, young (2-3 months) and old (15-18 months) mice of both sexes received continuous respiratory and cardiovascular monitoring for 6 h.

Transfusion Risk in Open, Laparoscopic, and Robotic-Assisted Surgery: A Propensity Score Matched Case-Control Study across Surgical Disciplines.

Introduction: Robotic-assisted surgery is increasingly performed in various surgical disciplines demonstrating improved oncological and functional outcomes compared to conventional surgery.

Objective: Unclear is how robotic-assisted surgery affects perioperative anemia and the need for blood products.

Methods: In this case-control study, 15,009 matched patient pairs undergoing urological, visceral, or thoracic surgery were included.

Persistent mortality in critical COVID-19 ICU cases from wild-type to delta variant: A descriptive cohort study.

The SARS-CoV-2 pandemic led to significant advancements in treatment and vaccination, contributing to a decline in overall COVID-19-related mortality. However, it remains unclear whether the mortality rate for critical cases treated on intensive care units has also decreased. This multicentric, multinational retrospective observational study analyzed 447 critically ill COVID-19 patients treated on ICUs across ten study centers in Germany and Austria.

Analysis of fatty acid-derived lipids in critically ill patients after cardiac surgery yields novel pathophysiologically relevant mediators with possible relevance for systemic inflammatory reactions.

Introduction: Critically ill patients suffer from a wide variety of clinical events, most of them leading to pro-inflammatory states such as sepsis or simply as consequence of major surgery. Many of these patients develop forms of acute kidney injury, heart or acute liver failure during intensive care. Lipid signaling is critically involved in triggering systemic inflammation processes, pain and vascular tone.

[Current state of patient knowledge regarding the preoperative impact and causes of anemia].

Background: Despite being treatable, the prevalence of anemia is relatively high, affecting up to 30% of the general population and 35% of patients undergoing surgery. Symptoms are often misinterpreted and patients frequently do not recognize anemia as a disease. As a result, it is often not discussed during medical consultations.

Reticulocyte hemoglobin content: a new frontier in iron deficiency diagnostics for major surgical patients.

Background: Iron deficiency (ID) is the most common nutritional deficiency among patients undergoing major surgery. Treatment of ID is straightforward, however implementing a comprehensive anemia management strategy within clinical routines is complex. Recently, reticulocyte hemoglobin content (Ret-He) has been evaluated as an early marker for ID diagnosis.

[Platelet Concentrates - Indication, Informed Consent, Transfusion and Adverse Events].

Transfusion of platelet concentrates (PC) can be a life-saving measure in case of severe thrombocytopenia or thrombocytopathy, particularly in bleeding patients. Although acaryote, platelets are involved in several important functions including immunomodulation, but their most important function is in primary and secondary haemostasis. In this German review, apheresis and whole blood derived PC are compared and indications as well as transfusion triggers and dosage of PC are discussed.

[Red Blood Cell Transfusion - Indications, Informed Consent and Associated Risks].

The aim of red blood cell (RBC) transfusion is to prevent or treat anemic tissue hypoxia in acute or chronic anemia. In 2022, approximately 3.2 million red blood cell transfusions were conducted in Germany.

Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring.

Background: Cortical high-frequency activation immediately before death has been reported, raising questions about an enhanced conscious state at this critical time. Here, we analyzed an electroencephalogram (EEG) from a comatose patient during the dying process with a standard bedside monitor and spectral parameterization techniques.

Methods: We report neurophysiologic features of a dying patient without major cortical injury.

Viscoelastic haemostatic assays to guide therapy in elective surgery: an updated systematic review and meta-analysis.

Background: Patients undergoing major surgery frequently experience major uncontrolled bleeding. The aim of this systematic review and meta-analysis was to evaluate the clinical efficacy of using viscoelastic haemostatic assays to manage peri-operative bleeding in elective surgery.

Methods: We searched PubMed/MEDLINE and Embase databases for randomised controlled trials according to pre-determined criteria.

[Cell salvage in obstetrics-Background and practical implementation].

Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality worldwide, with an increasing incidence in western countries over the past decades. During this period the numbers of PPH-related allogeneic red blood cell (RBC) transfusions have also significantly increased. Given the increasing scarcity and risks of allogeneic RBC transfusions, which are also associated with adverse maternal outcomes, optimized blood management strategies are urgently needed in obstetrics.

Identification of CRTH2 as a New PPARγ-Target Gene in T Cells Suggested CRTH2 Dependent Conversion of T2 Cells as Therapeutic Concept in COVID-19 Infection.

Background: COVID-19 is a serious viral infection, which is often associated with a lethal outcome. Therefore, understanding mechanisms, which affect the immune response during SARS-CoV2 infection, are important.

Methods: To address this, we determined the number of T cells in peripheral blood derived from intensive care COVID-19 patients.

Extracorporeal membrane oxygenation in cardiovascular medication poisoning. A German-wide retrospective study.

Medication poisoning, resulting from the ingestion of cardiotoxic drugs, presents a significant health issue. The mortality rate remains high for patients with myocardial dysfunction refractory to conventional treatments. Venoarterial Extracorporeal Membrane Oxygenation (V-A ECMO) provides temporary support, potentially enhancing patient outcomes.