Impact of bleeding and thrombosis on outcome of 945 COVID-19 VV-ECMO cases from a German registry.

Unlabelled: Bleeding and thromboembolic events (BTE) increase the mortality of COVID-19 acute respiratory distress syndrome (ARDS) treated with extracorporeal membrane oxygenation (ECMO). The current analysis aimed to assess frequency and determinants of BTE according to their location and severity in a retrospective analysis of the German ECMO COVID-19 registry. Logistic regression was applied to identify factors influencing ICU survival as well as variables associated with risks of BTE.

Pediatric emergency backpacks-effects of using xABCDE- and Broselow-systems on pediatric emergency care.

Background: Pediatric emergencies are a challenge for emergency medical service (EMS) personnel regarding medical expertise and equipment. To address the special requirements in terms of size and weight, attempts are being made to systematically structure pediatric emergency backpacks.

Objectives: The aim of the study was to compare two pediatric emergency backpacks.

[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.

Improved pathogen identification in sepsis or septic shock by clinical metagenomic sequencing.

Objectives: Despite limited sensitivity and specificity, blood cultures (BCs) still represent the gold standard of diagnostic care in septic patients. We aimed to overcome current diagnostic limitations by unbiased next-generation sequencing (NGS) of circulating microbial cell-free DNA (mcfDNA) in plasma samples.

Methods: We performed a prospective, observational, non-interventional, multicenter study (Next GeneSiS-Trial) to compare positivity rates for NGS-based identification of causative pathogens with BCs in patients suffering from sepsis or septic shock.

Predictive value of early postoperative copeptin after cardiac surgery: A two-centre prospective cohort study.

Background: Patients undergoing cardiac surgery are at increased risk for postoperative complications, making early postoperative risk evaluation crucial. Recent studies have shown that copeptin, a neurohumoral marker, is associated with major adverse events after noncardiac surgery. However, data on its role after cardiac surgery are scarce.

[Quality of early sepsis diagnostics in German intensive care units-Results of a nationwide survey].

Background: The management of sepsis patients remains an ongoing challenge in intensive care medicine and leads to unacceptably high morbidity and mortality rates, even in medically highly developed countries.

Objective: What is the state of the quality of early sepsis treatment on German intensive care units (ICUs)?

Material And Methods: To assess the quality of early sepsis treatment, we conducted a nationwide internet-based survey among members of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI).

Results: A total of 1935 intensive care physicians across Germany were surveyed of whom 459 experienced specialist physicans responded, including 38% chief physicians and 61% senior physicians.

Incidence of Sepsis-Induced Coagulopathy (INSIC) Trial: Study Protocol of a Combined Retrospective and Prospective, Multicenter, International, Cross-Sectional, Longitudinal, and Epidemiological Observational Trial.

Sepsis and septic shock are the most severe forms of infection. Due to the intensive cross-talk of the coagulation and immune system, coagulopathies regularly occur in sepsis. The International Society on Thrombosis and Hemostasis refers to these coagulation abnormalities as sepsis-induced coagulopathies (SICs).

Complementary role of transcriptomic endotyping and protein-based biomarkers for risk stratification in sepsis-associated acute kidney injury.

Background: Sepsis-associated acute kidney injury (SA-AKI) is a prevalent and severe complication in critically ill patients. However, diagnostic and therapeutic advancements have been hindered by the biological heterogeneity underlying the disease. Both transcriptomic endotyping and biomarker profiling have been proposed individually to identify molecular subtypes of sepsis and may enhance risk stratification.

[Updated position paper on "Ecological sustainability in anesthesiology and intensive care medicine" with specific recommendations for action of the German Society for Anesthesiology and Intensive Care Medicine and the Professional Association of German Anesthesiologists-Update 2024 : Compiled by the Forum Sustainability in Anesthesiology from the Professional Association of German Anesthesiologists (BDA) and the German Society for Anesthesiology and Intensive Care Medicine (DGAI)].

Anthropogenic climate change is progressing, with global warming now reaching 1.1 °C. At the same time, further environmental crises that jeopardize the conservation of our natural resources can be observed.

Anserine reduces mortality in experimental sepsis by preventing methylglyoxal-induced capillary leakage.

Background: We previously identified methylglyoxal as a biomarker for early identification and outcome prediction in human sepsis. We hypothesised that methylglyoxal causally impacts disease severity, and the methylglyoxal-scavenging dipeptide anserine can attenuate the detrimental effects of methylglyoxal.

Methods: Using a translational approach, secondary analyses of two observational trials were performed to test the initial hypotheses.

Host-derived Delta-like Canonical Notch ligand-1 in sepsis and septic shock: Infection site, pathogens and disease severity matter - Secondary analysis of data from a randomized controlled trial.

Background: Sepsis is a life-threatening condition and many biomarkers for diagnosing and treatment guidance have been investigated in recent years. However, new ones are emerging almost daily, only few markers with diagnostic value have passed to entered clinical routine application. Delta-like canonical Notch ligand-1 (DLL-1) seems to be a potential contributor in the differentiation between sepsis and non-septic infection.

Impending sepsis-induced coagulopathy (SIC) is associated with increased disease severity in SIC-negative patients: a secondary analysis of a prospective exploratory study.

Due to the intense crosstalk between the coagulation and immune systems, coagulation disorders are an integral part of the disturbed host response to infection that defines sepsis. These so-called sepsis-induced coagulopathies (SIC) are associated with increased morbidity and mortality. However, we still do not know enough about the prevalence and risk factors for SIC in different patient groups.

Association of the dopamine D2 receptor gene SNP rs1800497 with postoperative nausea and vomiting: A prospective cohort study.

Background: Postoperative nausea and vomiting (PONV) are the most frequent complications in the context of anaesthesia. Several studies suggest a contribution of genetic traits to PONV disposition. Single nucleotide polymorphisms (SNPs) located in the cholinergic receptor muscarinic 3 gene (rs2165870) and the potassium voltage-gated channel subfamily B member 2 (rs349358) have been described as independent risk factors for the occurrence of PONV.

Implications for the diagnosis of aspiration and aspergillosis in critically ill patients with detection of galactomannan in broncho-alveolar lavage fluids.

Invasive infections with Aspergillus fumigatus in ICU patients are linked to high morbidity and mortality. Diagnosing invasive pulmonary aspergillosis (IPA) in non-immunosuppressed patients is difficult, as Aspergillus antigen (galactomannan [GM]) may have other causes. This retrospective study analyzed 160 ICU surgical patients with positive GM in broncho-alveolar lavage fluid (BALF), classifying them based on AspICU criteria for suspected IPA (pIPA) or aspiration.

Systematic assessment of COVID-19 host genetics using whole genome sequencing data.

Courses of SARS-CoV-2 infections are highly variable, ranging from asymptomatic to lethal COVID-19. Though research has shown that host genetic factors contribute to this variability, cohort-based joint analyses of variants from the entire allelic spectrum in individuals with confirmed SARS-CoV-2 infections are still lacking. Here, we present the results of whole genome sequencing in 1,220 mainly vaccine-naïve individuals with confirmed SARS-CoV-2 infection, including 827 hospitalized COVID-19 cases.

Influence of HLA-G 3' Untranslated Region Haplotypes and SNP +3422 Gene Variants as Host Genetic Factors on the Outcomes of SARS-CoV-2 Infection During Acute and Post-Acute Phases in a German Cohort.

HLA-G, an important immune-checkpoint (IC) molecule that exerts inhibitory signalling on immune effector cells, has been suggested to represent a key player in regulating the immune response to Severe Acute Respiratory Syndrome Coronavirus Type 2 (SARS-CoV-2). Since specific single-nucleotide polymorphisms (SNP) in the HLA-G 3'untranslated region (UTR), which arrange as haplotypes, are crucial for the regulation of HLA-G expression, we analysed the contribution of these genetic variants as host factors in SARS-CoV-2 infection during acute and post-acute phases. HLA-G gene polymorphisms in the 3'UTR were investigated by sequencing in an unvaccinated Coronavirus Disease 2019 (COVID-19) cohort during acute SARS-CoV-2 infection (N = 505) and in the post-acute phase (N = 253).

Cell Salvage Using the Autotransfusion Device CATSmart: A Randomized Controlled Bicentric Trial Evaluating the Quality of Two New Flex Wash Programs.

Background: The use of cell salvage and autologous blood transfusion is an important and widespread method of blood conservation during surgeries with expected high blood loss. The continuous autotransfusion device CATSmart (Fresenius Kabi, Germany) contains two new washing programs on the device called Flex wash 3 and Flex wash 5. To the best of our knowledge, there are no published clinical data regarding the performance of the two new washing programs.

Histidine containing dipeptides protect epithelial and endothelial cell barriers from methylglyoxal induced injury.

Integrity of epithelial and endothelial cell barriers is of critical importance for health, barrier disruption is a hallmark of numerous diseases, of which many are driven by carbonyl stressors such as methylglyoxal (MG). Carnosine and anserine exert some MG-quenching activity, but the impact of these and of other histidine containing dipeptides on cell barrier integrity has not been explored in detail. In human proximal tubular (HK-2) and umbilical vein endothelial (HUVEC) cells, exposure to 200 µM MG decreased transepithelial resistance (TER), i.

Corrigendum: Preoperative Anxiolysis and Treatment Expectation (PATE Trial): open-label placebo treatment to reduce preoperative anxiety in female patients undergoing gynecological laparoscopic surgery - study protocol for a bicentric, prospective, randomized-controlled trial.

[This corrects the article DOI: 10.3389/fpsyt.2024.

Prevalence of relevant early complications during the first 24 h on a normal ward in patients following PACU care after medium and major surgery: a monocentric retrospective observational study.

Purpose: Even today, it remains a challenge for healthcare professionals to decide whether a clinically stable patient who is recovering from uncomplicated medium or major surgery would benefit from a postoperative intensive care unit (ICU) admission, or whether they would be at least as adequately cared for by a few hours of monitoring in the post-operative care unit (PACU).

Methods: In this monocentric retrospective observational study, all adult patients who (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI) in Anästh Intensivmed (50):S486-S489, 2009) underwent medium or major surgery between 1 January 1 2014 and 31 December 2018 at the Heidelberg University Surgical Center, and (Vimlati et al. in Eur J Anaesthesiol September 26(9):715-721, 2009) were monitored for 1-12 h in the PACU, and then (De Pietri et al.

A novel approach for in vivo DNA footprinting using short double-stranded cell-free DNA from plasma.

Here, we present a method for enrichment of double-stranded cfDNA with an average length of ∼40 bp from cfDNA for high-throughput DNA sequencing. This class of cfDNA is enriched at gene promoters and binding sites of transcription factors or structural DNA-binding proteins, so that a genome-wide DNA footprint is directly captured from liquid biopsies. In short double-stranded cfDNA from healthy individuals, we find significant enrichment of 203 transcription factor motifs.