Article
Critical Care Medicine
Neel Shah, Xilong Li, Prashanth Shanmugham, Eddy Fan, Ravi R. Thiagarajan, Ramgopal Venkataraman, Lakshmi Raman
Summary: Neurologic complications are common in pediatric patients supported by ECMO, and a large decrease in Paco(2) and increase in MAP following ECMO initiation are both associated with these complications.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Review
Genetics & Heredity
Aleksandra Ekkert, Aleksandra Sliachtenko, Algirdas Utkus, Dalius Jatuzis
Summary: Intracerebral hemorrhage (ICH) is a devastating type of stroke with unfavorable functional outcomes. Timely prevention and optimized treatment strategies are crucial given the burden of ICH. Genetic factors play a significant role in the pathogenesis of ICH, with various gene-related types identified. Although current data is mostly theoretical and scientific, emerging evidence holds promise for future clinical applications.
Article
Critical Care Medicine
Jad Malas, Qiudong Chen, Tao Shen, Dominic Emerson, Tyler Gunn, Dominick Megna, Pedro Catarino, Michael Nurok, Michael Bowdish, Joanna Chikwe, Susan Cheng, Joseph Ebinger, Abirami Kumaresan
Summary: This study aimed to describe the institutional experience with extremely prolonged venovenous extracorporeal membrane oxygenation (ECMO) support for patients with acute respiratory failure. The study found that most patients in this cohort had adult respiratory distress syndrome (ARDS) secondary to COVID-19. Prolonged ECMO support was successful in weaning patients off and enabling their recovery, with a high rate of survival.
CRITICAL CARE MEDICINE
(2023)
Article
Clinical Neurology
Jens Witsch, David Roh, Stephanie Oh, Costantino Iadecola, Ramon Diaz-Arrastia, Scott E. Kasner, Stephan A. Mayer, Santosh B. Murthy
Summary: Neutrophil-mediated inflammation exacerbates intracerebral hemorrhage (ICH) outcomes. This study aimed to investigate the association between serum levels of sICAM-1 and poor outcomes after ICH. After adjustment, sICAM-1 was found to be associated with mortality, poor outcome, and hematoma expansion.
Article
Critical Care Medicine
Sung-Min Cho, Joe Canner, Giorgio Caturegli, Chun Woo Choi, Eric Etchill, Katherine Giuliano, Giovanni Chiarini, Kate Calligy, Peter Rycus, Roberto Lorusso, Bo Soo Kim, Marc Sussman, Jose I. Suarez, Romergryko Geocadin, Errol L. Bush, Wendy Ziai, Glenn Whitman
Summary: This study found that approximately 5% of patients receiving venovenous extracorporeal membrane oxygenation experienced acute brain injury, with mortality rates doubling when ischemic or hemorrhagic strokes occurred. Risk factors such as lower pH, hypoxemia, and coagulation disturbances were associated with acute brain injury, highlighting the importance of further research on prevention and management strategies.
CRITICAL CARE MEDICINE
(2021)
Article
Clinical Neurology
Evangelos Pavlos Myserlis, Marios K. Georgakis, Stacie L. Demel, Padmini Sekar, Jaeyoon Chung, Rainer Malik, Hyacinth I. Hyacinth, Mary E. Comeau, Guido J. Falcone, Carl D. Langefeld, Jonathan Rosand, Daniel Woo, Christopher D. Anderson
Summary: Researchers developed a genomic risk score that predicts the risk of intracerebral hemorrhage (ICH) in individuals of European ancestry. The score showed better predictive power than standard clinical risk factors and may improve clinical decision making for high-risk populations.
Review
Hematology
Gerald Chi, Jane J. Lee, Shi Sheng, Jolanta Marszalek, Michael L. Chuang
Summary: Thromboprophylaxis is effective in preventing DVT and PE without increasing the risk of hematoma expansion or bleeding among ICH patients.
THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Critical Care Medicine
Benjamin Seeliger, Michael Doebler, Daniel Andrea Hofmaenner, Pedro D. Wendel-Garcia, Reto A. Schuepbach, Julius J. Schmidt, Tobias Welte, Marius M. Hoeper, Hans-Joerg Gillmann, Christian Kuehn, Stefan Felix Ehrentraut, Jens-Christian Schewe, Christian Putensen, Klaus Stahl, Christian Bode, Sascha David
Summary: This multicenter retrospective analysis investigates the risk of intracranial hemorrhage in COVID-19 patients receiving ECMO support. The results show a higher incidence and severity of intracranial hemorrhage in COVID-19 patients compared to viral non-COVID-19 patients on ECMO, with a higher ICU mortality rate.
CRITICAL CARE MEDICINE
(2022)
Article
Engineering, Biomedical
Lauren A. Raff, Rebecca G. Maine, Trista S. Reid
Summary: Despite improvements in critical care, mortality from ARDS remains high. V-V ECMO is used in severe cases, but the risk of hemorrhage may deter some providers.
Article
Critical Care Medicine
Akram Zaaqoq, Matthew Griffee, Thu-Lan Kelly, Jonathon Fanning, Silver Heinsar, Jacky Suen, Silvia Mariani, Gianluigi Li Bassi, Jeffrey Jacobs, Nicole White, John Fraser, Roberto Lorusso, Giles Peek, Sung-Min Cho
Summary: This study aims to characterize the prevalence and risk factors of stroke secondary to COVID-19 in patients on venovenous ECMO. The results showed that obesity and pre-ECMO vasopressor use were associated with an increased risk of stroke. In addition, stroke patients had a more significant relative decrease in Paco(2) and relative increase in Pao(2) within 48 hours after ECMO initiation compared to non-stroke patients, and they also had a higher in-hospital mortality rate.
CRITICAL CARE MEDICINE
(2023)
Review
Critical Care Medicine
Ricardo Teijeiro-Paradis, Whitney D. Gannon, Eddy Fan
Summary: This narrative review discusses the various complications that can occur during treatment with venovenous extracorporeal membrane oxygenation (V-V ECMO), including both short-term and long-term complications. Patient selection, timing of initiation, and management decisions greatly influence the presence and severity of these potential harms.
CRITICAL CARE MEDICINE
(2022)
Article
Critical Care Medicine
Kun He Lee, Vasileios-Arsenios Lioutas, Sarah Marchina, Magdy Selim
Summary: This study found that an early increase in ventricular size is independently associated with lower odds of good clinical outcome in the context of intracerebral hemorrhage, while measures of perihematomal edema (PHE) were not significantly associated with outcome.
NEUROCRITICAL CARE
(2022)
Article
Critical Care Medicine
Darya Rudym, Tai Pham, Craig R. Rackley, Giacomo Grasselli, Michaela Anderson, Matthew R. Baldwin, Jeremy Beitler, Cara Agerstrand, Alexis Serra, Lisle A. Winston, Desiree Bonadonna, Natalie Yip, Logan J. Emerson, Amy Dzierba, Joshua Sonett, Darryl Abrams, Niall D. Ferguson, Matthew Bacchetta, Matthieu Schmidt, Daniel Brodie
Summary: This study investigated the association between obesity and mortality in patients with ARDS receiving ECMO. The results showed that patients with obesity had lower ICU mortality than patients without obesity, supporting the idea that obesity should not be considered a general contraindication to ECMO.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Review
Critical Care Medicine
Melissa Lannon, Taylor Duda, Alisha Greer, Mark Hewitt, Arjun Sharma, Amanda Martyniuk, Julian Owen, Faizan Amin, Sunjay Sharma
Summary: This study reviewed the literature on intracranial hemorrhage (ICH) during ECMO treatment among COVID-19 patients. It found that COVID-19 patients had a higher risk of ICH compared to patients treated with ECMO for other indications. Therefore, strategies to reduce hemorrhage may include the use of atypical anticoagulants, conservative anticoagulation strategies, or advances in circuit design and surface coatings.
JOURNAL OF CRITICAL CARE
(2023)
Article
Critical Care Medicine
Richard Descamps, Mouhamed D. Moussa, Emmanuel Besnier, Marc-Olivier Fischer, Sebastien Preau, Fabienne Tamion, Cedric Daubin, Nicolas Cousin, Andre Vincentelli, Julien Goutay, Damien Du Cheyron
Summary: In patients under ECMO support, mean anti-Xa activity was identified as an independent risk factor for hemorrhagic complications. Anticoagulation targets may need to be revised downward in both VV- and VA-ECMO.
Article
Hematology
Dominik Jarczak, Kevin Roedl, Marlene Fischer, Geraldine de Heer, Christoph Burdelski, Daniel Peter Frings, Barbara Sensen, Olaf Boenisch, Pischtaz Adel Tariparast, Stefan Kluge, Axel Nierhaus
Summary: Immunomodulatory therapies have shown positive effects in severe COVID-19 patients, and hemadsorption may help remove inflammatory mediators. This study found a non-significant trend towards clinical improvement with hemadsorption therapy (HT) during the intervention period, suggesting that HT might be a stable option for selected patients before further therapeutic decisions.
BLOOD PURIFICATION
(2023)
Article
Anesthesiology
Kim C. Koschmieder, Sandra Funcke, Mahshid Shadloo, Hans O. Pinnschmidt, Gillis Greiwe, Marlene Fischer, Rainer Nitzschke
Summary: This study evaluated the predictive accuracy of heart rate and three nociception indices for predicting postoperative pain. It found that these measures did not have sufficient diagnostic accuracy for predicting postoperative pain.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Critical Care Medicine
Marius Marc-Daniel Mader, Rolf Lefering, Manfred Westphal, Marc Maegele, Patrick Czorlich
Summary: Patients with TBI often require invasive ventilation, putting them at risk of pulmonary failure and potential need for ECMO treatment. This study provides an overview of ECMO treatment in TBI patients based on data from the TraumaRegister DGU. The results show that while the mortality rate is higher in patients receiving ECMO, the majority of patients survive.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2023)
Article
Nutrition & Dietetics
Carola Mayer, Felix L. L. Naegele, Marvin Petersen, Maximilian Schell, Ghazal Aarabi, Thomas Beikler, Katrin Borof, Benedikt M. M. Frey, Julius Nikorowitsch, Juliana Senftinger, Carolin Walther, Jan-Per Wenzel, Birgit-Christiane Zyriax, Bastian Cheng, Goetz Thomalla
Summary: The study found that consuming 3-4 cups of coffee per day is associated with fewer neurodegenerative disorders and improved microstructural brain integrity. However, the relationship between coffee consumption and vascular brain damage and neurodegeneration remains unclear. Further research is needed to determine the long-term effects of coffee on brain microstructure.
Article
Medicine, General & Internal
Andras Piffko, Franz L. Ricklefs, Nils Schweingruber, Thomas Sauvigny, Marius Marc-Daniel Mader, Malte Mohme, Lasse Duhrsen, Manfred Westphal, Jan Regelsberger, Nils Ole Schmidt, Patrick Czorlich
Summary: Numerous pathological and inflammatory processes influence the clinical course of aneurysmal subarachnoid hemorrhage (aSAH), but our understanding of predictive factors and therapeutic consequences is limited. In this retrospective analysis of 484 aSAH patients, we evaluated the predictive value of clinically relevant factors for delayed cerebral ischemia (DCI) and ventriculoperitoneal (VP) shunt dependency, and found that corticosteroid treatment had different effects on the predictive factors depending on the outcome. Our study highlights the importance of considering corticosteroid-induced leukocytosis when interpreting systemic inflammatory markers in aSAH patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Emergency Medicine
Alexander Younsi, Andreas Unterberg, Ingo Marzi, Wolf-Ingo Steudel, Eberhard Uhl, Johannes Lemcke, Florian Berg, Mathias Woschek, Michaela Friedrich, Hans Clusmann, Hussam Aldin Hamou, Uwe Max Mauer, Magnus Scheer, Jurgen Meixensberger, Dirk Lindner, Kirsten Schmieder, Mortimer Gierthmuehlen, Christine Hoefer, Ulrike Nienaber, Marc Maegele
Summary: The TBI databank DGNC/DGU was developed by the German Society for Neurosurgery (DGNC) and the German Society for Trauma Surgery (DGU) to fill the gap in comprehensive data collection on traumatic brain injury (TBI). It includes over 300 clinical, imaging, and laboratory variables, and evaluates the treatment outcome after 6 and 12 months.
EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
(2023)
Article
Critical Care Medicine
Jennifer Goettsche, Volker Knospe, Thomas Sauvigny, Nils Schweingruber, Joern Grensemann, Martin S. Spitzer, Manfred Westphal, Christos Skevas, Patrick Czorlich
Summary: Terson syndrome (TS) is a common complication in patients with aneurysmal subarachnoid hemorrhage (aSAH), with an incidence rate of up to 46%. This study aimed to raise awareness of TS, evaluate previous scientific findings, identify risk factors associated with TS occurrence, and present a local diagnostic and treatment concept. A retrospective study was conducted on 617 aSAH patients, of which 367 patients (59.5%) underwent ophthalmological examination. Regression and receiver operating characteristic analyses revealed that higher WFNS grade and the occurrence of seizures were independent predictors of TS. Surgical treatment resulted in significant improvement in visual function for patients with TS. Screening for TS should be performed in aSAH patients with higher WFNS grade and seizures.
NEUROCRITICAL CARE
(2023)
Article
Clinical Neurology
Patrick Czorlich, Nils Schweingruber, Jennifer Goettsche, Marius M. Mader, Manfred Westphal
Summary: This study evaluated the rate and factors associated with acute low-pressure hydrocephalus (aLPH) after subarachnoid hemorrhage (SAH) and described its clinical course. The results showed that aLPH is a rare pathology in SAH patients and has a negative impact on the clinical course. Therefore, it should be considered and treated with forced cerebrospinal fluid drainage in patients with a lack of neurological improvement, ventricular enlargement, and normal intracranial pressure values.
NEUROSURGICAL FOCUS
(2023)
Article
Microbiology
Christina Koenig, Jens Martens-Lobenhoffer, Patrick Czorlich, Manfred Westphal, Stefanie M. Bode-Boeger, Stefan Kluge, Joern Grensemann
Summary: This study investigated the CSF penetration of fosfomycin in the treatment of ventriculitis. It found that fosfomycin has a high penetration rate into the CSF, leading to therapeutic concentrations for the treatment of ventriculitis. This provides a reliable treatment option for patients with ventriculitis.
ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS
(2023)
Article
Clinical Neurology
Stefan Wolf, Dorothee Mielke, Christoph Barner, Vesna Malinova, Thomas Kerz, Maria Wostrack, Patrick Czorlich, Farid Salih, Doortje C. Engel, Angelika Ehlert, Dimitre Staykov, Abdulrahman Y. Alturki, Ulrich Sure, Juergen Bardutzky, Henry W. S. Schroeder, Ludwig Schuerer, Juergen Beck, Tareq A. Juratli, Michael Fritsch, Johannes Lemcke, Anne Pohrt, Bernhard Meyer, Stefan Schwab, Veit Rohde, Peter Vajkoczy
Summary: A study found that early lumbar cerebrospinal fluid drainage can reduce the incidence of delayed cerebral ischemia and improve long-term outcome in patients after aneurysmal subarachnoid hemorrhage.
Article
Clinical Neurology
Marcel Seungsu Woo, Christina Mayer, Marlene Fischer, Stefan Kluge, Kevin Roedl, Christian Gerloff, Patrick Czorlich, Gotz Thomalla, Julian Schulze zur Wiesch, Nils Schweingruber
Summary: This study retrospectively analyzed data from patients admitted to the ICU due to acute COVID-19 disease in a large tertiary medical center in Germany. The study found a correlation between autonomic dysfunction and mortality in critically ill COVID-19 patients. These findings could contribute to the clinical management of COVID-19 patients admitted to the ICU.
NEUROLOGICAL RESEARCH AND PRACTICE
(2023)
Article
Cardiac & Cardiovascular Systems
Tobias Pantel, Axel Neulen, Marius Marc-Daniel Mader, Elena Kurz, Andras Piffko, Verena Fassl, Manfred Westphal, Jens Gempt, Florian Ringel, Patrick Czorlich
Summary: Cardiac arrest is occasionally seen in patients with aneurysmal subarachnoid hemorrhage (SAH). The impact of pre-hospital and emergency room treatment on SAH patients with out-of-hospital cardiac arrest (OHCA) remains unclear. This study found that time to resuscitation was significantly shorter with lay cardiopulmonary resuscitation (CPR), and delayed cranial computed tomography (CCT) diagnosis was associated with longer time to first CCT. Overall survival to discharge was 31.6%. The study recommends considering CCT diagnostics as part of the diagnostic algorithm in OHCA patients.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Public, Environmental & Occupational Health
Thomas Theo Brehm, Andreas Heyer, Marcel S. Woo, Marlene Fischer, Marc van der Meirschen, Dominic Wichmann, Dominik Jarczak, Kevin Roedl, Stefan Schmiedel, Marylyn M. Addo, Marc Luetgehetmann, Martin Christner, Samuel Huber, Ansgar W. Lohse, Stefan Kluge, Julian Schulze zur Wiesch
Summary: During the COVID-19 pandemic, the in-hospital mortality and rate of ICU admission among hospitalized patients have steadily decreased, indicating the significant impact of vaccine roll-out, therapeutic agents, and the emergence of new SARS-CoV-2 variants on disease severity. However, the unchanged duration of hospitalization demonstrates the persistent burden of COVID-19 on the healthcare system.
JOURNAL OF INFECTION AND PUBLIC HEALTH
(2023)
