Article
Clinical Neurology
Nils Schweingruber, Marius Mader, Anton Wiehe, Frank Roeder, Jennifer Goettsche, Stefan Kluge, Manfred Westphal, Patrick Czorlich, Christian Gerloff
Summary: The evolution of intracranial pressure in critically ill patients is difficult to predict. Machine learning models can assist in the clinical management of patients undergoing invasive ICP monitoring. A study used recurrent machine learning models to predict critical increases in ICP and validated the models in two independent datasets.
Article
Microbiology
Nilesh Kumta, Aaron J. Heffernan, Menino Osbert Cotta, Steven C. Wallis, Amelia Livermore, Therese Starr, Wai Tat Wong, Gavin M. Joynt, Jeffrey Lipman, Jason A. Roberts
Summary: Morbidity and mortality related to ventriculitis in neurocritical care patients remain high. Antibiotic dose optimization, particularly higher doses of meropenem, can improve therapeutic outcomes for critically ill patients with ventriculitis or extracranial infection by ensuring targeted cerebrospinal fluid exposures. Individualized dosing regimens need to be tailored based on factors such as renal function and pathogen susceptibility.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Review
Clinical Neurology
Jeffrey R. Vitt, Nicholas E. Loper, Shraddha Mainali
Summary: Given the complexity of cerebral pathology in patients with acute brain injury, various neuromonitoring strategies have been developed to better appreciate physiologic relationships and potentially harmful derangements. There is ample evidence that bundling several neuromonitoring devices, termed multimodal monitoring, is more beneficial compared to monitoring individual parameters as each may capture different and complementary aspects of cerebral physiology to provide a comprehensive picture that can help guide management.
FRONTIERS IN NEUROLOGY
(2023)
Review
Clinical Neurology
Teodor M. Svedung Wettervik, Anders Lewen, Per Enblad
Summary: Neurointensive care plays a crucial role in preventing secondary insults and reducing secondary brain injury. Traditional management focuses on avoiding high intracranial pressure and maintaining adequate cerebral perfusion pressure, but traumatic brain injury is highly heterogeneous. Introduction of multimodality monitoring has enhanced understanding of complex pathophysiology.
FRONTIERS IN NEUROLOGY
(2021)
Article
Medical Laboratory Technology
Sofie Colman, Sofie Dhaese, Veronique Stove, Jan J. De Waele, Alain G. Verstraete
Summary: Although measurable, the correlation between oral fluid concentrations and plasma concentrations of piperacillin and meropenem in non-intubated ICU patients is poor for piperacillin and better for meropenem, indicating that oral fluid may not be a suitable alternative matrix for therapeutic drug monitoring of these antibiotics. Difficulty in collecting oral fluid samples was also observed in this patient population.
CLINICA CHIMICA ACTA
(2021)
Article
Clinical Neurology
Samuel Lenell, Anders Lewen, Timothy Howells, Per Enblad
Summary: Elderly patients (≥ 65 years) show different patterns of secondary insults/physiological variables compared to younger patients, with high SBP (> 180) associated with favorable outcomes in the elderly. However, the same SBP threshold is associated with increased odds of death in younger patients. This suggests that blood pressure management may need to be adjusted based on age groups.
ACTA NEUROCHIRURGICA
(2022)
Article
Neurosciences
Stina Mauritzon, Fredrik Ginstman, Jan Hillman, Karin Wardell
Summary: Cerebral blood flow is monitored in the neurointensive care unit (NICU) to prevent further brain damage. This study used laser Doppler flowmetry to continuously monitor brain microcirculation and successfully identified physiological changes and movement artifacts. The results suggest that continuous monitoring of microvascular blood flow can improve understanding of the injured brain and potentially detect secondary insults earlier.
FRONTIERS IN NEUROSCIENCE
(2022)
Article
Neurosciences
Yanaika S. Hok-A-Hin, Anke A. Dijkstra, Alberto Rabano, Jeroen J. Hoozemans, Lucia Castillo, Harro Seelaar, John C. van Swieten, Yolande A. L. Pijnenburg, Charlotte E. Teunissen, Marta Del Campo
Summary: This study found increased levels of APOL1 in FTLD post-mortem brain tissue, regardless of the pathological subtypes. APOL1 was mainly expressed in neuronal and glial cells, but did not co-localize with pTau or pTDP-43. However, the levels of APOL1 in CSF were comparable between FTD patients and controls, and between pathological subtypes.
NEUROBIOLOGY OF DISEASE
(2022)
Article
Immunology
Anna Wozniak, Lrena Smolka, Aleksandra Dusinska, Weronika Misiag, Mariusz Chabowski
Summary: The aim of this study was to investigate the relationship between the incidence of pressure ulcers and blood lactate levels in intensive care unit patients. Through the analysis of arterial blood lactate levels and pressure ulcer monitoring records of 125 patients, it was found that the incidence of pressure ulcers in ICU patients was consistent with the reported rates in literature. However, no correlation was found between arterial blood lactate levels and the incidence of pressure ulcers. Given the limited sample size, the findings should be interpreted with caution. Larger population studies over a longer period of time are recommended to further explore this issue.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Article
Infectious Diseases
Christoph Tiede, Ute Chiriac, Daniel Dubinski, Florian J. Raimann, Otto R. Frey, Anka C. Roehr, Anna Wieduwilt, Michael Eibach, Natalie Filmann, Christian Senft, Kai Zacharowski, Volker Seifert, Jan Mersmann
Summary: The study presents a retrospective analysis of continuous infusion and TDM-guided dose optimization in ventriculitis patients, showing that dose adjustment based on TDM can ensure sufficient CSF concentrations for all patients within 48 hours of treatment.
Article
Anesthesiology
Eamon P. Raith, Astri M. Luoma, Mark Earl, Meera Dalal, Sandra Fairley, Felicity Fox, Katharine Hunt, Charlotte Willett, Ugan Reddy
Summary: This report details the experience of repurposing a neuro-ICU for managing severely ill COVID-19 patients in the UK during the pandemic. The ICU capacity was successfully increased to accommodate COVID-19 patients while still maintaining access for urgent neurological cases. Increase in ICU beds and mechanical ventilation capacity led to a higher acceptance rate of critically ill patients during the pandemic.
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
(2021)
Article
Infectious Diseases
Jill Combrinck, Phophi Tshavhungwe, Ursula Rohlwink, Nico Enslin, Nqobile Thango, Jed Lazarus, Katie Kriegler, Sandra Castel, Noha Abdelgawad, Helen Mcilleron, Paolo Denti, Lubbe Wiesner, Anthony Figaji
Summary: This study found significant differences in drug concentrations between spinal cerebrospinal fluid (CSF) and ventricular CSF in patients with tuberculous meningitis (TBM). The concentrations of total protein and rifampicin were higher in spinal CSF than in ventricular CSF.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Article
Clinical Neurology
Anna Hofmann, Corinna Blum, Constanze Single, Kamal Adeyemi, Patricia Schwarz, Vasileios Siokas, Tim W. W. Rattay, Helene A. A. Haeberle, Reimer Riessen, Bettina Brendel, Iris Haug, Ruth Boesel, Manola Zago, Peter Martus, Ulf Ziemann, Annerose Mengel, Katharina Feil
Summary: This study aims to assess the neuroenhancing effects of amantadine in non-traumatic neurointensive patients with persisting coma. An open-label pilot study will recruit 43 patients meeting the clinical criteria and administer amantadine treatment. The primary endpoint is improvement in Glasgow Coma Scale. The results will help evaluate the clinical utility of amantadine for treating persisting coma in non-traumatic brain injury.
Article
Biochemistry & Molecular Biology
John C. O'Donnell, Kevin D. Browne, Svetlana Kvint, Leah Makaron, Michael R. Grovola, Saarang Karandikar, Todd J. Kilbaugh, D. Kacy Cullen, Dmitriy Petrov
Summary: Neurocritical care has significant impact on outcomes after brain injury, but is rarely used in preclinical studies. We created a neurointensive care unit for swine to account for neurocritical care, collect monitoring data, and validate therapeutics in this unique space. Our multidisciplinary team developed neurocritical care techniques and medical management for swine following brain injury. Incorporating neurocritical care in swine studies will improve translational research for brain injury.
Article
Clinical Neurology
Rongqing Li, Jinxia Jiang, Yu Song, Jianan Zhang, Yawen Wu, Lingzhi Wu, Xiaoping Zhu, Li Zeng
Summary: This study aimed to explore the risk factors for lower extremity DVT in neurointensive care unit patients and develop a reliable predictive model. The study found that age, GCS score, D-dimer level, muscle strength, and infection were independent predictors for lower extremity DVT.
FRONTIERS IN NEUROLOGY
(2022)
Article
Pharmacology & Pharmacy
David Busse, Philipp Simon, Lisa Schmitt, David Petroff, Christoph Dorn, Arne Dietrich, Markus Zeitlinger, Wilhelm Huisinga, Robin Michelet, Hermann Wrigge, Charlotte Kloft
Summary: This study found that higher doses and prolonged infusions are needed for obese and non-obese patients at MIC values equal to or greater than 2 mg/L. Higher PTA was achieved with prolonged infusions in obese patients and with continuous infusions in non-obese patients.
CLINICAL PHARMACOKINETICS
(2022)
Article
Pharmacology & Pharmacy
Zoe Oesterreicher, Sabine Eberl, Beatrix Wulkersdorfer, Peter Matzneller, Claudia Eder, Esther van Duijn, Wouter H. J. Vaes, Birgit Reiter, Thomas Stimpfl, Walter Jager, Alina Nussbaumer-Proell, Daniela Marhofer, Peter Marhofer, Oliver Langer, Markus Zeitlinger
Summary: This study confirms the feasibility of microdosing for pharmacokinetic measurements in plasma and subcutaneous tissue, and suggests that microdosing combined with microdialysis is a potentially useful tool in clinical antimicrobial drug development. Further studies are needed to assess its applicability for pulmonary pharmacokinetics with bronchoalveolar lavage.
CLINICAL PHARMACOKINETICS
(2022)
Article
Pharmacology & Pharmacy
Anselm Jorda, Jolanta M. Siller-Matula, Markus Zeitlinger, Bernd Jilma, Georg Gelbenegger
Summary: In patients with COVID-19, higher-dose anticoagulation compared to prophylactic-dose anticoagulation reduces the risk of thromboembolic events but increases the risk of major bleeding, with no significant impact on the risk of death.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Pharmacology & Pharmacy
Hans-Georg Eichler, Mark Trusheim, Brigitte Schwarzer-Daum, Kay Larholt, Markus Zeitlinger, Martin Brunninger, Michael Sherman, David Strutton, Gigi Hirsch
Summary: Basic scientists and drug developers are working on innovations towards precision medicine, but there are challenges in reimbursement and coverage for precision medicines. Stakeholders are exploring new payment models to address these challenges.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Infectious Diseases
Heimo Lagler, Christine Bangert, Tamara Quint, Zoe Osterreicher, Alina Nussbaumer-Proll, Sabine Eberl, Maria Weber, Matthias Karer, Morten O. A. Sommer, Markus Zeitlinger
Summary: This study compared three commonly used methods for sampling Staphylococcus aureus on atopic dermatitis skin lesions and investigated the effectiveness of skin disinfection. The results showed significant differences in quantifying S. aureus load between different sampling methods, highlighting the importance of method selection. Skin disinfection led to a reduction in S. aureus load, but complete eradication was not achieved. This data suggests the need for further clinical studies on the effectiveness of topical anti-staphylococcal antibiotics and consideration of alternative disinfection regimes in atopic dermatitis patients.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2022)
Article
Oncology
Anne Weiss, Emilie Delavenne, Carina Matias, Heimo Lagler, Daniel Simon, Ping Li, Jon U. Hansen, Teresa Pires dos Santos, Bimal Jana, Petra Priemel, Christine Bangert, Martin Bauer, Sabine Eberl, Alina Nussbaumer-Proell, Zoe Anne Oesterreicher, Peter Matzneller, Tamara Quint, Maria Weber, Hanne Morck Nielsen, Thomas Rades, Helle Krogh Johansen, Henrik Westh, Wooseong Kim, Eleftherios Mylonakis, Christian Friis, Luca Guardabassi, John Pace, Carina Vingsbo Lundberg, Fatima M'Zali, Pascal Butty, Nikolaj Sorensen, Henrik Bjorn Nielsen, Rasmus Toft-Kehler, Emma Guttman-Yassky, Georg Stingl, Markus Zeitlinger, Morten Sommer
Summary: The study found that ATx201 OINTMENT 2% is an effective treatment for reducing Staphylococcus aureus colonization in patients with atopic dermatitis, while increasing the diversity of the skin microbiome.
CLINICAL AND TRANSLATIONAL MEDICINE
(2022)
Article
Microbiology
Mohammad H. Alshaer, Brooke Barlow, Nicole Maranchick, Miriam Moser, Leon Gramss, Heinz Burgmann, Valentin Al Jalali, Michael Woelfl-Duchek, Walter Jaeger, Stefan Poschner, Walter Ploechl, Andrea Reinprecht, Karl Roessler, Andreas Gruber, Markus Zeitlinger, Charles A. Peloquin, Arthur Hosmann
Summary: This study investigated the pharmacokinetics of Meropenem in the central nervous system and simulated dosing regimens. Continuous infusion was found to be more effective in achieving therapeutic targets compared to intermittent infusion, based on drug concentration measurements and brain tissue samples.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2022)
Article
Pharmacology & Pharmacy
Felix Bergmann, Peter Matzneller, Maria Weber, Lusine Yeghiazaryan, Thorsten Fuereder, Thomas Weber, Markus Zeitlinger
Summary: Improving medical care, contributing to scientific research, and trusting treating physicians are the main motives for clinical trial participation among participants. Older patients have higher expectations of receiving optimal treatment during participation. Healthy volunteers with financial motives have participated in more clinical trials. Participants have high trust in medical staff and government research institutions, but low trust in pharmaceutical and health insurance companies.
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Article
Pharmacology & Pharmacy
Christoph Dorn, David Petroff, Alexander Kratzer, Frieder Kees, Charlotte Kloft, Markus Zeitlinger, Hermann Wrigge, Philipp Simon
Summary: This study investigated the concentrations of Tigecycline in plasma and subcutaneous tissue in obese patients compared to non-obese patients. The results showed that the concentrations of Tigecycline were lower in obese patients, indicating a need for an increased dose.
EUROPEAN JOURNAL OF DRUG METABOLISM AND PHARMACOKINETICS
(2022)
Article
Infectious Diseases
K. Iqbal, H. Rohde, J. Huang, T. Tikiso, L. F. Amann, M. Zeitlinger, S. G. Wicha
Summary: This study assessed the pharmacokinetic-pharmacodynamic (PKPD) relationship for tedizolid against Enterococcus in the hollow-fibre infection model. The results indicated that the recommended human dose was insufficient to suppress bacterial growth.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2022)
Article
Pharmacology & Pharmacy
Valentin al Jalali, Martin Bauer, Michael Woelfl-Duchek, Maysa Sarhan, Sebastian G. Wicha, Stefan Poschner, Walter Jaeger, Franz Koenig, Christoph Male, Markus Zeitlinger
Summary: This study developed and validated modified microdialysis (MD) catheters for obtaining concentration-time profiles of antibiotics in pediatric patients. The study showed good alignment between MD and plasma measurements and established a pharmacometric model. This proof-of-concept study is encouraging for future application of MD in pediatric patients.
CLINICAL PHARMACOKINETICS
(2023)
Article
Infectious Diseases
Maria Sanz-Codina, Sebastian G. Wicha, Beatrix Wulkersdorfer, Valentin Al Jalali, Wisse Van Os, Matthias G. Vossen, Martin Bauer, Edith Lackner, Christoph Dorn, Markus Zeitlinger
Summary: This clinical study compared in vitro and in vivo methods to determine the protein binding (PB) of ceftriaxone. The results showed significant differences in PB between the two methods, especially during the distribution phase. The study also found that the PB of ceftriaxone was nonlinear and saturable, and the choice of PB determination method could impact the breakpoint determination and dose optimization of antibiotics.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Article
Chemistry, Medicinal
Sebastian Schnaubelt, Felix Eibensteiner, Julia Oppenauer, Daniel Tihanyi, Marco Neymayer, Roman Brock, Andrea Kornfehl, Christoph Veigl, Valentin Al Jalali, Sonja Anders, Barbara Steinlechner, Hans Domanovits, Patrick Sulzgruber
Summary: Push-dose Landiolol was found to be safe and effective in achieving rate and rhythm control in critically ill ICU patients with sudden-onset non-compensatory supraventricular tachycardia. It had a significant impact on heart rate but no clinically relevant impact on blood pressure. No adverse events were observed.
Article
Pharmacology & Pharmacy
Lisa Christina Horvath, Felix Bergmann, Arthur Hosmann, Stefan Greisenegger, Kerstin Kammerer, Bernd Jilma, Jolanta M. Siller-Matula, Markus Zeitlinger, Georg Gelbenegger, Anselm Jorda
Summary: This study compared the efficacy between thrombectomy alone and thrombectomy with intravenous thrombolysis in patients with acute ischemic stroke due to large-vessel occlusion. The results showed that although combined treatment increased successful reperfusion, it also increased the risk of overall intracranial hemorrhage. Thrombectomy alone was non-inferior to combined treatment in terms of functional independence at a 10% non-inferiority margin, but not at a 5% inferiority margin.
VASCULAR PHARMACOLOGY
(2023)