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Introduction
Additional affiliations
June 2009 - March 2014
June 2009 - present
University Hospital Carl Gustav Carus Dresden
Position
- Consultant
Publications
Publications (54)
Zusammenfassung
Die nosokomiale Pneumonie bleibt eine häufige Komplikation von Krankenhausaufenthalten. Die meisten Daten liegen zur beatmungsassoziierten Pneumonie vor, aber auch auf Normalstationen ist vermehrt mit dieser Erkrankung zu rechnen. Problematisch ist die Zunahme von Infektionen mit multiresistenten Erregern (MRE). Diese erschwert die...
Background
Uncertainty persists regarding the optimal ventilatory strategy in trauma patients developing acute respiratory distress syndrome (ARDS). This work aims to assess the effects of two mechanical ventilation strategies with high positive end-expiratory pressure (PEEP) in experimental ARDS following blunt chest trauma.
Methods
Twenty-six ju...
This study aims at comparing the very short-term effects of conventional and noisy (variable) pressure support ventilation (PSV) in mechanically ventilated patients with acute hypoxemic respiratory failure.
13 mechanically ventilated patients with acute hypoxemic respiratory failure were enrolled in this monocentric, randomized crossover study. Pat...
Objectives:
Studies correlating the arterial partial pressure of oxygen to the fraction of nonaerated lung assessed by CT shunt yielded inconsistent results. We systematically analyzed this relationship and scrutinized key methodological factors that may compromise it. We hypothesized that both physiological shunt and the ratio between PaO2 and th...
Background:
Nosocomial pneumonia is among the most common types of infection in hospitalized patients. The increasing prevalence of multi-drug resistant organisms (MDROs) in recent years points to the need for an up-to-date clinical guideline.
Methods:
An interdisciplinary S3 guideline was created on the basis of a systematic literature review i...
Bei der Entstehung und Etablierung der Intensivmedizin kann der Chirurgie die dominierende Rolle zugeschrieben werden. Die ersten Überwachungsstationen entwickelten sich in chirurgischen Universitätskliniken. Zahlreiche wissenschaftliche Erkenntnisse und interventionelle Maßnahmen haben Chirurgen zur Intensivmedizin beigetragen und chirurgische Kra...
The dominant role for the emergence and establishment of intensive care medicine can be attributed to surgery. The first critical care units were developed in surgical university hospitals. Numerous scientific findings and interventional procedures have been contributed to intensive care medicine by surgeons and surgical disease symptoms shaped the...
The creation of a center for interdisciplinary operative intensive care through the fusion of several smaller intensive care units from various specialties is mainly driven by economic reasons. To specify some conditions for making such a fusion less expensive and to identify the impact of larger intensive care units on the quality of patients' tre...
Quantitative computed tomography (qCT)-based assessment of total lung weight (Mlung) has the potential to differentiate atelectasis from consolidation and could thus provide valuable information for managing trauma patients fulfilling commonly used criteria for acute lung injury (ALI). We hypothesized that qCT would identify atelectasis as a freque...
Clinical applications of quantitative computed tomography (qCT) in patients with pulmonary opacifications are hindered by the radiation exposure and by the arduous manual image processing. We hypothesized that extrapolation from only ten thoracic CT sections will provide reliable information on the aeration of the entire lung.
CTs of 72 patients wi...
Ein 45-jahriger Urlaubsgast bietet wenige Tage nach Anreise auf der Ferieninsel Lanzarote die Symptomatik eines akuten Abdomens mit Bewusstseinstrubung und Fieber. Die Notfall-Laparotomie bleibt ohne Nachweis eines Auslosers des Krankheitsbildes. Bei fortschreitender Zustandsverschlechterung, Sepsis und Mehrorgandysfunktionssyndrom (MODS) wird der...
A forty-five year old male tourist suffers a febrile illness, delirium and severe abdominal pain on the fifth day of his holiday trip to the Canary Islands (Spain). After hospitalization he presents a surgical abdomen which requires emergency laparotomy however without detectable pathology. Progressing critical illness and septic shock leads to mul...
Targeted monitoring of analgesia, sedation and delirium, as well as their appropriate management in critically ill patients is a standard of care in intensive care medicine. With the undisputed advantages of goal-oriented therapy established, there was a need to develop our own guidelines on analgesia and sedation in intensive care in Germany and t...
Perioperative immunonutrition is aiming at modulating altered immunological and metabolic functions in the context of major surgery. It is defined as the supplementation of constitutionally essential substrates such as glutamine, arginine, omega-3-fatty acids or nucleotides. The application of such formula is recommended for patients undergoing maj...
A high level of interdisciplinary teamwork on the part of surgeons, anaesthesiologists, critical care physicians and radiologists is of the essence in the care of multiple trauma patients. Surgical and medical procedures and diagnostic measures require constant coordination and adjustment. Regular re-evaluation of the patient's status is mandatory...
Mechanical ventilation in critical ill patients can result in the superimposion of iatrogenic lung injury and a worsening of morbidity and mortality. Underlying pathophysiological mechanisms are high inspiratory pressures (barotrauma), high tidal volumes (volutrauma), shear stress (atelectrauma) and local or generalized inflammation (biotrauma). Pr...
The increase in intra-abdominal pressure may be followed by a renal, gut, respiratory and cardial dysfunction and an increase in intra-cranial pressure. The review focuses risk factors and pathophysiological consequences of intra-abdominal hypertension and of abdominal compartment syndrome. Patients with intra-abdominal hypertension and abdominal c...
Ein pathologischer Anstieg des intraabdominellen Drucks kann Funktionsstorungen der Niere, des Darms, der Lunge, des Herzens, aber auch einen erhohten intrakraniellen Druck nach sich ziehen. Risikofaktoren und pathophysiologische Konsequenzen der intraabdominellen Hypertonie und des abdominellen Kompartmentsyndroms werden diskutiert. Es wird auf an...
Ein lungenschonendes maschinelles Beatmungsregime mit Drucklimitierung, kleinen Tidalvolumina (6–8ml/kg ideales KG), adäquatem
positiven endexspiratorischen Druck („positive end-expiratory pressure”, PEEP) und frühen Rekrutierungsmanövern ist von zentraler
Bedeutung für die erfolgreiche Behandlung des akuten Lungenversagens („acute lung injury“, AL...
Basic therapy of acute lung injury (ALI) covers a pressure-limited lung protective mechanical ventilation with low tidal volumes (6-8 ml/kg ideal body weight), adequate positive end-expiratory pressure (PEEP) combined with early recruitment maneuvers and a restrictive fluid management (in hypoproteinemic patients preferably with albumin and diureti...
Perioperative immunonutrition is aiming at modulating altered immunological and metabolic functions in the context of major surgery. It is defined as the supplementation of constitutionally essential substrates such as glutamine, arginine, omega-3-fatty acids or nucleotides. The application of such formula is recommended for patients undergoing maj...
Lung hyperinflation may be assessed by computed tomography (CT). As shown for patients with emphysema, however, CT image reconstruction affects quantification of hyperinflation. We studied the impact of reconstruction parameters on hyperinflation measurements in mechanically ventilated (MV) patients.
Observational analysis.
A University hospital-af...
The present prospective study was designed to evaluate the effectiveness and safety of prothrombin complex concentrate (PCC) for emergency reversal of oral anticoagulation with phenprocoumon, a long-acting coumarin. Patients were eligible for study entry if they required emergency reversal of phenprocoumon anticoagulation because they needed invasi...
To present and discuss the rationale and possible benefits of timely alveolar recruitment in early post-traumatic acute respiratory distress syndrome.
A 17-year-old patient who had sustained blunt thoracic trauma presented with severe hypoxaemia on admission and whole body computed tomography showed pulmonary contusion and substantial bilateral ate...
BACKGROUND: Recombinant activated factor VII (rFVIIa, NovoSeven®) has been registered for the treatment of bleeding episodes in patients with inherited or acquired haemophilia A or B with
inhibitors. The definite spectrum of indications for rFVIIa has not yet been established. METHODS: We describe a case of treatment
of acute haemorrhage in a patie...
Although the frequency of major surgical procedures in elderly patients is increasing, the impact of age as an independent factor on in-hospital mortality and capacity planning is uncertain. Therefore, we analyzed how age, gender, number of diagnoses, and number of operations per patient are reflecting the demographic changes going on in the last d...
Investigation of oxygenation and lung aeration during mechanical ventilation according to the open lung concept in patients with acute lung injury or acute respiratory distress syndrome.
Retrospective analysis.
Surgical intensive care unit of a university hospital.
We retrospectively identified 17 patients with acute lung injury/acute respiratory d...
Multislice spiral CT plays a growing role in assessing acute polytraumatized patients. CT Viewer software offers fast and efficient reconstruction of the large CT data sets.
Early thyroidectomy is the treatment of choice for thyrotoxic storm in patients with thyroid autonomy often induced by iodine. However, older patients who are mostly affected by this condition often have underlying chronic cardiopulmonary diseases, apparently contradicting surgical intervention. The published evidence for suitable treatment strateg...
Traumatic herniation of the lung is uncommon. We report a patient suffering from multiple injuries including severe pulmonary
contusion and traumatic parasternal lung herniation, who developed acute respiratory distress syndrome. In spite of the lung
herniation, we used mechanical ventilation according to the Open Lung Concept. Oxygenation improved...
To evaluate the efficacy and safety of intravenous infusions of an improved prothrombin complex concentrate (PCC) formulation.
Twenty-two adults with haemostatic defects due to severe liver disease (Quick's test 50%), which required rapid haemostasis because of bleeding or before urgent surgery or invasive intervention. Laboratory follow-up, includ...
The growing knowledge on the pathophysiological role of endotoxin, cytokines and ist regulation by soluble receptors stimulated efforts for a new infectional immunological monitoring for patients at risk on intensive care unit. In critically ill patients after major surgery or trauma with or without severe sepsis and after allogeneic liver and kidn...
In the early clinical phase the comprehensive imaging of patients with multiple trauma using helical CT is already established. Aim of this study was to assess whether MSCT may improve the patient management and the diagnostic results. The procedure is designed as follows: after life-thretening treatment x-ray of chest and ultrasound are carried ou...
Die klinische Erstversorgung Polytraumatisierter schließt inzwischen in vielen Unfallkliniken den frühzeitigen Einsatz der Spiral-CT ein. Kann die neuerlich eingeführte Mehrschicht-Spiral-CT Ergebnisse und Patientenmanagement weiter verbessern? Nach lebensrettenden Sofortmaßnahmen, Thoraxröntgen und Notsonographie im Schockraum erfolgte die CT: Von...
The pathomorphological substratum of the pulmonary contusion is a parenchymatous hemorrhage followed by interstitial and alveolar edema, finally resulting in a severe damage of the surfactant system. The pathophysiological consequence is an imbalance between ventilation and perfusion, which causes the clinical finding of hypoxia.
Between December 1...
Die frühzeitige klinische Diagnosestellung ist das entscheidende Kriterium zur Beherrschung einer fulminant verlaufenden Weichteilinfektion in Form der Subpektoralphlegmone. Die Erfassung von Prädisposition und Anamnese sind ebenfalls gleichrangig bei der einleitenden Behandlung von Infektionen, um herauszukristallisieren, wo Risikofaktoren erfüllt...
Objective The aim of our study was to investigate the effects of these new strategies [the new approach by Amato et al. (NAA) and the modified “open lung” concept (OLC)] on cerebral perfusion using an animal model. Method After inducing ARDS with a thorax contusion, 38 pigs (German Edelschwein), divided into two groups, were mechanically ventilated...
Penetrierende Thoraxläsionen sind in Europa im Vergleich zu den angloamerikanischen Ländern selten. Hervorgerufen werden sie durch Stich- oder Schussverletzungen. Sämtliche intrathorakal gelegenen anatomischen Strukturen können in Mitleidenschaft gezogen werden. Am häufigsten treten Pneumo- und Hämatothorax sowie Lungenparenchymverletzungen auf. An...
We report an analysis of 22 patients with pyoderma fistulans sinifica disease underwent different surgical treatment. Prefering radical excision of the relevant skin area and simultaneous mesh-graft covering, secondary suture or mesh grafting were also performed. The prognosis is favourable, if the disease is diagnosed early enough and treated surg...
With a case report the specific diagnostic and therapeutic problems of cervicomediastinal bleeding after lesion of the perioesophageal vein and spontaneous closure are shown in view of the clinical course.
