Dierk A Vagts

Publications (73) View all

• Chapter: M

  Peter Biro, Dierk A. Vagts, Uta Emmig, Thomas Pasch
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  ABSTRACT: Familiäres Narkose-Hyperthermie-Sy, maligne Hyperpyrexie, engl. »malignant hyperthermia, human stress syndrome«.
  07/2010: pages 155-186;
• Source

  Available from: Kai Zacharowski

  Article: Bbeta15-42 (FX06) reduces pulmonary, myocardial, liver, and small intestine damage in a pig model of hemorrhagic shock and reperfusion.

  Jan P Roesner, Peter Petzelbauer, Alexander Koch, Nguyen Tran, Thomas Iber, Dierk A Vagts, Thomas W L Scheeren, Brigitte Vollmar, Gabriele E F Nöldge-Schomburg, Kai Zacharowski
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  ABSTRACT: The fibrin-derived peptide Bbeta15-42 (also called FX06) has been shown to reduce myocardial infarct size following ischemia/reperfusion. Hemorrhagic shock (HS) followed by volume resuscitation represents a similar scenario, whereby a whole organism is vulnerable to reperfusion injury. We subjected male farm-bred landrace pigs ( approximately 30 kg) to HS by withdrawing blood to a mean arterial pressure of 40 mm Hg for 60 minutes. Pigs were then resuscitated with shed blood and crystalloids for 60 minutes, and at this time, FX06 (2.4 mg/kg, n = 8) or vehicle control (phosphate buffered saline; 2.4 mg/kg, n = 7) was injected as an intravenous bolus. University hospital laboratory. Anesthetized male farm-bred landrace pigs. Data are presented as mean +/- sd. Five hours after resuscitation, controls presented acute lung injury (Pao2/Fio2-ratio <300 mm Hg; extra-vascular lung water index (marker for lung injury): 9.0 +/- 1.8 mL/kg) and myocardial dysfunction/damage (cardiac index: 4.3 +/- 0.25 L/min/m; stroke volume index: 30 +/- 6 mL/m; cardiac TnT levels: 0.58 +/- 0.25 ng/mL). In contrast, FX06-treated animals showed significantly improved pulmonary and circulatory function (Pao2/Fio2-ratio >*400 mm Hg; extra-vascular lung water index: *5.2 +/- 2.1 mL/kg, cardiac index: *6.3 +/- 1.4 L/min/m; stroke volume index: *51 +/- 11 mL/m; cardiac TnT levels: *0.11 +/- 0.09 ng/mL; *p < 0.05). Also, tissue oxygenation (tpO2; mm Hg) was significantly improved during reperfusion in FX06-treated pigs when compared with controls (liver 51 +/- 4 vs. *65 +/- 4; serosa 44 +/- 5 vs. *55 +/- 7; mucosa 14 +/- 4 vs. *26 +/- 4). Finally, FX06 reduced accumulation of myeloperoxidase-positive cells (mainly neutrophils) in myocardium, liver, and small intestine and reduced interleukin-6 plasma levels (*p < 0.05; compared with controls). We conclude that in a pig model of HS and reperfusion, administration of FX06 during reperfusion protects shock- susceptible organs such as heart, lung, liver, and small intestine.
  Critical care medicine 01/2010; 37(2):598-605. · 6.37 Impact Factor
• Article: [Delivering bad news: How to improve communication with relatives].

  Nicola Schindler, Achim W Schindler, Dierk Vagts
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  ABSTRACT: Communicating bad news, e.g. the message of the death of a close relative, is not a straight forward task for physicians. Typical common inter-speaking attitudes often fail in this difficult situation. Even simple rules and cooking recipes are seldom helpful. Medical training unfortunately does not cover this topic sufficiently. Hence physicians have to learn from trial and error. However, this trial-and-error-method may provoke an unfavourable course of conversation. Training and knowledge of evidence-based rules can improve communicative faculties and facilitate delivering bad news.
  ains · Anästhesiologie · Intensivmedizin 10/2009; 44(10):700-4. · 0.41 Impact Factor
• Source

  Available from: Dierk A Vagts

  Article: Thoracic epidural anesthesia in sepsis--is it harmful or protective?

  Christian Mutz, Dierk A Vagts
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  ABSTRACT: Research interest in epidural anesthesia during sepsis has grown over the past years and studies have tried to determine its mechanisms, which should, theoretically, protect organs and reduce morbidity and mortality. However, different experimental approaches in different animal models have provided conflicting results over whether epidural anesthesia has protective or harmful effects and whether these alter depending on the phase of sepsis, the spread of epidural anesthesia or additional supportive therapies. In the future, more standardized research is necessary to integrate the results of all studies, which have been published.
  Critical care (London, England) 09/2009; 13(5):182. · 4.61 Impact Factor
• Article: Intrathoracic blood volume (ITBV)-guided volume therapy maintains intestinal perfusion and oxygenation despite positive end expiratory pressure (PEEP) ventilation

  T Iber, C Mutz, D Vagts, J Roesner, V Kurzweg, M Hebig, G Noeldge-Schomburg
  Critical Care 04/2012; 8:1-2. · 4.93 Impact Factor