Markus Alb

Publications of Markus Alb

• Cardiopulmonary function and oxygen delivery during total liquid ventilation.

  Authors: Charalambos Tsagogiorgas, Markus Alb, Peter Herrmann, Michael Quintel, Juergen P Meinhardt

  Pediatric pulmonology. 05/2011; 46(10):964-75.

  Total liquid ventilation (TLV) with perfluorocarbons has shown to improve cardiopulmonary function in the injured and immature lung; however there remains controversy over the normal lung.Total liquid ventilation (TLV) with perfluorocarbons has shown to improve cardiopulmonary function in the injured and immature lung; however there remains controversy over the normal lung. Hemodynamic effects of TLV in the normal lung currently remain undetermined. This study compared changes in cardiopulmonary and circulatory function caused by either liquid or gas tidal volume ventilation. In a prospective, controlled study, 12 non-injured anesthetized, adult New Zealand rabbits were primarily conventionally gas-ventilated (CGV). After instrumentation for continuous recording of arterial (AP), central venous (CVP), left artrial (LAP), pulmonary arterial pressures (PAP), and cardiac output (CO) animals were randomized into (1) CGV group and (2) TLV group. In the TLV group partial liquid ventilation was initiated with instillation of perfluoroctylbromide (12 ml/kg). After 15 min, TLV was established for 3 hr applying a volume-controlled, pressure-limited, time-cycled ventilation mode using a double-piston configured TLV. Controls (CGV) remained gas-ventilated throughout the experiment. During TLV, heart rate, CO, PAP, MAP, CVP, and LAP as well as derived hemodynamic variables, arterial and mixed venous blood gases, oxygen delivery, PVR, and SVR did not differ significantly compared to CGV. Liquid tidal volumes suitable for long-term TLV in non-injured rabbits do not significantly impair CO, blood pressure, and oxygen dynamics when compared to CGV.

• Image findings of patients with H1N1 virus pneumonia and acute respiratory failure.

  Authors: Thomas Henzler, Mathias Meyer, Armin Kalenka, Markus Alb, Gerald Schmid-Bindert, Sönke Bartling, Joseph U Schoepf, Stefan O Schoenberg, Christian Fink

  Academic radiology. 06/2010; 17(6):681-5.

  The aim of this study was to assess the findings of chest radiography and high-resolution computed tomography in patients requiring intensive care unit treatment for severe H1N1 virus pneumonia. InThe aim of this study was to assess the findings of chest radiography and high-resolution computed tomography in patients requiring intensive care unit treatment for severe H1N1 virus pneumonia. In 2009, 10 patients required treatment in an intensive care unit for confirmed H1N1 pneumonia. All patients underwent chest radiography and high-resolution computed tomography. All 10 patients required mechanical ventilation because of respiratory failure. Nine patients presented with severe acute respiratory distress syndrome, and one patient died. Four patients underwent extracorporeal membrane oxygenation (ECMO) therapy. The results of chest radiography and high-resolution computed tomographic scans of these patients were systematically analyzed. The mean age of all patients was 44.1 +/- 12.3 years. All 10 patients showed abnormal results on chest radiography. The radiographic abnormalities were bilateral and multifocal in 10 patients. The predominant radiographic findings were consolidations (n = 9), ground-glass opacities (n = 8), and reticular opacities (n = 2). The most frequent computed tomographic findings at presentation consisted of bilateral ground-glass opacities (n = 9), pleural effusion (n = 9), areas of consolidation (n = 8), interstitial marking (n = 8), and crazy paving (n = 4). All patients undergoing ECMO therapy showed extensive bilateral ground-glass opacities, multifocal areas of consolidation, and crazy paving. Pleural effusion was present in three of four patients undergoing ECMO therapy. Patients requiring treatment in an intensive care unit for severe H1N1 pneumonia are at high risk for developing acute respiratory distress syndrome and frequently require ECMO therapy.

• Effects of positive end-expiratory pressure on respiratory function and hemodynamics in patients with acute respiratory failure with and without intra-abdominal hypertension: a pilot study.

  Authors: Joerg Krebs, Paolo Pelosi, Charalambos Tsagogiorgas, Markus Alb, Thomas Luecke

  Critical care (London, England). 10/2009; 13(5):R160.

  ABSTRACT: INTRODUCTION: To investigate the effects of positive end-expiratory pressure (PEEP) on respiratory function and hemodynamics in patients with Acute Lung Injury (ALI) or Acute RespiratoryABSTRACT: INTRODUCTION: To investigate the effects of positive end-expiratory pressure (PEEP) on respiratory function and hemodynamics in patients with Acute Lung Injury (ALI) or Acute Respiratory Distress Syndrome (ARDS) with normal intra-abdominal pressure (IAP < 12 mmHg) and with intra-abdominal hypertension (IAH, defined as IAP [greater than or equal to] 12 mmHg) during lung protective ventilation and a decremental PEEP, a prospective, observational clinical pilot study was performed. METHODS: Twenty patients with ALI/ARDS with normal IAP or IAH treated in the surgical intensive care unit in a university hospital were studied. The mean IAP in patients with IAH and normal IAP was 16+/-3 mmHg and 8+/-3 mmHg, respectively (P < 0.001). At different PEEP levels (5,10,15,20cm H2O) we measured respiratory mechanics, partitioned into its lung and chest wall components, alveolar recruitment, gas-exchange, hemodynamics, extravascular lung water index (EVLWI) and intrathoracic blood volume index (ITBVI). RESULTS: We found that ALI/ARDS patients with IAH, as compared to those with normal IAP, were characterized by: a) no differences in gas-exchange, respiratory mechanics, partitioned into its lung and chest wall components, as well as hemodynamics and EVLWI/ITBVI; b) decreased elastance of the respiratory system and the lung, but no differences in alveolar recruitment and oxygenation or hemodynamics, when PEEP was increased at 10 and 15cm H2O; c) at higher levels of PEEP, EVLWI was lower in ALI/ARDS patients with IAH as compared with those with normal IAP. CONCLUSIONS: IAH, within the limits of IAP measured in the present study, does not affect interpretation of respiratory mechanics, alveolar recruitment and hemodynamics.

• [Critical illness polyneuropathy and myopathy. Pathogenesis and diagnostic]

  Authors: Markus Alb, Stephanie Hirner, Thomas Luecke

  Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS. 05/2007; 42(4):250-8.

  Since the first description of Bolton et al., critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are increasingly observed as a complication in intensive care patients. CIP andSince the first description of Bolton et al., critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are increasingly observed as a complication in intensive care patients. CIP and CIM commonly occur in patients with an ICU length of stay exceeding one week. Typically, these patients show weakness of the limbs and difficulties in weaning from the respirator. Neurological and electrophysiological examinations as well as muscle biopsies if myopathy is of concern may help to characterize and identify polyneuropathy and myopathy.