Alf Kozian

Alf Kozian
Otto-von-Guericke-Universität Magdeburg | OvGU · Department of Anaesthesiology and Intensive Care

M.D., Ph.D., Professor

About

78
Publications
23,797
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,967
Citations
Citations since 2017
14 Research Items
1245 Citations
2017201820192020202120222023050100150200
2017201820192020202120222023050100150200
2017201820192020202120222023050100150200
2017201820192020202120222023050100150200
Introduction
Alf Kozian currently works at the Department of Anaesthesiology and Intensive Care, Otto-von-Guericke-Universität Magdeburg. Alf does research in Anaesthetics. Their current project is 'Pharmacokinetics of volatile anesthetics.'
Additional affiliations
February 2005 - present
Uppsala University
Position
  • Researcher
Education
February 2021 - October 2021
Otto-von-Guericke-Universität Magdeburg
Field of study
  • Project Management
January 2020 - January 2020
Otto-von-Guericke-Universität Magdeburg
Field of study
  • Intensive Care Medicine
October 2018 - January 2019
Berufsverband Deutscher Anästhesisten
Field of study
  • Operating room management

Publications

Publications (78)
Chapter
In daily practice, management of patients with thoracic trauma is challenging for the anesthetist. Injuries to airways, lungs, diaphragm, heart, and main vessels are the main difficulties. Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Ther...
Article
Background: Previous studies have established the role of various tissue compartments in the kinetics of inhaled anesthetic uptake and elimination. The role of normal lungs in inhaled anesthetic kinetics is less understood. In juvenile pigs with normal lungs, the authors measured desflurane and sevoflurane washin and washout kinetics at three diff...
Article
Background Kinetics of the uptake of inhaled anesthetics have been well studied, but the kinetics of elimination might be of more practical importance. The objective of the authors’ study was to assess the effect of the overall ventilation/perfusion ratio ( .VA/.Q ), for normal lungs, on elimination kinetics of desflurane and sevoflurane. Methods...
Article
Full-text available
Durch die Leitstelle wird der Hausarzt zu einem 56-jährigen Patienten mit der Diagnose „Atemnot“ gerufen. Bei seinem Eintreffen findet der Arzt einen nach Luft ringenden Patienten mit aufgestützten Armen, am offenen Fenster sitzend, mit einem Dosieraerosol in der Hand vor.
Article
Full-text available
This article contains data on experimental endpoints of a randomized controlled animal trial. Fourteen healthy piglets underwent mechanical ventilation including injurious one-lung ventilation (OLV), seven of them experienced four cycles of remote ischemic preconditioning (RIP) on one hind limb immediately before OLV, seven of them did not receive...
Article
Background: One-lung ventilation (OLV) may result in lung injury due to increased mechanical stress and tidal recruitment. As a result, a pulmonary inflammatory response is induced. The present randomized, controlled, animal experiment was undertaken to assess the effects of remote ischemic preconditioning (RIP) on diffuse alveolar damage and immu...
Article
Full-text available
Background: Transfusion of blood products and mechanical ventilation with injurious settings are considered risk factors for postoperative lung injury in surgical Patients. Methods: A systematic review and individual patient data meta-analysis was done to determine the independent effects of peri-operative transfusion of blood products, intra-op...
Article
Background: Increasing numbers of patients with obstructive lung diseases need anesthesia for surgery. These conditions are associated with pulmonary ventilation/perfusion (VA/Q) mismatch affecting kinetics of volatile anesthetics. Pure shunt might delay uptake of less soluble anesthetic agents but other forms of VA/Q scatter have not yet been exa...
Article
Zusammenfassung In der anästhesiologischen Praxis ist das Thoraxtrauma eine große Herausforderung. Verletzungen von Atemwegen, Lunge, Zwerchfell, Herz und großen thorakalen Gefäßen sind die vorherrschenden Probleme. Art und Ausmaß des chirurgischen Eingriffs sowie Wirkungen von Anästhetika und mechanischer Ventilation auf die pulmonale und kardiale...
Article
Full-text available
Background: Combined epidural analgesia (EA) and patient controlled analgesia (PCA) for postoperative pain control after total knee arthroplasty (TKA) is well established. Previous studies demonstrated the effectiveness of femoral nerve block (FNB) in combination with PCA. This study compares clinical efficiency and adverse events of pain therapy o...
Conference Paper
Full-text available
One-lung ventilation (OLV) results in alveolar injury due to increased mechanical stress, atelectasis formation, and tidal recruitment [1]. An inflammatory response is induced in the ventilated lung characterized by leukocyte recruitment and neutrophil dependent tissue destruction. Remote ischemic preconditioning (RIP), in which short episodes of i...
Conference Paper
Full-text available
The pharmacokinetics of desflurane (DES) at 1MAC is impaired by methacholine (MCh) induced ventilation/perfusion (VA/Q) mismatch [1]. The rise and decline of the arterial concentrations were decreased by bronchoconstriction during uptake and elimination. DES has the lowest solubility of modern volatile anesthetics (0.35 in pig blood) followed by se...
Conference Paper
Full-text available
The main factors determining alveolar and subsequent blood concentrations of inhaled anesthetics are alveolar ventilation and pulmonary perfusion (VA/Q), the latter essentially equal to cardiac output. The changes of uptake and elimination of a volatile based on uneven distribution of ventilation and/or perfusion have been demonstrated [1]. The sol...
Article
Full-text available
Modern thoracic surgery with its emerging focus on minimally invasive techniques requires intraoperative one-lung ventilation to achieve optimal surgical exposure. The double-lumen tube has been considered to be the golden standard for almost 60 years; however, new indications and surgical techniques in thoracic, cardiac, esophageal and ventral spi...
Article
In daily practice, acute and chronic pulmonary diseases are common issues presenting to the anesthetist. Respiratory physiology in general is affected by both general and regional anesthesia, which results in an increased number of perioperative complications in pulmonary risk patients. Therefore, anesthetic management of patients with bronchial as...
Article
Background: Protective mechanical ventilation strategies using low tidal volume or high levels of positive end-expiratory pressure (PEEP) improve outcomes for patients who have had surgery. The role of the driving pressure, which is the difference between the plateau pressure and the level of positive end-expiratory pressure is not known. We inves...
Article
Full-text available
The data of a corresponding animal experiment demonstrates that nebulized methacholine (MCh) induced severe bronchoconstriction and significant inhomogeneous ventilation and pulmonary perfusion (V̇A/Q̇) distribution in pigs, which is similar to findings in human asthma. The inhalation of MCh induced bronchoconstriction and delayed both uptake and e...
Article
Full-text available
Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. Randomized con...
Article
Full-text available
The mean age of patients presenting for thoracic surgery is rising steadily, associated with an increased demand for thoracic surgical treatments by geriatric patients. With increasing age, physiologic changes and comorbidities have to be considered. Thoracic anesthesia for elderly patients requires greater specific knowledge. Respiratory mechanics...
Article
Background Lung injury is a serious complication of surgery. We did a systematic review and meta-analysis to assess whether incidence, morbidity, and in-hospital mortality associated with postoperative lung injury are affected by type of surgery and whether outcomes are dependent on type of ventilation. Methods We searched MEDLINE, CINAHL, Web of S...
Article
Full-text available
The thoracic surgical patient is at special risk for increased postoperative pulmonary complications, such as atelectasis, impaired lung function and pneumonia, as well as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) with high mortality after lung resections. One-lung ventilation (OLV) induces proinflammatory responses esp...
Data
Dynamic computed tomography scan during OLV with V T = 10 ml/kg without preceding ARM. Please note the shearing and stretching of the most dependent parts in the lower ventilated lung
Conference Paper
Full-text available
/Volumes/HDD/Thomas/Eigene Dokumente/Eigene Dokumente und Papiere/Forschung-Publikation/Kinetics of Volatile Uptake/Publikation-Kinetics of Volatile Uptake/Kretzschmar Abstract DAC 2014.docx
Article
Full-text available
Background: Acute lung injury after thoracic surgery relates to alveolar inflammation induced by one-lung ventilation (OLV) and surgical manipulation. However, alveolar recruitment manoeuvres (ARM), conventional ventilation, and airway manipulation may increase alveolar trauma. This study evaluates pulmonary immune effects of these co-factors in a...
Article
Background The increased tidal volume (V(T)) applied to the ventilated lung during one-lung ventilation (OLV) enhances cyclic alveolar recruitment and mechanical stress. It is unknown whether alveolar recruitment maneuvers (ARMs) and reduced V(T) may influence tidal recruitment and lung density. Therefore, the effects of ARM and OLV with different...
Article
Full-text available
One-lung ventilation (OLV) results in alveolar proinflammatory effects, whereas their extent may depend on administration of anesthetic drugs. The current study evaluates the effects of different volatile anesthetics compared with an intravenous anesthetic and the relationship between pulmonary and systemic inflammation in patients undergoing open...
Article
Full-text available
The increased tidal volume (V(T)) applied to the ventilated lung during one-lung ventilation (OLV) enhances cyclic alveolar recruitment and mechanical stress. It is unknown whether alveolar recruitment maneuvers (ARMs) and reduced V(T) may influence tidal recruitment and lung density. Therefore, the effects of ARM and OLV with different V(T) on pul...
Article
Rationnelle L’échographie carotidienne préopératoire avec des stratégies préventives pourrait réduire le risque d’AVC pendant la chirurgie cardiaque. Puisque l’échographie systématique chez tous les malades n’est pas réalisable, une approche d’examen sélectif a été étudiée. Méthodes Un modèle pronostique prévoyant l’atteinte carotidienne a été dév...
Article
Full-text available
Preoperative carotid sonography with consecutive preventive strategies might reduce stroke risk during cardiac surgery. Since routine sonography in all patients may be unfeasible, an approach to examine preselected patients was investigated. A prognostic model predicting carotid disease was developed using the clinical data of 1,768 routinely exami...
Article
Full-text available
Mechanical stress during one-lung ventilation (OLV) results in lung injury. This study compared the effects of mechanical ventilation, OLV, and surgical manipulation on diffuse alveolar damage (DAD) after application of different anesthetic regimens. Prospective, randomized, controlled, blinded animal experiment. University hospital. Twenty-one pig...
Article
Full-text available
The implantation of cardiac resynchronization/defibrillation devices (CRT-Ds) increasingly is used in patients with congestive heart failure and left bundle-branch block. There are no data on the effects of anesthesia and surgery on outcome after implantation. A retrospective, observational study; postoperative survey. University hospital. Three hu...
Article
Full-text available
One-lung ventilation (OLV) exposes the dependent lung to increased mechanical stress which may affect the postoperative course. This study evaluates regional pulmonary gas/tissue distribution in a porcine model of OLV. Nine anaesthetized and mechanically ventilated (V(T)=10 ml kg(-1), FI(O(2))=0.40, PEEP=5 cm H(2)O) pigs were studied. After lung se...
Article
Full-text available
One-lung ventilation (OLV) increases mechanical stress in the lung and affects ventilation and perfusion (V, Q). There are no data on the effects of OLV on postoperative V/Q matching. Thus, this controlled study evaluates the influence of OLV on V/Q distribution in a pig model using a gamma camera technique [single-photon emission computed tomograp...
Article
Full-text available
Severe carotid stenosis and occlusion are associated with an increased risk of stroke during and after cardiac surgery with cardiopulmonary bypass. Relevance of an impaired cerebral autoregulation caused by stenosis/occlusion is unknown. We prospectively assessed the incidence of stroke in relation to severity of carotid disease and corresponding a...
Article
Full-text available
One-lung ventilation (OLV) induces a pro-inflammatory response including cytokine release and leucocyte recruitment in the ventilated lung. Whether volatile or i.v. anaesthetics differentially modulate the alveolar inflammatory response to OLV is unclear. Thirty patients, ASA II or III, undergoing open thoracic surgery were randomized to receive ei...
Article
Full-text available
The authors report the exceptional case of an adult with Niemann-Pick Type B and coronary artery disease who underwent elective coronary artery bypass graft (CABG) surgery. The anesthetic management for this procedure was planned carefully because impaired perfusion of the splanchnic region resulting from anesthetic drugs, mechanical ventilation, a...
Article
Full-text available
Bleeding disorders and hemorrhages cause considerable morbidity and mortality in cardiac surgical patients. Possible thromboembolic complications make the use of recombinant activated factor VII (rFVIIa) in the treatment of bleeding after cardiac surgery controversial. Case Reports: We describe 2 patients who experienced intractable bleeding after...
Article
Objectives: The Paracor ventricular support system (PVSS) intends to reduce mechanical stress, improve ventricular function, and reverse cardiac remodeling in heart failure patients with dilated ventricles. Minimal invasive surgical approach ist the advantage of the PVSS in contrast to the CorCap (ACORN). The aim of the study was to investigate the...
Conference Paper
One-lung ventilation (OLV) during thoracic surgery is an established procedure. OLV and surgical manipulation may result in mechanical stress of the lungs leading to atelectasis formation and shunt increase resulting in a ventilation/perfusion mismatch. The aim of the study was to assess the influence of OLV on postoperative ventilation-perfusion d...
Conference Paper
One-lung ventilation (OLV) with normal tidal volumes (10ml/kg) may result in biotrauma of the ventilated lung which is characterized by increased concentrations of proinflammatory cytokines in the bronchoalveolar lavage fluid [1]. The effects of inhalational or intravenous anesthetic drugs on the immunological response to OLV are unclear. A prospec...
Article
Full-text available
This review presents an overview of the different problems and challenges after thoracic surgery. It covers the pathophysiological changes that may occur regularly in the early and late period following surgery. In addition, surgical complications with anesthesiological implications for diagnosis, treatment and prevention are discussed, and consequ...
Article
Unlabelled: Mechanical ventilation (MV) may induce an inflammatory alveolar response. One-lung ventilation (OLV) with tidal volumes (Vt) as used during two-lung ventilation is a suggested algorithm but may impose mechanical stress of the dependent lung and potentially aggravate alveolar mediator release. We studied whether ventilation with differe...
Article
A 24-year-old female with a history of former heroin addiction underwent open heart surgery for a mechanical tricuspid valve replacement. Anaesthesiological management included a thoracic epidural catheter at the Th(2)/Th(3) segments and balanced general anaesthesia (remifentanil, desflurane/propofol). Additionally, clonidine (2 microg*kg(-1)*h(-1)...
Article
Zusammenfassung Trotz der großen Zahl i.v.-Drogenabhängiger sind die anästhesiologischen Konzepte zur Behandlung von heroinabhängigen Patienten unklar, um ein akutes Entzugssyndrom oder den Rückfall zur Sucht zu vermeiden. Wir berichten über eine 24-jährige Patientin, die sich 11 Monate nach erfolgreichem Heroinentzug einem elektiven Trikuspidalkla...
Article
Full-text available
This review presents a brief overview of the non-analgetic effects of thoracic epidural anaesthesia. It covers the cardiac, pulmonary and gastrointestinal effects of thoracic epidural anaesthesia. The results of newer studies are of particular importance regarding mortality and major morbidity after thoracic epidural anaesthesia. The clinical effec...

Network

Cited By