Gabriel Putzer

• PD; MD; EDAIC
• Medical Doctor at Innsbruck Medical University

Background and aim: Limited data are available concerning the impact of CPR interventions on cerebral oxygenation during hypothermic cardiac arrest. We therefore studied cerebral perfusion pressure (CPP), brain tissue oxygen tension (PbtO2), cerebral venous oxygen saturation (ScvO2) and regional cerebral oxygen saturation (rSO2) in an animal model...

Background: Recent studies have shown that during cardiopulmonary resuscitation (CPR) head-up position (HUP) as compared to standard supine position (SUP) decreases intracranial pressure (ICP) and increases cerebral perfusion pressure (CPP). The impact of this manoeuvre on brain oxygenation and metabolism is not clear. We therefore investigated HU...

Background The influence of adrenaline during cardiopulmonary resuscitation (CPR) on the neurological outcome of cardiac arrest survivors is unclear. As little is known about the pathophysiological effects of adrenaline on cerebral oxygen delivery and cerebral metabolism we investigated its effects on parameters of cerebral oxygenation and cerebral...

Background The effects of adrenaline on cerebral blood vessels during cardiopulmonary resuscitation (CPR) are not well understood. We developed an extracorporeal CPR model that maintains constant low systemic blood flow while allowing adrenaline-associated effects on cerebral vasculature to be assessed at different mean arterial pressure (MAP) leve...

Background Bolus administration of adrenaline during cardiopulmonary resuscitation (CPR) results in only short-term increases in systemic and cerebral perfusion pressure (CePP) with unclear effects on cerebral oxygenation. The aim of this study was to investigate the effects of bolus compared to continuous adrenaline administration on cerebral oxyg...

This work describes the use of high resolution online microdialysis coupled with a wireless microfluidic electrochemical sensing platform for continuous monitoring of the effect of cardiac arrest and resuscitation methods on brain glucose and other key neurochemicals in a porcine model. The integrated portable device incorporates low-volume three-d...

Background: Cardiac arrest is the most time-sensitive medical condition, and survival probability is highly dependent on early, high-quality cardiopulmonary resuscitation (CPR) measures. Resuscitation registries are established tools for continuous quality improvement and serve as a source for research. Yet they lack comprehensive information on th...

Background Normothermic machine perfusion (NMP) of liver grafts has been shown to reduce intraoperative catecholamine consumption and the need for allogenic blood products after reperfusion compared with organs undergoing classical static cold storage (SCS). This study aimed to investigate the effects of an NMP phase after SCS (NMP after SCS) of li...

Research question Pulse detection decisions during cardiopulmonary resuscitation (CPR) are commonly augmented by end-tidal CO2-concentration (etCO2) levels and trend as etCO2 is a surrogate measure of systemic blood flow during (CPR)1. However, ventilatory and circulatory parameters influence the interpretability of etCO2 heavily. Recently develope...

Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Sec...

Background Intraosseous access is a recommended alternative to venous access in emergencies. For its application, knowledge of the correct insertion depth is indispensable. We aimed to determine sex-specific differences on the appropriate insertion depth for intraosseous access in adults at the insertion sites most frequently used, namely the proxi...

Study objective: Multifactorial comparison of flow-controlled ventilation (FCV) to standard of pressure-controlled ventilation (PCV) in terms of oxygenation in cardiac surgery patients after chest closure. Design: Prospective, non-blinded, randomized, controlled trial. Setting: Operating theatre at an university hospital, Austria. Patients: Patient...

Background Hemodynamic instability after liver graft reperfusion increases recipient morbidity after liver transplantation. The etiologies of hemodynamic disturbances appear to be multifactorial and are poorly understood. Normothermic machine perfusion (NMP) provides an opportunity to analyze graft quality prior to transplantation. In the present s...

Background: Many articles described a massive decline in surgical procedures during the COVID-19 pandemic waves. Especially the reduction in oncologic and emergency procedures led to the concern that delays and cancelling surgical activity might lead to a substantial increase in preventable deaths. Methods: Overall numbers and types of surgery w...

Background In pressure-controlled ventilation (PCV) a decelerating gas flow pattern occurs during inspiration and expiration. In contrast, flow-controlled ventilation (FCV) guarantees a continuous gas flow throughout the entire ventilation cycle where the inspiration and expiration phases are simply performed by a change of gas flow direction. Aim...

Background: Flow-controlled ventilation (FCV) represents a novel ventilation method, which guarantees a continuous gas flow during inspiration and expiration. Long term comparison to volume- and pressure-controlled ventilation (PCV) after five- and ten hours have shown improved gas exchange parameters and lung tissue aeration. Aim of this porcine...

Background: A continuous gas flow provided by flow-controlled ventilation (FCV) facilitates accurate dynamic compliance measurement and allows the clinician to individually optimise positive end-expiratory and peak pressure settings accordingly. Objective: The aim of this study was to compare the efficiency of gas exchange and impact on haemodyn...

Background Tyrol, a province of Austria with about 760,000 inhabitants, was one of the first regions in Europe, along with northern Italy, to be affected by the pandemic spread of the coronavirus in spring 2020. A lockdown with far-reaching restrictions in all areas of life occurred from 16 March 2020. Restrictions were imposed in the areas of gast...

Background: Flow-controlled ventilation (FCV) enables precise determination of dynamic compliance due to a continuous flow coupled with direct tracheal pressure measurement. Thus, pressure settings can be adjusted accordingly in an individualised approach. Objective: The aim of this study was to compare gas exchange of individualised FCV to pres...

Background: The COVID-19 pandemic caused an important reduction in surgical activities during the first wave. Aim of this retrospective time-trend analysis was to examine whether also during the second wave in fall and winter 2020/2021 surgical interventions decreased. Methods: Absolut numbers and types of surgeries in a tertiary university hosp...

Background: Transplantation activity during the first wave of the coronavirus disease 2019 (COVID-19) pandemic was severely affected worldwide. This retrospective analysis aimed to assess the impact of COVID-19 on organ donations and transplantations in the Eurotransplant region during the first 12 mo of the pandemic. Specifically, we compared don...

Background Indirect core body temperature (CBT) monitoring from skin sensors is gaining attention for in-field applications thanks to non-invasivity, portability, and easy probe positioning. Among skin sensors, heat-flux devices, such as the so-called Double Sensor (DS), have demonstrated reliability under various experimental and clinical conditio...

Background The aim of this manikin study was to evaluate the quality of cardiopulmonary resuscitation (CPR) with restricted patient access during simulated avalanche rescue using over-the-head and straddle position as compared to standard position. Methods In this prospective, randomised cross-over study, 25 medical students (64% male, mean age 24...

Innsbruck Medical University Hospital, Austria, provides the highest level of care for a region of approximately 1.8 million people. During the early COVID-19 outbreak in spring 2020 surgical activity was drastically reduced with the prime goal of preserving hospital capacities, especially intensive care beds. We conducted a retrospective analysis...

Background Flow-controlled ventilation (FCV) is a novel ventilation method increasingly being used clinically, particularly during the current COVID-19 pandemic. However, the continuous flow pattern in FCV during inspiration and expiration has a significant impact on respiratory parameters and ventilatory settings compared to conventional ventilati...

The endothelial glycocalyx is a thin layer consisting of proteoglycans, glycoproteins and glycosaminoglycans that lines the luminal side of vascular endothelial cells. It acts as a barrier and contributes to the maintenance of vascular homeostasis and microperfusion. During solid organ transplantation, the endothelial glycocalyx of the graft is dam...

Background: Complete snow avalanche burial is associated with high mortality. The aim of this study was to assess the feasibility and incidence of organ retrieval in brain-dead donors following cardiorespiratory arrest due to avalanche burial and to evaluate the function of transplanted organs. Methods: The transplant registry of the Medical Uni...

Objective Patients undergoing transcatheter aortic valve implantation (TAVI) frequently present with chronic kidney disease and are therefore particularly susceptible to nephrotoxic influences like iodinated contrast media. Acute kidney injury after TAVI is a severe complication that independently predicts short- and long-term mortality. The presen...

Background Flow-controlled ventilation is a novel ventilation method which allows to individualize ventilation according to dynamic lung mechanic limits based on direct tracheal pressure measurement at a stable constant gas flow during inspiration and expiration. The aim of this porcine study was to compare individualized flow-controlled ventilatio...

Avalanche patients who are completely buried but still able to breathe are exposed to hypothermia, hypoxia and hypercapnia (triple H syndrome). Little is known about how these pathologic changes affect brain physiology. Study aim was to investigate the effect of hypothermia, hypoxia and hypercapnia on brain oxygenation and systemic and cerebral hae...

Background: Flow-controlled ventilation is a novel ventilation method which allows to individualize ventilation according to dynamic lung mechanic limits based on direct tracheal pressure measurement at a stable constant gas flow during inspiration and expiration. The aim of this porcine study was to compare individualized flow-controlled ventilati...

The understanding and neurological prognostication of hypoxic ischemic encephalopathy (HIE) after hypothermic cardiac arrest (CA) is limited. Recent data suggest that the protein tau (total tau) might be a useful marker for outcome in patients with HIE. This translational porcine study aimed to analyze brain physiology in relation to total tau prot...

Background: The Ambu Aura Gain is a newer second-generation supraglottic airway device designed for fibreoptic bronchoscopy (FOB)-guided tracheal intubation. Methods: 57 patients between 18 months and 6 years of age were randomized to receive either the Ambu Aura-I (n:29) or the Ambu Aura Gain (n:28). Primary endpoint was the time for intubation...

Background: Flow-controlled ventilation is a novel ventilation method which allows to individualize ventilation according to dynamic lung mechanic limits based on direct tracheal pressure measurement at a stable constant gas flow during inspiration and expiration. The aim of this porcine study was to compare individualized flow-controlled ventilati...

Effects of brain temperature modulation on cerebral hemodynamics are unclear. We aimed at investigating changes of dynamic cerebral autoregulation (AR) indices during induction of deep hypothermia (HT) in a porcine model mimicking the clinical scenario of accidental HT. Thirteen pigs were surface-cooled to a core temperature of 28°C. High-frequency...

Aims: This study aimed to determine the time needed for one or two companion rescuers to access, extricate, and deliver cardiopulmonary resuscitation (CPR) to a fully buried manikin during a simulated avalanche burial scenario. Materials and Methods: In this randomized, single-blinded study, 18 medical students were required to extricate a manikin...

Background This study presents a count of publications and citations for all articles published by university Departments of Anaesthesiology in Germany, Austria and Switzerland between 2011 and 2015. The results were compared with former analyses of these countries from 2001–2010 as well as similar international studies. Methods We performed a Pub...

Multimodal neuromonitoring has become a fundamental part of management for many neurosurgical disorders such as subarachnoid hemorrhage and severe traumatic brain injury. Obviously, brain tissue oxygen tension monitoring requires insertion of a probe into the brain parenchyma through a single multiple lumen bolt, or in a subcutaneously tunneled fas...

The aim of this study was to analyse publication trends from the anaesthetic literature of the G-20 countries. We performed a literature search in Medline to identify articles related to anaesthetic departments published between 2001 and 2015, by specific G-20 countries according to the affiliation field of the authors, and to three time periods 20...

Background This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest. Methods The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce this narrative review. ResultsThe hospital use of minimally-inv...

Background: Ventilation of an unprotected airway may result in stomach inflation. The purpose of this study was to evaluate the effect of clinically realistic stomach inflation on cardiopulmonary function during hemorrhagic shock in a porcine model. Methods: Pigs were randomized to a sham control group (n = 9), hemorrhagic shock [35 mLkg over 15...

Epitympanic temperature (T ty ) measured with thermistor probes correlates with core body temperature (T core ), but the reliability of measurements at low ambient temperature is unknown. The aim of this study was to determine if commercially-available thermistor-based T ty reflects T core in low ambient temperature and if T ty is influenced by ins...

Background: Chest compression quality is decisive for overall outcome after cardiac arrest. Chest compression depth may decrease when cardiopulmonary resuscitation (CPR) is performed on a mattress, and the use of a backboard does not necessarily improve compression depth. Mechanical chest compression devices may overcome this problem. Objectives:...

Ströhle, Mathias, Gabriel Putzer, Emily Procter, and Peter Paal. Apparent cooling rate of 7°C per hour in an avalanche victim. High Alt Biol Med 16:000-000, 2015.-Avalanche victims can become hypothermic within 35 minutes of snow burial. However, reported cooling rates for avalanche victims are highly variable and it is poorly understood how much c...

Bei Patienten mit schwerer akzidenteller Hypothermie besteht bis heute Unsicherheit in der Wahl der optimalen Behandlung und des Zielkrankenhauses. In dieser Arbeit werden Empfehlungen für die prä- und innerklinische Versorgung und den Transport von akzidentell hypothermen Patienten vorgestellt. Fortschritte in der Behandlung und Verfügbarkeit von...

This study assessed the publication performance of university departments of anesthesiology in Austria, Germany and Switzerland. The number of publications, original articles, impact factors and citations were evaluated. A search was performed in PubMed to identify publications related to anesthesiology from 2001 to 2010. All articles from anesthes...

Uncertainty exists on how to treat patients suffering from accidental hypothermia and on the optimal transport decisions. The aim of this review is to provide an updated evidence-based reference for the pre-hospital and in-hospital management of patients with accidental hypothermia and for the transport decisions required to facilitate treatment. A...

Intra-hepatic cholestasis arising from biliary strictures is a frequent complication in pediatric patients after liver transplantation. Minimally invasive procedures such as percutaneous drainage placement and balloon dilation are the preferred diagnostic and therapeutic modalities. We report the case of a 12-month-old Caucasian boy with biliary at...

It has been shown that shift work constitutes a great health hazard, particularly when chronodisruption is involved. Anesthetists are used to working for a certain number of 24-h shifts every month. The work-related lack of sleep in combination with light exposure is suspected to alter melatonin courses. The main aim of the present study was to ana...