Jan Schmitz

• Doctor of Medicine
• University of Cologne

Zusammenfassung In Nagern wurde beobachtet, dass der Neuromodulator Adenosin während Hypoxie im Gehirn freigesetzt wird und es vor Sauerstoffmangel und Überlastung schützt, indem Blutfluss, Stoffwechsel und elektrische Aktivität angepasst werden. An 10 Probanden wurde geprüft, ob durch Hypoxie – einem Sauerstoffpartialdruck auf 5500 m entsprechend...

After longer duration space missions, some astronauts experience structural and functional changes in the eye and structural changes in the brain, termed Spaceflight-Associated Neuro-Ocular Syndrome (SANS). Countermeasures against SANS are required to minimize potential operation impacts and negative long-term health consequences. Headward fluid sh...

Circadian clocks in the body drive daily cycles in physiology and behavior. A master clock in the brain maintains synchrony with the environmental day–night cycle and uses internal signals to keep clocks in other tissues aligned. Work in cell cultures uncovered cyclic changes in tissue oxygenation that may serve to reset and synchronize circadian c...

In animal studies it has been observed that the inhibitory neuromodulator adenosine is released into the cerebral interstitial space during hypoxic challenges. Adenosine's actions on the A1 adenosine receptor (A1AR) protect the brain from oxygen deprivation and overexertion through adjustments in cerebral blood flow, metabolism, and electric activi...

Numerous accidents occur with General Aviation aircraft every year. To date, pre-emptive prediction of survival or death is impossible. The current study aims to identify significant factors elementary to predict survival after General Aviation (GA) aircraft accidents. The Implementation of a scoring system, including these factors, may facilitate...

Air traveler numbers are predicted to reach 4.0 billion in 2024. Between 1/15,000–50,000 passengers will experience acute medical problems inflight with cardiac arrests requiring cardiopulmonary resuscitation (CPR) accounting for 0.3% of medical emergencies. Hypoxia in airplane cabins could impair oxygenation and physical performance of caregivers....

Background: Cardiopulmonary resuscitation (CPR) is essential for saving lives during cardiac arrest, but performing CPR in extreme environments poses unique challenges. In scenarios ranging from hypogravity or microgravity to confined spaces like aeroplanes and underwater scenarios, traditional CPR techniques may be inadequate. This scoping review...

Background Numerous accidents occur with General Aviation aircraft every year. To date, pre-emptive prediction of survival or death is impossible. The current study aims to identify significant factors elementary to predict survival after General Aviation (GA) aircraft accidents. The Implementation of a scoring system, including these factors, may...

ZUSAMMENFASSUNG Zwischen 1/15 000 und 1/50 000 Passagiere haben während eines Fluges akute medizinische Probleme, wobei Herzstillstände, die eine kardiopulmonale Wiederbelebung (CPR) erfordern, 0,3 % der medizinischen Notfälle ausmachen. Hypoxie in der Flugzeugkabine könnte die Sauerstoffversorgung und die körperliche Leistungsfähigkeit des Helfend...

Background Pre-hospital endotracheal intubation (ETI) is a sophisticated procedure with a comparatively high failure rate. Especially, ETI in confined spaces may result in higher difficulty, longer times, and a higher failure rate. This study analyses if Helicopter Emergency Medical Services (HEMS) intubation (time-to) success are influenced by noi...

The digitization of aircraft cockpits places high demands on the colour vision of pilots. The present study investigates colour vision changes upon acute exposure to hypobaric hypoxia. The digital Waggoner Computerized Color Vision Test and the Waggoner D-15 were performed by 54 healthy volunteers in a decompression chamber. Respective altitude lev...

Background: Cardiopulmonary resuscitation (CPR) during hyperbaric oxygen therapy (HBOT) presents unique challenges due to limited access to patients in cardiac arrest (CA) and the distinct physiological conditions present during hyperbaric therapy. Despite these challenges, guidelines specifically addressing CPR during HBOT are lacking. This revie...

Long duration spaceflights to the Moon or Mars are at risk for emergency medical events. Managing a hypoxemic distress and performing an advanced airway procedure such as oro-tracheal intubation may be complicated under weightlessness due to ergonomic constraints. An emergency free-floating intubation would be dangerous because of high failure rate...

Introduction The ability to metabolize fructose to bypass the glucose pathway in near-anaerobic conditions appears to contribute to the extreme hypoxia tolerance of the naked-mole rats. Therefore, we hypothesized that exogenous fructose could improve endurance capacity and cognitive performance in humans exposed to hypoxia. Methods In a randomized...

Introduction Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and the event is recognised rapidly as patients are usually under full monitoring. This guideline covers the perioperative period and is complementary to the European Resusci...

Introduction: Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and the event is recognised rapidly as patients are usually under full monitoring. This guideline covers the perioperative period and is complementary to the European Resus...

(1) Background: Cardiopulmonary resuscitation (CPR), as a form of basic life support, is critical for maintaining cardiac and cerebral perfusion during cardiac arrest, a medical condition with high expected mortality. Current guidelines emphasize the importance of rapid recognition and prompt initiation of high-quality CPR, including appropriate ca...

Introduction: Since Gagarin became the first human to travel into space and complete one orbit around the Earth, on 12 April 1961, the number of manned spaceflights has increased significantly. Spaceflight is still complex and has potential risk for incidents and accidents. The aim of this study was to analyze how safe it is for humans to travel in...

ZUSAMMENFASSUNG Mit zunehmender Anwendung digitaler Anzeigetechnik in Flugzeugcockpits steigt die Bedeutung zuverlässiger Beurteilung des Farbsehvermögens im Rahmen von Flugtauglichkeitsuntersuchungen. Dabei finden vermehrt digitale Testmethoden Anwendung, die häufig platzsparend und (orts-)unabhängig von Umgebungslichtbedingungen durchgeführt werd...

BACKGROUND: There is a paucity of research on general aviation accidents in Germany. The authorities investigate only a fraction of all national accidents. The current study analyzes existing accident reports and aims to identify injury severity in regard to concomitant risk factors. METHODS: Data of flight accidents was analyzed for aircraft of <5...

The human body reacts to hypobaric hypoxia, e.g., during a stay at high altitude, with several mechanisms of adaption. Even short-time exposition to hypobaric hypoxia leads to complex adaptions. Proteomics facilitates the possibility to detect changes in metabolism due to changes in proteins. The present study aims to identify time-dependent change...

Background: Targeted temperature management (TTM) is considered standard therapy for patients after out-of-hospital cardiac arrest (OHCA), cardiopulmonary resuscitation (CPR), and return of spontaneous circulation (ROSC). To date, valid protein markers do not exist to prognosticate survivors and non-survivors before the end of TTM. The aim of this...

Abstract: Background: Although there have been no reported cardiac arrests in space to date, the risk of severe medical events occurring during long-duration spaceflights is a major concern. These critical events can endanger both the crew as well as the mission and include cardiac arrest, which would require cardiopulmonary resuscitation (CPR). Th...

Background: Although there have been no reported cardiac arrests in space to date, the risk of severe medical events occurring during long-duration spaceflights is a major concern. These critical events can endanger both the crew as well as the mission and include cardiac arrest, which would require cardiopulmonary resuscitation (CPR). Thus far, fi...

Diving accidents are comparatively rare and represent a special challenge for lay helpers and healthcare professionals. They must be treated quickly and competently as they are life-threatening and may lead to long-term health problems if treatment is initiated too late. Therefore, precise knowledge of the pathophysiology during diving and adherenc...

Ca. 7 % aller Schwangeren steigen mindestens einmal während der Schwangerschaft ins Flugzeug. Dies stellt Fluggesellschaften, Schwangere und nicht zuletzt beratende Flugmediziner vor Fragen und Herausforderungen hinsichtlich der Flugreisetauglichkeit. Ziel der vorliegenden Arbeit ist es, die Bandbreite der Transportbedingungen für Schwangere der 25...

Die Zahl flugmedizinischer Untersuchungsstellen korreliert nur bedingt mit der Einwohnerzahl eines EU-Staates. Grund dafür ist die Orientierung der Dichte flugmedizinischer Sachverständiger (AME) am länderspezifischen Flugverkehrsaufkommen, das beispielsweise durch geografische Gegebenheiten (Flächenstaat, Insel usw.) oder der wirtschaftlichen Ausr...

ZUSAMMENFASSUNG In den kommenden Jahren rücken Langzeitmissionen mit Errichtung einer Raumstation in der Mondumlaufbahn und bemannte Mars- missionen in erreichbare Nähe. Eine kurzfristige Evakuierung wird nicht möglich sein und die Besatzung muss, ggf. auch ohne ärztliche Unterstützung, autark eine Vielzahl möglicher medizinischer Ereig- nisse vers...

ZUSAMMENFASSUNG Die Häufigkeit von Blitzunfällen ist weltweit unterschiedlich verteilt. Die klimatischen Bedingungen in den Tropen und Subtropen, in Küstenregionen sowie in Bergregionen begünstigen die Entstehung von Gewittern. Der Klimawandel wird die von Blitzgewittern ausgehende Gefahrenlage übereinstimmenden Prognosen zufolge in fast allen Teil...

In Deutschland gibt es insgesamt etwa 385 flugmedizinische Sachverständige (Aeromedical Examiners, AMEs). Ihre Aufgabe besteht in der Durchführung flugmedizinischer Tauglichkeitsuntersuchungen und der Ausstellung entsprechender Tauglichkeitszeugnisse (Medicals) für Luftfahrtpersonal. Ziel der nachfolgenden Untersuchung ist es, einen Überblick über...

In the next few years, the number of long-term space missions will significantly increase. Providing safe concepts for emergencies including airway management will be a highly challenging task. The aim of the present trial is to compare different airway management devices in simulated microgravity using a free-floating underwater scenario. Five dif...

These European Resuscitation Council (ERC) Cardiac Arrest in Special Circumstances guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. This section provides guidelines on the modifications required to basic and advanced life support for the prevention and treatment of car...

Background: Medical support for space exploration missions must prepare for severe medical events in conditions of microgravity. A key component to managing these events is techniques of airway management. The aim of the present trial is to com- pare airway management devices in simulated microgravity. Methods: In this randomized cross-over trial (...

Background Medical emergencies frequently occur in commercial airline flights, but valid data on causes and consequences are rare. Therefore, optimal extent of onboard emergency medical equipment remains largely unknown. Whereas a minimum standard is defined in regulations, additional material is not standardized and may vary significantly between...

Background: Sudden cardiac arrest is one of the leading causes of death in Europe and the whole world. Effective chest compressions and advanced airway management have been shown to improve survival rates. Supraglottic airway devices such as the laryngeal tube (LT) are a well-known strategy for patients with cardiac arrest during both Basic (BLS)...

Background: With the "Artemis"-mission mankind will return to the Moon by 2024. Prolonged periods in space will not only present physical and psychological challenges to the astronauts, but also pose risks concerning the medical treatment capabilities of the crew. So far, no guideline exists for the treatment of severe medical emergencies in microg...

ZUSAMMENFASSUNG Medizinische Maßnahmen während Raumfahrtmissionen erfordern ein hohes Maß an Planung in Bezug auf die Durchführbarkeit von auf der Erde bekannten Maßnahmen. Variationen in Bezug auf Gravitation, Strahlung und einer veränderten menschlichen Physiologie bedingen, dass etablierte Verfahren auf die Gegebenheiten des Weltalls wissenschaf...

Purpose of review: The present review provides an overview of the different fields of procedural sedation and analgesia (PSA), describing the evidence from recently published studies concerning anxiety and moderate pain, cardiac interventions, gastrointestinal interventions, and PSA use in infants. It also provides guidance for practitioners of bo...

Zusammenfassung Zukünftig werden Raumfahrtmissionen (Langzeitflüge) zum Mond oder Mars durchgeführt werden. Langzeit- missionen gehen mit einem erhöhten medizinischen Risiko einher und die autarke Crew muss alleine und ohne Hilfe von außen Notfälle beherrschen. Atemwegsmanagement stellt hierbei eine Kernkompetenz für viele Notfälle dar. Bisher wurd...

ZUSAMMENFASSUNG Jedes Jahr reisen fast 4 Mrd. Menschen mit kommerziell betriebenen Flugzeugen durch die Welt. Statistisch ereignet sich pro 20 000 Passagiere ein medizinischer Zwischenfall an Bord eines Luftfahrzeugs. Medizinisches Personal sieht sich mit veränderten Umgebungsbedingungen, Unterschieden der medizinischen Ressourcen und Patienten mit...

Background In patients up to the age of 40 years old severe trauma is the most frequent cause of death in Germany. According to the current S3 guidelines on treatment of polytrauma and the severely injured, since 2011 the presence of a shock room coordinator should be considered, who can improve the survival of patients by optimized treatment quali...

Astronauten in Schwerelosigkeit zeigen eine Verschiebung von Körperflüssigkeiten kopfwärts im Vergleich zum Aufenthalt auf der Erde mit bisher weitestgehend unerforschten Auswirkungen auf den zerebral-venösen Ausfluss. Die Autoren der vorgestellten Publikation untersuchten deshalb in einer prospektiven Kohortenstudie, inwieweit sich der Fluss und d...

Zusammenfassung Das Ziel der vorliegenden Arbeit ist es, einen Überblick über den aktuellen Stand der Forschung zum Atemwegsmanagement in Schwerelosigkeit zu geben. Dafür wurde ein narratives Review von bisher publizierter Literatur über Atemwegsmanagement in (simulierter) Schwerelosigkeit erstellt. Mittels einer Suche in PubMed wurden 3 Originalar...

Background Recent studies demonstrated that in-hospital emergencies are linked to a higher patient mortality. In approximately 10% of patients an unexpected incident occurs during the hospital stay. Therefore, the establishment of in-hospital medical emergency teams (MET) is becoming more important in the interdisciplinary emergency treatment. The...

As mankind strives to explore space beyond the moon by planning space exploration missions to Mars and as space tourism becomes closer to operational viability, medical planning for those missions must consider the possibility of life threatening medical emergencies. For Earth, well-established and proven guidelines concerning cardiopulmonary resus...

Zusammenfassung Im Lichte zukünftiger Langzeitraumfahrtmissionen fernab der Erdumlaufbahn besitzt die Fähigkeit der Crew zur autonomen, medizinischen Versorgung einen besonderen Stellenwert. Hier ist insbesondere die Durchführung einer Anästhesie bei einer dringend notwendigen Operation von entscheidender Bedeutung, um unter Umständen die Mission w...

Background Neurodegeneration with brain iron accumulation (NBIA) forms a group of rare hereditary diseases with rapid neurodegenerative progression due to an abnormal accumulation of iron in the basal ganglia. This causes extrapyramidal symptoms as well as dystonia and mental retardation. The most common form of NBIA is pantothenate kinase-associat...

ZUSAMMENFASSUNG Aufgrund der guten medizinischen Selektion, der guten körperlichen Konstitution und der engmaschigen, intensiven Betreuung sind relevante medizinische Probleme bei Astronauten im Weltall vergleichsweise selten. Bisher sind 5 relevante Methoden zur Durchführung von Thoraxkompressionen im Rahmen einer kardiopulmonalen Reanimation (CPR...

Bislang ist bekannt, dass Aufenthalte in Schwerelosigkeit neben vielfältigen Effekten insbesondere eine Abnahme der Muskelmasse sowie eine Abnahme der Knochendichte begünstigen 1. Untersuchungen über die Auswirkungen von Schwerelosigkeit auf das zentrale Nervensystem (ZNS) sind allerdings rar. Diese Untersuchungen haben insbesondere dann Relevanz,...