Karin Amrein

Karin Amrein
Medical University of Graz · Division for Endocrinology and Diabetology

MD, MSc

About

207
Publications
27,743
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
3,589
Citations
Citations since 2016
114 Research Items
2919 Citations
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
Introduction
Vitamin D in critical illness Glucose control in critical illness Osteoporosis Hypoparathyroidism
Additional affiliations
August 2008 - July 2016
Medical University of Graz
Position
  • Professor (Associate)

Publications

Publications (207)
Article
Full-text available
Background: Cell stress promotes degradation of mitochondria which release danger-associated molecular patterns that are catabolized to N-formylmethionine. We hypothesized that in critically ill adults, the response to N-formylmethionine is associated with increases in metabolomic shift-related metabolites and increases in 28-day mortality. Metho...
Article
Full-text available
In this narrative review, we discuss the relevant issues of therapeutic plasma exchange (TPE) in critically ill patients. For many conditions, the optimal indication, device type, frequency, duration, type of replacement fluid and criteria for stopping TPE are uncertain. TPE is a potentially lifesaving but also invasive procedure with risk of adver...
Article
Objectives This study assessed opinions and experiences of healthcare professionals, former patients and family members during the first wave of the COVID-19 pandemic and focuses on challenges in family-centred care for ICU patients and affected families. Research Methodology/Design A two-round modified Delphi process assessed the opinions and expe...
Article
Baclofen is commonly used to treat muscular spasticity and other conditions such as pain, alcohol withdrawal, and myoclonus. It is contraindicated in chronic kidney disease. As it is eliminated predominantly by the kidneys, acute kidney injury can lead to acute baclofen overdose with central nervous system affection due to drug accumulation. Curren...
Article
Full-text available
Zusammenfassung Hintergrund Angehörige von kritisch Kranken auf der Intensivstation („intensive care unit“, ICU) sind in einer herausfordernden Situation: Sie befinden sich häufig in einer existenziellen Krise mit einer großen emotionalen Belastung, gleichzeitig sind sie oftmals aktiv in therapeutische Entscheidungen mit eingebunden. Die Besuchsre...
Article
Full-text available
Background The number of dialysis patients is steadily increasing. Associated comorbidities include impaired bone and mineral metabolism, termed chronic kidney disease-mineral and bone disorder (CKD-MBD), leading to a high fracture risk, increased morbidity and mortality and impaired quality of life. While the bone density is assessed with dual-ene...
Article
Background: Patients on extracorporeal life support (ECLS), either for respiratory or cardiac support, are at high risk of malnutrition; guidelines on nutrition in critical care have not incorporated solid evidence regarding these settings. The aim of this narrative review is to gather the available evidence in the existing literature and transpos...
Article
Full-text available
Pharmacological interventions are essential for the treatment and management of critical illness. Although women comprise a large proportion of the critically ill, sex-specific pharmacological properties are poorly described in critical care. The sex-specific effects of vitamin D3 treatment in the critically ill are not known. Therefore, we perform...
Article
Background Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. Recent research has shown the importance of MNs in common pathologies, with significant deficiencies impacting the outcome. Objective This guideline aims to provide information for daily clinical nutrition practice regarding assessment...
Article
Full-text available
Procalcitonin is a biomarker of systemic inflammation and may have importance in the immune response. The metabolic response to elevated procalcitonin in critical illness is not known. The response to inflammation is vitally important to understanding metabolism alterations during extreme stress. Our aim was to determine if patients with elevated p...
Article
Full-text available
Background: Bibliometric analyses show gender bias against women in scientific publications and citations. We hypothesized that a metric of an individual senior author's inclusivity of women as first authors in critical care publications would predict gender inequality. Methods: Using PubMed and Web of Science, we conducted a bibliometric analys...
Article
Full-text available
Chronic inflammation induces proinflammatory cytokine cascades. In addition to systemic inflammation, hypoxemia, hypercapnia, a catabolic metabolism, gonadal or thyroid dysfunction, musculoskeletal dysfunction and inactivity as well as vitamin D deficiency contribute to an increased risk of fragility fractures. Iatrogenic causes of osteoporosis are...
Article
Full-text available
Celiac disease (CD) and autoimmune thyroid diseases (AITD) like Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) frequently coexist, entailing numerous potential impacts on diagnostic and therapeutic approaches. Possible correlations might exist through gut microbiota, regulating the immune system and inflammatory responses, promoting autoimmu...
Article
Purpose of review: To summarize the recent evidence on the role of vitamin D deficiency in critically ill patients and emerging data claiming a role of vitamin D in COVID-19. Recent findings: Vitamin D is a strong predictor for worse outcomes in critically ill patients, and as well in COVID-19. The vitamin D content in typical nutrition regimes...
Article
Full-text available
Sepsis remains the leading cause of mortality in hospitalized patients, contributing to 1 in every 2-3 deaths. From a pathophysiological view, in the recent definition, sepsis has been defined as the result of a complex interaction between host response and the infecting organism, resulting in life-threatening organ dysfunction, depending on microc...
Article
Background & Aims Vitamin D’s pleiotropic effects include immune modulation, and its supplementation has been shown to prevent respiratory tract infections. The effectivity of vitamin D as a therapeutic intervention in critical illness remains less defined. The current study analyzed clinical and immunologic effects of vitamin D levels in patients...
Article
Full-text available
Metabolism differs in women and men at homeostasis. Critically ill patients have profound dysregulation of homeostasis and metabolism. It is not clear if the metabolic response to critical illness differs in women compared to men. Such sex-specific differences in illness response would have consequences for personalized medicine. Our aim was to det...
Article
Background & aims In critically ill patients with liver disease, vitamin D deficiency is associated with higher disease severity, increased frequency of infections, and worse outcomes. This study sought to describe the trend of vitamin D in orthotopic liver transplantation (OLT) recipients and its association with outcomes. Methods Prospective obs...
Article
Full-text available
Background & aims: It is unclear if intervention can mitigate the dramatic alterations of metabolic homeostasis present in critical illness. Our objective was to determine the associations between increased 25-hydroxyvitamin D levels following high dose vitamin D3 and more favorable metabolomic profiles in critical illness. Methods: We performed...
Article
Full-text available
Background Sarcopenia, defined as loss of muscle mass, quality and function, is a part of the frailty syndrome. In critical illness, sarcopenia has rarely been evaluated regarding clinical outcomes. Therefore, we evaluated the association of sarcopenia with both hospital length of stay (HLOS) and 6‑month mortality in critically ill patients using a...
Article
This review aims to provide an overview of metabolic and endocrine challenges in the setting of intensive care medicine. These are a group of heterogeneous clinical conditions with a high degree of overlap, as well as nonspecific signs and symptoms. Several diseases involve multiple organ systems, potentially causing catastrophic dysfunction and de...
Article
Full-text available
A healthy gut microbiota not only has beneficial effects on the activity of the immune system, but also on thyroid function. Thyroid and intestinal diseases prevalently coexist—Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) are the most common autoimmune thyroid diseases (AITD) and often co-occur with Celiac Disease (CD) and Non-celiac wheat...
Article
Purpose of review: There is growing evidence that bone health is impacted during and after critical illness in multiple ways. In this review, we provide a practical update on postcritical care bone loss with an insight on identification of persons at risk, prevention and treatment strategies. Recent findings: Critical illness is associated with...
Article
Full-text available
Background and Aims Despite the presumed importance of preventing and treating micronutrient and mineral deficiencies, it is still not clear how to optimize measurement and administration in critically ill patients. In order to design future comparative trials aimed at optimizing micronutrient and mineral management, an important first step is to g...
Article
Full-text available
Background The most prevalent etiology for hypoparathyroidism is postsurgical. In the literature, years or even decades of delay for the diagnosis have been reported, with sometimes extremely low calcium levels and dramatic clinical manifestations including heart failure and seizures requiring treatment in the emergency room or intensive care unit....
Article
Full-text available
Background: Besides anemia, iron deficiency may cause more subtle symptoms, including the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis of the IronWoMan randomized controlled trial (RCT) was to compare the frequency and severity of symptoms associate...
Preprint
Background: Besides anemia, iron deficiency may cause more subtle symptoms including those of the restless legs syndrome (RLS), the chronic fatigue syndrome (CFS) or sleeping disorders. Objective: The aim of this pre-planned secondary analysis was to compare the frequency and severity of symptoms associated with iron deficiency before and after (in...
Article
Der Vitamin D-Hype hat nach der ersten Publikation 2009 mit einem Letter im New England Journal of Medicine auch die Intensivstation (ICU) erfasst. Nach auf große Hoffnung folgender Ernüchterung durch rezente Hochdosis-Vitamin-Studien bei Kritisch Kranken (wie zuletzt "Marik-Gate" beim Critical Care Reviews Meeting in Belfast 2020) erscheint Skepsi...
Article
Full-text available
Vitamin D testing and the use of vitamin D supplements have increased substantially in recent years. Currently, the role of vitamin D supplementation, and the optimal vitamin D dose and status, is a subject of debate, because large interventional studies have been unable to show a clear benefit (in mostly vitamin D replete populations). This may be...
Article
Full-text available
Background There is controversy about the impact of acute illness on vitamin D levels. This study was carried out to assess the influence of perioperative fluid loading on 25-hydroxy-vitamin D [25(OH)D] levels. The study evaluated the clinical utility of a commonly available chemiluminescence assay (ECLIA, IDS-iSYS) and liquid chromatography/mass s...
Article
Full-text available
Background: Vitamin D supplementation has shown promise for reducing mortality in the intensive care setting. As a steroid prohormone with pleiotropic effects, there may be a lag between administration and observing clinical benefit. This secondary analysis of the VITdAL-ICU study sought to explore whether the effect size of vitamin D on mortality...
Article
Full-text available
Introduction Observational studies have demonstrated an association between vitamin D deficiency and increased risk of morbidity and mortality in critically ill patients. Cohort studies and pilot trials have suggested promising beneficial effects of vitamin D replacement in the critical ill, at least in patients with severe vitamin D deficiency. As...
Article
Only a few thyroid nodules are perceived as functional or optically disturbing. If there is a need for action, surgical intervention is the long-term standard by which thermoablative procedures (radiofrequency-, laser-, microwave ablation, high intensity focused ultrasound) must be measured against in terms of safety, effectiveness and patient sati...
Article
Full-text available
Der primäre Hyperparathyreoidismus (pHPT) ist eine relativ häufige endokrine Erkrankung. Die Unterscheidung zwischen „asymptomatischem pHPT“ und „asymptomatischem pHPT mit begleitenden, oft stummen Komplikationen“ muss gründlich untersucht und herausgearbeitet werden, damit die beste weitere Vorgehensweise für den Patienten festgelegt werden kann....
Article
Question What are the use, diagnostic capability and outcomes of bronchoscopy added to non-invasive testing in immunocompromised patients? In this setting, an inability to identify the cause of acute hypoxemic respiratory failure is associated with worse outcome. Every effort should be made to obtain a diagnosis, either with non-invasive testing al...
Article
Objective: The purpose of this study was to evaluate if vitamin D deficiency is associated with increased rates of persistent critical illness, and whether repletion of vitamin D among patients with this deficiency leads to decreased persistent critical illness. Design: Retrospective cohort analysis. Setting: Seven intensive care units (ICUs)...
Article
Introduction: Frequent blood donation often leads to iron deficiency and even anemia but appropriate strategies for detection and prevention are currently not mandatory. At the Medical University of Graz, we conducted a single-center prospective clinical trial to compare oral and IV iron supplementation in iron deficient blood donors including Aus...
Article
Full-text available
Background & aims: Recent studies indicate that vitamin D deficiency is associated with increased morbidity and mortality in critically ill patients. Knowledge about the functional role and clinical relevance of vitamin D for patients undergoing cardiac surgery is sparse. Therefore, we investigated the clinical significance of vitamin D levels on...
Conference Paper
Full-text available
INTRODUCTION Vitamin D is a pro-hormone with pleiotropic effects and its deficiency has been associated to increased mortality in intensive care unit (ICU). OBJECTIVE Post-hoc analysis of the VITdAL-ICU study excluding patients deceased in the early course of ICU stay. METHODS In this post-hoc analysis vitamin D supplementation effect was explored...
Conference Paper
Full-text available
INTRODUCTION. Vitamin D has pleiotropic effects that extend beyond the muskuloskeletal system, with a strong association between a poor vitamin D status and excess morbidity and mortality. Vitamin D deficiency is common in patients with chronic liver disease, and has been associated with increased morbidity and mortality, but has not been extensive...
Article
Full-text available
The prevalence of vitamin D deficiency in intensive care units ranges typically between 40 and 70 %. There are many reasons for being or becoming deficient in the ICU. Hepatic, parathyroid and renal dysfunction aditionally increase the risk for developing vitamin D deficiency. Moreover, therapeutic interventions like fluid resuscitation, dialysis,...
Article
Full-text available
A patient’s admission to an intensive care unit (ICU) has a significant impact on family members and other relatives. In order for them to be able to cope with such a stressful situation, the availability of appropriate understandable and accessible information is crucial. The information asymmetry between relatives and medical professionals may ad...
Article
Full-text available
Background: Relatives of intensive care patients have a very high need for information. This is due to the acute and serious, often life-threatening illness of the patients and the very complex and technical environment of an intensive care unit (ICU). Unmet needs for information can increase anxiety, sleep disorders, stress, and depressive sympto...
Article
Full-text available
Hypoparathyroidism represents the last endocrine disorder that is not treated by the replacement of the missing hormone. The disease occurs mostly postoperatively and often manifests itself through hypocalcemia, though it can also present a wide spectrum of symptoms. Many patients suffer from an impaired quality of life. The current standard treatm...
Article
Full-text available
Recent trials have sparked new interest in an old concept – vitamin therapy in critical illness or “metabolic resuscitation”. In this mini-review, we summarize data on the most promising players in this setting: thiamine (vitamin B1), vitamin C and vitamin D.
Article
Full-text available
Background: Monopolar radiofrequency ablation is currently deemed an exotic treatment option for benign thyroid nodules in many central European countries. The aim of this study was to evaluate prospectively the safety and efficacy of this method in a large patient cohort following its introduction in Austria. Methods: Peri- and post-interventio...
Article
Full-text available
Background: Clinical research has recently demonstrated that vitamin D deficiency (VDD) is highly prevalent in the pediatric intensive care unit (PICU) and associated with worse clinical course. Multiple adult ICU trials have suggested that optimization of vitamin D status through high-dose supplementation may reduce mortality and improve other cl...