Ulrich Goebel

Ulrich Goebel
St. Franziskus-Hospital Münster · Department of Anesthesiology and Critical Care

Prof. Dr. med., MBA

About

169
Publications
27,764
Reads
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3,589
Citations
Citations since 2016
97 Research Items
2942 Citations
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
Additional affiliations
February 2012 - March 2019
University Medical Center Freiburg
Position
  • Professor (Associate)
September 2009 - January 2012
University Medical Center Freiburg
Position
  • Consultant
June 2003 - August 2009
University Medical Center Freiburg
Position
  • Fellow
Education
October 2013 - August 2015
University of Bayreuth
Field of study
  • Business
March 1999 - October 1999
Maastricht University
Field of study
  • Medicine
October 1995 - September 2001
RWTH Aachen University
Field of study
  • Medicine

Publications

Publications (169)
Article
Full-text available
Background The concomitant occurrence of the symptoms intravascular hypovolemia, peripheral edema and hemodynamic instability is typically named Capillary Leak Syndrome (CLS) and often occurs in surgical critical ill patients. However, neither a unitary definition nor standardized diagnostic criteria exist so far. We aimed to investigate common cha...
Article
Full-text available
Rationale: Pre-clinical and autopsy studies have fueled the hypothesis that a dysregulated vascular endothelium might play a central role in the pathogenesis of ARDS and multi-organ failure in COVID-19. Objectives To comprehensively characterize and quantify microvascular alterations in patients with COVID-19. Methods: Hospitalized adult patients...
Article
Full-text available
Background: Nonoperating room anesthesia during gastroenterological procedures is a growing field in anesthetic practice. While the numbers of patients with severe comorbidities are rising constantly, gastrointestinal endoscopic interventions are moving closer to minimally invasive endoscopic surgery. The LMA Gastro™ is a new supraglottic airway d...
Article
Background: Postoperative pulmonary and renal complications are frequent in patients undergoing lung surgery. Hyper- and hypovolaemia may contribute to these complications. We hypothesized that goal-directed haemodynamic management based on oesophageal Doppler monitoring would reduce postoperative pulmonary complications in a randomized clinical p...
Article
Purpose Facemask ventilation during the induction of general anesthesia in paediatric patients remains a challenge as it may result in hypoxic conditions and gastric insufflation with subsequent regurgitation and aspiration. So far, it is unclear if pressure-controlled or manual facemask ventilation is preferable in children. We hypothesized that p...
Article
Full-text available
Background Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. Methods This i...
Article
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Aims Although coronavirus disease 2019 (COVID-19) and bacterial sepsis are distinct conditions, both are known to trigger endothelial dysfunction with corresponding microcirculatory impairment. The purpose of this study was to compare microvascular injury patterns and proteomic signatures in COVID-19 and bacterial sepsis patients. Methods and resu...
Article
Importance: Intraoperative handovers of anesthesia care are common. Handovers might improve care by reducing physician fatigue, but there is also an inherent risk of losing critical information. Large observational analyses report associations between handover of anesthesia care and adverse events, including higher mortality. Objective: To deter...
Article
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Background: Neuronal ischemia-reperfusion injury (IRI), such as it can occur in glaucoma or strokes, is associated with neuronal cell death and irreversible loss of function of the affected tissue. Hydrogen sulfide (H2S) is considered a potentially neuroprotective substance, but the most effective route of application and the underlying mechanism...
Article
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Purpose: Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. Methods: The COVIP study is a prospective internatio...
Article
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Purpose: The number of patients ≥ 80 years admitted into critical care is increasing. Coronavirus disease 2019 (COVID-19) added another challenge for clinical decisions for both admission and limitation of life-sustaining treatments (LLST). We aimed to compare the characteristics and mortality of very old critically ill patients with or without CO...
Article
Full-text available
Background: health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected. Objective: to quantify HRQoL in order to identify areas of interventions. Design: prospective observation study. Setting: admissions to E...
Article
Full-text available
Background: The ischemia-reperfusion injury (IRI) of neuronal tissue, such as the brain and retina, leads to possible cell death and loss of function. Current treatment options are limited, but preliminary observations suggest a protective effect of hydrogen sulfide (H2S). However, the dosage, timing, and mechanism of inhaled H2S treatment after I...
Article
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It is estimated that 10% of carbon throughout the cosmos is in the form of carbon monoxide (CO) [1]. Earth’s earliest prebiotic atmosphere included the trinity of gasotransmitters CO, nitric oxide (NO), and hydrogen sulfide (H2S), for which all of life has co-evolved with [2]. Speculation for extraterrestrial life in harsh environments is similarly...
Article
We previously found that argon exerts its neuroprotective effect in part by inhibition of the toll-like receptors (TLR) 2 and 4. The downstream transcription factors signal transducer and activator of transcription 3 (STAT3) and nuclear factor kappa B (NF-κB) are also affected by argon and may play a role in neuroprotection. It also has been demons...
Article
Full-text available
Carbon monoxide (CO) is not only known as a toxic gas due to its characteristics as an odorless molecule and its rapid binding to haem-containing molecules, thus inhibiting the respiratory chain in cells resulting in hypoxia. For decades, scientists established evidence about its endogenously production in the breakdown of haem via haem-oxygenase (...
Article
Full-text available
Zusammenfassung Für die Aufrechterhaltung der Organdurchblutung ist eine intakte Makro- und Mikrozirkulation essentiell. Sowohl das wachsende Verständnis um die Bedeutung der Mikrozirkulation im Organversagen als auch die Möglichkeit, diese zu visualisieren, lenken die Aufmerksamkeit der Intensivmedizin auf die mikrovaskuläre Endstrombahn. Als Surr...
Article
Purpose In acute renal injury, diuretics are widely considered to be harmful. Nevertheless, they are used frequently after kidney transplantation. We hypothesized that diuretics administered in the early postoperative treatment after kidney transplantation increase the incidence of delayed graft function (DGF). Methods In this monocentric, retrosp...
Article
Full-text available
Introduction: Spinal cord ischemia after cardiovascular interventions continues to be a devastating problem in modern surgery. The role of intraspinal vascular networks and anterior radiculomedullary arteries (ARMA) in preventing spinal cord ischemia is poorly understood. Materials and methods: Landrace pigs (n = 30, 35.1 ± 3.9 kg) underwent a l...
Article
Objectives: Neurologic damage following cardiac arrest remains a major burden for modern resuscitation medicine. Cardiopulmonary resuscitation with extracorporeal circulatory support holds the potential to reduce morbidity and mortality. Furthermore, the endogenous gasotransmitter carbon monoxide attracts attention in reducing cerebral injury. We...
Article
Aims: Heart disease of different aetiology remains the leading cause of cardiac arrest (CA). Despite efforts to improve the quality of cardiopulmonary resuscitation (CPR), subsequent myocardial and systemic damage after CA still present a major long-term burden. Low-dose carbon monoxide (CO) is known to exert protective effects in cardiovascular p...
Article
Full-text available
Für die Aufrechterhaltung der Organdurchblutung ist eine intakte Makro- und Mikrozirkulation essentiell. Sowohl das wachsende Verständnis um die Bedeutung der Mikrozirkulation im Organversagen als auch die Möglichkeit, diese zu visualisieren, lenken die Aufmerksamkeit der Intensivmedizin auf die mikrovaskuläre Endstrombahn. Als Surrogat-Parameter s...
Preprint
Background: Perioperative damage of neuronal tissue due to insufficient cerebral circulation as a result of hypotension or stroke, lead to permanent destruction and functional impairment via apoptotic and inflammatory pathways. Recently, the noble gas argon has been shown to exert neuroprotective effects. Despite intensive research, the exact mecha...
Article
Background: The current standard of analyzing microcirculatory video microscopy is time-consuming and occurs away from the patient, limiting its clinical utility. Point-of-care assessment with incident dark field (IDF) microscopy, however, may offer greater clinical applicability. We aimed to determine the reproducibility of the Point of Care Micr...
Article
Background: Deleterious consequences like acute kidney injury frequently occur upon successful resuscitation from cardiac arrest. Extracorporeal life support is increasingly used to overcome high cardiac arrest mortality. Carbon monoxide (CO) is an endogenous gasotransmitter, capable of reducing renal injury. In our study, we hypothesize that addi...
Article
Full-text available
Background: Postoperative pulmonary complications (PPCs) represent the most frequent complications after esophagectomy. The aim of this study was to identify modifiable risk factors for PPCs and 90-days mortality related to PPCs after esophagectomy in esophageal cancer patients. Methods: This is a single center retrospective cohort study of 335...
Article
Purpose: Delayed graft function is a major complication after kidney transplantation affecting patients' long-term outcome. The aim of this study was to identify modifiable risk factors for delayed graft function after deceased donor kidney transplantation. Methods: This is a single-center retrospective cohort study of a university transplantati...
Article
Abstract AIMS: Heart disease of different etiology remains the leading cause of cardiac arrest (CA). Despite efforts to improve the quality of cardiopulmonary resuscitation (CPR), subsequent myocardial and systemic damage after CA still present a major long-term burden. Low-dose carbon monoxide (CO) is known to exert protective effects in cardiovas...
Article
Full-text available
Background The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for livi...
Preprint
Background The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for livi...
Preprint
Background The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for livi...
Article
Extracorporeal circulation can be accompanied by increased vascular permeability leading to pathological fluid balance and organ dysfunction. The second messenger cAMP is involved in capillary permeability and maintains endothelial integrity. The aim of the present study was to evaluate the effect of phosphodiesterase-4 (PDE4) inhibition with rolip...
Article
Full-text available
Hintergrund Die extrakorporale kardiopulmonale Reanimation (eCPR) ist Bestandteil der ERC-Reanimationsleitlinien 2015. Mit zunehmender Verfügbarkeit dieser Therapieoption besteht bei medizinischem Fachpersonal, das regelhaft in erweiterte Reanimationsmaßnahmen eingebunden ist, jedoch Unsicherheit hinsichtlich medizinischer und organisatorischer Fra...
Preprint
Background: The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for liv...
Article
Full-text available
Background: Concepts for optimizing mechanical ventilation focus mainly on modifying the inspiratory phase. We propose flow-controlled expiration (FLEX) as an additional means for lung protective ventilation and hypothesize that it is capable of recruiting dependent areas of the lungs. This study investigates potential recruiting effects of FLEX u...
Article
Full-text available
Evoked potential monitoring has evolved as an essential tool not only for elaborate neurological diagnostics, but also for general clinical practice. Moreover, it is increasingly used to guide surgical procedures and prognosticate neurological outcome in the critical care unit, e.g. after cardiac arrest. Experimental animal models aim to simulate a...
Data
Original data set. Table of tcMEP latencies and amplitudes on the forelimb and on the hind limb as well as latencies and amplitudes of median and tibial SSEPs. (PDF)
Article
Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre,...
Article
Full-text available
Background Postoperative complications after lung surgery are frequent, having a detrimental effect on patients’ further course. Complications may lead to an increased length of hospital stay and cause additional costs. Several risk factors have been identified but it is still difficult to predict contemporary which patients are at risk. We hypothe...
Data
Multivariate regression analysis for IL-6. FEV1 = forced expiratory volume in 1 second; PEF = peak expiratory flow; VC = vital capacity; IL-6 = interleukin 6; T0 = Before surgery; T1 = at the end of surgery at wound closure; T2 = 24 hours after surgery; ARBs = Angiotensin-receptor-II blockers; surgical approach (thoracoscopy versus thoracotomy). (D...
Data
Multivariate regression analysis for IL-10. FEV1 = forced expiratory volume in 1 second; PEF = peak expiratory flow; VC = vital capacity; IL-10 = interleukin 10; T0 = Before surgery; T1 = at the end of surgery at wound closure; T2 = 24 hours after surgery; ARBs = Angiotensin-receptor-II blockers; surgical approach (thoracoscopy versus thoracotomy)....
Data
Multivariate regression analysis for patients with IL-8 and IL-6 levels above the 3rd quartile at the end of surgery. FEV1 = forced expiratory volume in 1 second; PEF = peak expiratory flow; VC = vital capacity; IL-6 = interleukin 6; IL-8 = interleukin 8; T1 = at the end of surgery at wound closure; ARBs = Angiotensin-receptor-II blockers; surgical...
Data
Study protocol approved by the local Ethics Committee. (DOCX)
Data
Postoperative complications. GDT = Goal-directed therapy. Number of patients and percentage within each group. (DOCX)
Data
Multivariate regression analysis of absolute interleukin levels. FEV1 = forced expiratory volume in 1 second; PEF = peak expiratory flow; VC = vital capacity; IL-10 = interleukin 10; IL-8 = interleukin 8; IL-6 = interleukin 6; T0 = Before surgery; T1 = at the end of surgery at wound closure; T2 = 24 hours after surgery; ARBs = Angiotensin-receptor-...
Data
Aggregation of interleukin levels into quartiles. IL-10 = interleukin 10; IL-8 = interleukin 8; IL-6 = interleukin 6; T0 = Before surgery; T1 = at the end of surgery at wound closure; T2 = 24 hours after surgery. (DOCX)
Article
Objectives: Anterior radiculomedullary arteries (ARMAs) link dorsal segmental arteries and the intraspinal compartment of the spinal collateral network. The number of thoracic ARMA is highly variable from one person to another. The impact of the number of ARMAs on spinal cord perfusion during thoracic aortic procedures is unknown. We investigated...
Article
Full-text available
Background: The bone cement implantation syndrome (BCIS) is a frequent and potentially disastrous intraoperative complication in patients undergoing cemented hip arthroplasty. Several risk factors have been identified, however randomized controlled trials to reduce the incidence of BCIS are still pending. We hypothesized that goal-directed hemodyn...
Article
Carbon monoxide (CO) has demonstrated therapeutic potential in multiple inflammatory conditions including intensive care applications such as organ transplantation or sepsis. Approaches to translate these findings into future therapies, however, have been challenged by multiple hurdles including handling and toxicity issues associated with systemic...
Article
Aim: Standardized modeling of cardiac arrest and cardiopulmonary resuscitation (CPR) is crucial to evaluate new treatment options. Experimental porcine models are ideal, closely mimicking human-like physiology. However, anteroposterior chest diameter differs significantly, being larger in pigs and thus poses a challenge to achieve adequate perfusi...