Herrmann, Peter

[["dc.bibliographiccitation.firstpage","R165"],["dc.bibliographiccitation.issue","2"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.lastpage","R171"],["dc.bibliographiccitation.volume","9"],["dc.contributor.author","Rylander, C."],["dc.contributor.author","Tylen, U."],["dc.contributor.author","Rossi-Norrlund, R."],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Quintel, M."],["dc.contributor.author","Bake, B."],["dc.date.accessioned","2018-11-07T11:10:20Z"],["dc.date.available","2018-11-07T11:10:20Z"],["dc.date.issued","2005"],["dc.description.abstract","Introduction The aim of this study was to assess the volume of gas being poorly ventilated or non-ventilated within the lungs of patients treated with mechanical ventilation and suffering from acute respiratory distress syndrome (ARDS). Methods A prospective, descriptive study was performed of 25 sedated and paralysed ARDS patients, mechanically ventilated with a positive end-expiratory pressure (PEEP) of 5 cmH(2)O in a multidisciplinary intensive care unit of a tertiary university hospital. The volume of poorly ventilated or non-ventilated gas was assumed to correspond to a difference between the ventilated gas volume, determined as the end-expiratory lung volume by rebreathing of sulphur hexafluoride (EELVSF6), and the total gas volume, calculated from computed tomography images in the end-expiratory position (EELVCT). The methods used were validated by similar measurements in 20 healthy subjects in whom no poorly ventilated or non-ventilated gas is expected to be found. Results EELVSF6 was 66% of EELVCT, corresponding to a mean difference of 0.71 litre. EELVSF6 and EELVCT were significantly correlated (r(2) = 0.72; P < 0.001). In the healthy subjects, the two methods yielded almost identical results. Conclusion About one-third of the total pulmonary gas volume seems poorly ventilated or non-ventilated in sedated and paralysed ARDS patients when mechanically ventilated with a PEEP of 5 cmH2O. Uneven distribution of ventilation due to airway closure and/or obstruction is likely to be involved."],["dc.identifier.doi","10.1186/cc3058"],["dc.identifier.isi","000227588300017"],["dc.identifier.pmid","15774050"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/1370"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53192"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1466-609X"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Uneven distribution of ventilation in acute respiratory distress syndrome"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","67"],["dc.bibliographiccitation.journal","BMC Anesthesiology"],["dc.bibliographiccitation.volume","16"],["dc.contributor.author","Ball, Lorenzo"],["dc.contributor.author","Brusasco, Claudia"],["dc.contributor.author","Corradi, Francesco"],["dc.contributor.author","Paparo, Francesco"],["dc.contributor.author","Garlaschi, Alessandro"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Pelosi, Paolo"],["dc.date.accessioned","2018-11-07T10:10:04Z"],["dc.date.available","2018-11-07T10:10:04Z"],["dc.date.issued","2016"],["dc.description.abstract","Background: Computed tomography (CT) reconstruction parameters, such as slice thickness and convolution kernel, significantly affect the quantification of hyperaerated parenchyma (VHYPER%). The aim of this study was to investigate the mathematical relation between VHYPER% calculated at different reconstruction settings, in mechanically ventilated and spontaneously breathing patients with different lung pathology. Methods: In this retrospective observational study, CT scans of patients of the intensive care unit and emergency department were collected from two CT scanners and analysed with different kernel-thickness combinations (reconstructions): 1.25 mm soft kernel, 5 mm soft kernel, 5 mm sharp kernel in the first scanner; 2.5 mm slice thickness with a smooth (B41s) and a sharp (B70s) kernel on the second scanner. A quantitative analysis was performed with Maluna (R) to assess lung aeration compartments as percent of total lung volume. CT variables calculated with different reconstructions were compared in pairs, and their mathematical relationship was analysed by using quadratic and power functions. Results: 43 subjects were included in the present analysis. Image reconstruction parameters influenced all the quantitative CT-derived variables. The most relevant changes occurred in the hyperaerated and normally aerated volume compartments. The application of a power correction formula led to a significant reduction in the bias between VHYPER% estimations (p < 0.001 in all cases). The bias in VHYPER% assessment did not differ between lung pathology nor ventilation mode groups (p > 0.15 in all cases). Conclusions: Hyperaerated percent volume at different reconstruction settings can be described by a fixed mathematical relationship, independent of lung pathology, ventilation mode, and type of CT scanner."],["dc.identifier.doi","10.1186/s12871-016-0232-z"],["dc.identifier.isi","000382198600001"],["dc.identifier.pmid","27553378"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13872"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/39782"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1471-2253"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Lung hyperaeration assessment by computed tomography: correction of reconstruction-induced bias"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","R129"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","12"],["dc.contributor.author","Waeschle, Reiner M."],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Hilgers, Reinhard"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Neumann, Peter"],["dc.contributor.author","Quintel, Michael"],["dc.date.accessioned","2018-11-07T11:19:45Z"],["dc.date.available","2018-11-07T11:19:45Z"],["dc.date.issued","2008"],["dc.description.abstract","Introduction The purpose of this study was to assess the relation between glycaemic control and the severity of sepsis in a cohort of patients treated with intensive insulin therapy (IIT). Methods In a prospective, observational study, all patients in the intensive care unit (ICU) (n = 191) with sepsis, severe sepsis or septic shock were treated with IIT (target blood glucose (BG) level 80 to 140 mg/dl instead of strict normoglycaemia). BG values were analysed by calculating mean values, rate of BG values within different ranges, rate of patients experiencing BG values within different levels and standard deviation (SD) of BG values as an index of glycaemic variability. Results The number of patients with hypoglycaemia and hyperglycaemia was highly dependent on the severity of sepsis (critical hypoglycaemia <= 40 mg/dl: sepsis: 2.1%, severe sepsis: 6.0%, septic shock: 11.5%, p = 0.1497; hyperglycaemia: > 140 mg/dl: sepsis: 76.6%, severe sepsis: 88.0%, septic shock: 100%, p = 0.0006; > 179 mg/dl: sepsis: 55.3%, severe sepsis: 73.5%, septic shock: 88.5%, p = 0.0005; > 240 mg/dl: sepsis: 17.0%, severe sepsis: 48.2%, septic shock: 45.9%, p = 0.0011). Multivariate analyses showed a significant association of SD levels with critical hypoglycaemia especially for patients in septic shock (p = 0.0197). In addition, SD levels above 20 mg/dl were associated with a significantly higher mortality rate relative to those with SD levels below 20 mg/dl (24% versus 2.5%, p = 0.0195). Conclusions Patients with severe sepsis and septic shock who were given IIT had a high risk of hypoglycaemia and hyperglycaemia. Among these patients even with a higher target BG level, IIT mandates an increased awareness of the occurrence of critical hypoglycaemia, which is related to the severity of the septic episode."],["dc.identifier.doi","10.1186/cc7097"],["dc.identifier.isi","000261561100017"],["dc.identifier.pmid","18939991"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/4949"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/55364"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1466-609X"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","The impact of the severity of sepsis on the risk of hypoglycaemia and glycaemic variability"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","153"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","Biomedical Engineering"],["dc.bibliographiccitation.lastpage","158"],["dc.bibliographiccitation.volume","56"],["dc.contributor.author","Nguyen, Xuan P."],["dc.contributor.author","Kronemayer, Ralf"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Mejía, Atila"],["dc.contributor.author","Daw, Zamira"],["dc.contributor.author","Nguyen, Xuan D."],["dc.contributor.author","Kränzlin, Bettina"],["dc.contributor.author","Gretz, Norbert"],["dc.date.accessioned","2012-10-04T14:49:10Z"],["dc.date.accessioned","2021-10-27T13:10:57Z"],["dc.date.available","2012-10-04T14:49:10Z"],["dc.date.available","2021-10-27T13:10:57Z"],["dc.date.issued","2011"],["dc.description.abstract","In the present article, we describe the validation of a new non-invasive method for measuring blood pressure (BP) which also enables to determine the three BP values: systolic, diastolic and mean value. Our method is based on the pulse transit time (PTT) measurement along an artery directly at the BP cuff. The accuracy of this method was evaluated by comparison with the direct simultaneous measurement of blood pressure from 40 anesthetized female mice. Close correlation between the gained data from these two methods was observed."],["dc.identifier.doi","10.1515/bmt.2011.013"],["dc.identifier.doi","10.1515/BMT.2011.013"],["dc.identifier.fs","584457"],["dc.identifier.isi","000293104900003"],["dc.identifier.pmid","21657988"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/8026"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/91547"],["dc.language.iso","en"],["dc.notes.intern","Migrated from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","0013-5585"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Validation of a new non-invasive blood pressure measurement method on mice via pulse wave propagation time measurement on a cuff"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.journal","Frontiers in Physiology"],["dc.bibliographiccitation.volume","12"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Busana, Mattia"],["dc.contributor.author","Cressoni, Massimo"],["dc.contributor.author","Lotz, Joachim"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Saager, Leif"],["dc.contributor.author","Meissner, Konrad"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Gattinoni, Luciano"],["dc.date.accessioned","2021-12-01T09:24:03Z"],["dc.date.available","2021-12-01T09:24:03Z"],["dc.date.issued","2021"],["dc.description.abstract","Knowledge of gas volume, tissue mass and recruitability measured by the quantitative CT scan analysis (CT-qa) is important when setting the mechanical ventilation in acute respiratory distress syndrome (ARDS). Yet, the manual segmentation of the lung requires a considerable workload. Our goal was to provide an automatic, clinically applicable and reliable lung segmentation procedure. Therefore, a convolutional neural network (CNN) was used to train an artificial intelligence (AI) algorithm on 15 healthy subjects (1,302 slices), 100 ARDS patients (12,279 slices), and 20 COVID-19 (1,817 slices). Eighty percent of this populations was used for training, 20% for testing. The AI and manual segmentation at slice level were compared by intersection over union (IoU). The CT-qa variables were compared by regression and Bland Altman analysis. The AI-segmentation of a single patient required 5–10 s vs. 1–2 h of the manual. At slice level, the algorithm showed on the test set an IOU across all CT slices of 91.3 ± 10.0, 85.2 ± 13.9, and 84.7 ± 14.0%, and across all lung volumes of 96.3 ± 0.6, 88.9 ± 3.1, and 86.3 ± 6.5% for normal lungs, ARDS and COVID-19, respectively, with a U-shape in the performance: better in the lung middle region, worse at the apex and base. At patient level, on the test set, the total lung volume measured by AI and manual segmentation had a R 2 of 0.99 and a bias −9.8 ml [CI: +56.0/−75.7 ml]. The recruitability measured with manual and AI-segmentation, as change in non-aerated tissue fraction had a bias of +0.3% [CI: +6.2/−5.5%] and −0.5% [CI: +2.3/−3.3%] expressed as change in well-aerated tissue fraction. The AI-powered lung segmentation provided fast and clinically reliable results. It is able to segment the lungs of seriously ill ARDS patients fully automatically."],["dc.description.abstract","Knowledge of gas volume, tissue mass and recruitability measured by the quantitative CT scan analysis (CT-qa) is important when setting the mechanical ventilation in acute respiratory distress syndrome (ARDS). Yet, the manual segmentation of the lung requires a considerable workload. Our goal was to provide an automatic, clinically applicable and reliable lung segmentation procedure. Therefore, a convolutional neural network (CNN) was used to train an artificial intelligence (AI) algorithm on 15 healthy subjects (1,302 slices), 100 ARDS patients (12,279 slices), and 20 COVID-19 (1,817 slices). Eighty percent of this populations was used for training, 20% for testing. The AI and manual segmentation at slice level were compared by intersection over union (IoU). The CT-qa variables were compared by regression and Bland Altman analysis. The AI-segmentation of a single patient required 5–10 s vs. 1–2 h of the manual. At slice level, the algorithm showed on the test set an IOU across all CT slices of 91.3 ± 10.0, 85.2 ± 13.9, and 84.7 ± 14.0%, and across all lung volumes of 96.3 ± 0.6, 88.9 ± 3.1, and 86.3 ± 6.5% for normal lungs, ARDS and COVID-19, respectively, with a U-shape in the performance: better in the lung middle region, worse at the apex and base. At patient level, on the test set, the total lung volume measured by AI and manual segmentation had a R 2 of 0.99 and a bias −9.8 ml [CI: +56.0/−75.7 ml]. The recruitability measured with manual and AI-segmentation, as change in non-aerated tissue fraction had a bias of +0.3% [CI: +6.2/−5.5%] and −0.5% [CI: +2.3/−3.3%] expressed as change in well-aerated tissue fraction. The AI-powered lung segmentation provided fast and clinically reliable results. It is able to segment the lungs of seriously ill ARDS patients fully automatically."],["dc.identifier.doi","10.3389/fphys.2021.676118"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/94836"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-478"],["dc.publisher","Frontiers Media S.A."],["dc.relation.eissn","1664-042X"],["dc.rights","http://creativecommons.org/licenses/by/4.0/"],["dc.title","Using Artificial Intelligence for Automatic Segmentation of CT Lung Images in Acute Respiratory Distress Syndrome"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","R35"],["dc.bibliographiccitation.issue","2"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","16"],["dc.contributor.author","Heuer, J. F."],["dc.contributor.author","Sauter, Philipp A."],["dc.contributor.author","Pelosi, Paolo"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Brück, Wolfgang"],["dc.contributor.author","Perske, Christina"],["dc.contributor.author","Schoendube, Fritz"],["dc.contributor.author","Crozier, Thomas Allen"],["dc.contributor.author","Bleckmann, Annalen"],["dc.contributor.author","Beißbarth, Tim"],["dc.contributor.author","Quintel, Michael I."],["dc.date.accessioned","2018-11-07T09:14:38Z"],["dc.date.available","2018-11-07T09:14:38Z"],["dc.date.issued","2012"],["dc.description.abstract","Introduction: There is mounting evidence that injury to one organ causes indirect damage to other organ systems with increased morbidity and mortality. The aim of this study was to determine the effects of acid aspiration pneumonitis (AAP) on extrapulmonary organs and to test the hypothesis that these could be due to circulatory depression or hypoxemia. Methods: Mechanically ventilated anesthetized pigs were randomized to receive intrabronchial instillation of hydrochloric acid (n = 7) or no treatment (n = 7). Hydrochloric acid (0.1 N, pH 1.1, 2.5 ml/kg BW) was instilled into the lungs during the inspiratory phase of ventilation. Hemodynamics, respiratory function and computer tomography (CT) scans of lung and brain were followed over a four-hour period. Tissue samples of lung, heart, liver, kidney and hippocampus were collected at the end of the experiment. Results: Acid instillation caused pulmonary edema, measured as increased extravascular lung water index (ELWI), impaired gas exchange and increased mean pulmonary artery pressure. Gas exchange tended to improve during the course of the study, despite increasing ELWI. In AAP animals compared to controls we found: a) cardiac leukocyte infiltration and necrosis in the conduction system and myocardium; b) lymphocyte infiltration in the liver, spreading from the periportal zone with prominent areas of necrosis; c) renal inflammation with lymphocyte infiltration, edema and necrosis in the proximal and distal tubules; and d) a tendency towards more severe hippocampal damage (P > 0.05). Conclusions: Acid aspiration pneumonitis induces extrapulmonary organ injury. Circulatory depression and hypoxemia are unlikely causative factors. ELWI is a sensitive bedside parameter of early lung damage."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2012"],["dc.identifier.doi","10.1186/cc11214"],["dc.identifier.isi","000313196800001"],["dc.identifier.pmid","22380702"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/7500"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/27465"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1466-609X"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/2.0"],["dc.title","Effects of pulmonary acid aspiration on the lungs and extra-pulmonary organs: a randomized study in pigs"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","R85"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","13"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Hinz, Jose"],["dc.contributor.author","Severgnini, Paolo"],["dc.contributor.author","Calderini, Edoardo"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Pelosi, Paolo"],["dc.date.accessioned","2018-11-07T08:34:16Z"],["dc.date.available","2018-11-07T08:34:16Z"],["dc.date.issued","2009"],["dc.description.abstract","Introduction Non-invasive ventilation (NIV) with a helmet device is often associated with poor patient-ventilator synchrony and impaired carbon dioxide (CO(2)) removal, which might lead to failure. A possible solution is to use a high free flow system in combination with a time-cycled pressure valve placed into the expiratory circuit (HF-BiPAP). This system would be independent from triggering while providing a high flow to eliminate CO(2). Methods Conventional pressure support ventilation (PSV) and time-cycled biphasic pressure controlled ventilation (BiVent) delivered by an Intensive Care Unit ventilator were compared to HF-BiPAP in an in vitro lung model study. Variables included delta pressures of 5 and 15 cmH2O, respiratory rates of 15 and 30 breaths/min, inspiratory efforts (respiratory drive) of 2.5 and 10 cmH2O) and different lung characteristics. Additionally, CO(2) removal and noise exposure were measured. Results Pressurization during inspiration was more effective with pressure controlled modes compared to PSV (P < 0.001) at similar tidal volumes. During the expiratory phase, BiVent and HF-BiPAP led to an increase in pressure burden compared to PSV. This was especially true at higher upper pressures (P < 0.001). At high level of asynchrony both HF-BiPAP and BiVent were less effective. Only HF-BiPAP ventilation effectively removed CO2 (P < 0.001) during all settings. Noise exposure was higher during HF-BiPAP (P < 0.001). Conclusions This study demonstrates that in a lung model, the efficiency of NIV by helmet can be improved by using HF-BiPAP. However, it imposes a higher pressure during the expiratory phase. CO2 was almost completely removed with HF-BiPAP during all settings."],["dc.description.sponsorship","departmental funds"],["dc.identifier.doi","10.1186/cc7907"],["dc.identifier.isi","000269311700024"],["dc.identifier.pmid","19500369"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/5757"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/17774"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1466-609X"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/2.0"],["dc.title","High flow biphasic positive airway pressure by helmet - effects on pressurization, tidal volume, carbon dioxide accumulation and noise exposure"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","52"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Intensive Care Medicine Experimental"],["dc.bibliographiccitation.volume","9"],["dc.contributor.author","Regli, Adrian"],["dc.contributor.author","Ahmadi-Noorbakhsh, Siavash"],["dc.contributor.author","Musk, Gabrielle C."],["dc.contributor.author","Reese, David J."],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Firth, Martin J."],["dc.contributor.author","Pillow, J. J."],["dc.date.accessioned","2021-11-25T11:25:05Z"],["dc.date.accessioned","2022-08-16T12:52:18Z"],["dc.date.available","2021-11-25T11:25:05Z"],["dc.date.available","2022-08-16T12:52:18Z"],["dc.date.issued","2021-10-04"],["dc.date.updated","2022-07-29T12:18:44Z"],["dc.description.abstract","Background\r\n Intra-abdominal hypertension (IAH) is common in critically ill patients and is associated with increased morbidity and mortality. High positive end-expiratory pressures (PEEP) can reverse lung volume and oxygenation decline caused by IAH, but its impact on alveolar overdistension is less clear. We aimed to find a PEEP range that would be high enough to reduce atelectasis, while low enough to minimize alveolar overdistention in the presence of IAH and lung injury.\r\n \r\n \r\n Methods\r\n Five anesthetized pigs received standardized anesthesia and mechanical ventilation. Peritoneal insufflation of air was used to generate intra-abdominal pressure of 27 cmH2O. Lung injury was created by intravenous oleic acid. PEEP levels of 5, 12, 17, 22, and 27 cmH2O were applied. We performed computed tomography and measured arterial oxygen levels, respiratory mechanics, and cardiac output 5 min after each new PEEP level. The proportion of overdistended, normally aerated, poorly aerated, and non-aerated atelectatic lung tissue was calculated based on Hounsfield units.\r\n \r\n \r\n Results\r\n PEEP decreased the proportion of poorly aerated and atelectatic lung, while increasing normally aerated lung. Overdistension increased with each incremental increase in applied PEEP. “Best PEEP” (respiratory mechanics or oxygenation) was higher than the “optimal CT inflation PEEP range” (difference between lower inflection points of atelectatic and overdistended lung) in healthy and injured lungs.\r\n \r\n \r\n Conclusions\r\n Our findings in a large animal model suggest that titrating a PEEP to respiratory mechanics or oxygenation in the presence of IAH is associated with increased alveolar overdistension."],["dc.identifier.citation","Intensive Care Medicine Experimental. 2021 Oct 04;9(1):52"],["dc.identifier.doi","10.1186/s40635-021-00416-5"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/93553"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/112748"],["dc.language.iso","en"],["dc.rights","CC BY 4.0"],["dc.rights.holder","The Author(s)"],["dc.subject","Intra-abdominal hypertension"],["dc.subject","Positive end-expiratory pressure"],["dc.subject","Computed tomography"],["dc.subject","Lung volumes"],["dc.subject","Acute lung injury"],["dc.subject","Abdominal compartment syndrome"],["dc.subject","Over-distension"],["dc.subject","Atelectasis"],["dc.subject","Mechanical ventilation"],["dc.title","Computed tomographic assessment of lung aeration at different positive end-expiratory pressures in a porcine model of intra-abdominal hypertension and lung injury"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","121"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Critical Care"],["dc.bibliographiccitation.volume","22"],["dc.contributor.author","Klapsing, Philipp"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Wende, Christoph"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Bleckmann, Annalen"],["dc.contributor.author","Heuer, Jan F."],["dc.date.accessioned","2019-07-09T11:45:28Z"],["dc.date.available","2019-07-09T11:45:28Z"],["dc.date.issued","2018"],["dc.description.abstract","BACKGROUND: Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon) settings with HFOV settings based on mean transpulmonary pressures (PLmean) in an animal model of experimental acute respiratory distress syndrome (ARDS). METHODS: ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0.1 N, pH 1.1; 2.5 ml/kg body weight). The animals were initially ventilated in volume-controlled mode with low tidal volumes (6 ml kg- 1) at three positive end-expiratory pressure (PEEP) levels (5, 10, 20 cmH2O) followed by HFOVcon and then HFOV PLmean each at PEEP 10 and 20. The continuous distending pressure (CDP) during HFOVcon was set at mean airway pressure plus 5 cmH2O. For HFOV PLmean it was set at mean PL plus 5 cmH2O. Baseline measurements were obtained before and after induction of ARDS under volume controlled ventilation with PEEP 5. The same measurements and computer tomography of the thorax were then performed under all ventilatory regimens at PEEP 10 and 20. RESULTS: Cardiac output, stroke volume, mean arterial pressure and intrathoracic blood volume index were significantly higher during HFOV PLmean than during HFOVcon at PEEP 20. Lung density, total lung volume, and normally and poorly aerated lung areas were significantly greater during HFOVcon, while there was less over-aerated lung tissue in HFOV PLmean. The groups did not differ in oxygenation or extravascular lung water index. CONCLUSION: HFOV PLmean is associated with less hemodynamic compromise and less pulmonary overdistension than HFOVcon. Despite the increase in non-ventilated lung areas, oxygenation improved with both regimens. An individualized approach with HFOV settings based on transpulmonary pressure could be a useful ventilatory strategy in patients with ARDS. Providing alveolar stabilization with HFOV while avoiding harmful distending pressures and pulmonary overdistension might be a key in the context of ventilator-induced lung injury."],["dc.identifier.doi","10.1186/s13054-018-2028-7"],["dc.identifier.pmid","29743121"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15219"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59236"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.publisher","BioMed Central"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","High-frequency oscillatory ventilation guided by transpulmonary pressure in acute respiratory syndrome: an experimental study in pigs"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","26"],["dc.bibliographiccitation.journal","Tobacco Induced Diseases"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Haarmann, Helge"],["dc.contributor.author","Gossler, Alexandra"],["dc.contributor.author","Herrmann, Peter"],["dc.contributor.author","Bonev, Slavtcho"],["dc.contributor.author","Xuan Phuc Nguyen, Xuan Phuc Nguyen"],["dc.contributor.author","Hasenfuß, Gerd"],["dc.contributor.author","Andreas, Stefan"],["dc.contributor.author","Raupach, Tobias"],["dc.date.accessioned","2017-09-07T11:44:44Z"],["dc.date.available","2017-09-07T11:44:44Z"],["dc.date.issued","2016"],["dc.description.abstract","Background: Varenicline is an effective smoking cessation medication. Some concern has been raised that its use may precipitate adverse cardiovascular events although no patho-physiological mechanism potentially underlying such an effect has been reported. The aim of this study was to test the hypothesis that varenicline impacts on sympatho-vagal balance during smoking withdrawal. Methods: In this randomised, placebo-controlled trial, muscle sympathetic nerve activity (MSNA), baroreflex sensitivity (BRS), heart rate, and blood pressure were assessed in 17 smokers four weeks before a quit attempt (baseline) and again on the third day of that quit attempt (acute smoking withdrawal). Results: Regarding the primary endpoint of our study, we did not find a significant effect of varenicline compared to placebo on changes in MSNA burst incidence between baseline and acute smoking withdrawal (-3.0 +/- 3.3 vs.-3.9 +/- 5.0 bursts/100 heart beats; p = 0.308). However, heart rate and systolic blood pressure significantly decreased in the placebo group only, while no significant changes in these parameters were observed in the varenicline group. Exposure to smoking cues during acute withdrawal lead to a significant increase of heart rate in the placebo group, while heart rate decreased in the varenicline group, and the difference in these changes was significant between groups (+ 2.7 +/- 1.0 vs.-1.8 +/- 0.5 1/min; p = 0.002). In all 17 participants combined, a significant increase in heart rate during smoking cue exposure was detected in subjects who relapsed in the course of six weeks after the quit date compared to those who stayed abstinent (+ 2.5 +/- 1.2 vs.-1.1 +/- 0.7; p = 0.018). Six-week abstinence rates were higher in the varenicline group compared to placebo (88 vs. 22 % p = 0.015). Conclusion: We did not find evidence of adverse effects of varenicline on sympatho-vagal balance. Varenicline probably blunts the heart rate response to smoking cues, which may be linked to improved cessation outcome."],["dc.identifier.doi","10.1186/s12971-016-0091-x"],["dc.identifier.gro","3141637"],["dc.identifier.isi","000381574200001"],["dc.identifier.pmid","27507930"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13863"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/3900"],["dc.notes.intern","WoS Import 2017-03-10 / Funder: Pfizer(R)"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","final"],["dc.notes.submitter","PUB_WoS_Import"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1617-9625"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Effects of varenicline on sympatho-vagal balance and cue reactivity during smoking withdrawal: a randomised placebo-controlled trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]