Mörer, Onnen

[["dc.bibliographiccitation.artnumber","e0284"],["dc.bibliographiccitation.firstpage","1"],["dc.bibliographiccitation.issue","11"],["dc.bibliographiccitation.journal","Critical Care Explorations"],["dc.bibliographiccitation.lastpage","5"],["dc.bibliographiccitation.volume","2"],["dc.contributor.author","Hofmann-Winkler, Heike"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Alt-Epping, Sabine"],["dc.contributor.author","Bräuer, Anselm"],["dc.contributor.author","Büttner, Benedikt"],["dc.contributor.author","Müller, Martin"],["dc.contributor.author","Fricke, Torben"],["dc.contributor.author","Grundmann, Julian"],["dc.contributor.author","Harnisch, Lars-Olav"],["dc.contributor.author","Heise, Daniel"],["dc.contributor.author","Kernchen, Andrea"],["dc.contributor.author","Pressler, Meike"],["dc.contributor.author","Stephani, Caspar"],["dc.contributor.author","Tampe, Björn"],["dc.contributor.author","Kaul, Artur"],["dc.contributor.author","Gärtner, Sabine"],["dc.contributor.author","Kramer, Stefanie"],["dc.contributor.author","Pöhlmann, Stefan"],["dc.contributor.author","Winkler, Martin Sebastian"],["dc.date.accessioned","2020-11-27T11:23:20Z"],["dc.date.accessioned","2021-10-27T13:22:21Z"],["dc.date.available","2020-11-27T11:23:20Z"],["dc.date.available","2021-10-27T13:22:21Z"],["dc.date.issued","2020"],["dc.description.abstract","Objectives: Severe acute respiratory syndrome coronavirus 2 cell entry depends on angiotensin-converting enzyme 2 and transmembrane serine protease 2 and is blocked in cell culture by camostat mesylate, a clinically proven protease inhibitor. Whether camostat mesylate is able to lower disease burden in coronavirus disease 2019 sepsis is currently unknown. Design: Retrospective observational case series. Setting: Patient treated in ICU of University hospital Göttingen, Germany. Patients: Eleven critical ill coronavirus disease 2019 patients with organ failure were treated in ICU. Interventions: Compassionate use of camostat mesylate (six patients, camostat group) or hydroxychloroquine (five patients, hydroxychloroquine group). Measurements and Main Results: Clinical courses were assessed by Sepsis-related Organ Failure Assessment score at days 1, 3, and 8. Further, viral load, oxygenation, and inflammatory markers were determined. Sepsis-related Organ Failure Assessment score was comparable between camostat and hydroxychloroquine groups upon ICU admission. During observation, the Sepsis-related Organ Failure Assessment score decreased in the camostat group but remained elevated in the hydroxychloroquine group. The decline in disease severity in camostat mesylate treated patients was paralleled by a decline in inflammatory markers and improvement of oxygenation. Conclusions: The severity of coronavirus disease 2019 decreased upon camostat mesylate treatment within a period of 8 days and a similar effect was not observed in patients receiving hydroxychloroquine. Camostat mesylate thus warrants further evaluation within randomized clinical trials."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2020"],["dc.identifier.doi","10.1097/CCE.0000000000000284"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/17663"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/92088"],["dc.language.iso","en"],["dc.notes.intern","Migrated from goescholar"],["dc.relation.eissn","2639-8028"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.title","Camostat Mesylate May Reduce Severity of Coronavirus Disease 2019 Sepsis: A First Observation"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","36"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","20"],["dc.contributor.author","Fanelli, Vito"],["dc.contributor.author","Ranieri, Marco V."],["dc.contributor.author","Mancebo, Jordi"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Morley, Scott"],["dc.contributor.author","Moran, Indalecio"],["dc.contributor.author","Parrilla, Francisco"],["dc.contributor.author","Costamagna, Andrea"],["dc.contributor.author","Gaudiosi, Marco"],["dc.contributor.author","Combes, Alain"],["dc.date.accessioned","2018-11-07T10:18:16Z"],["dc.date.available","2018-11-07T10:18:16Z"],["dc.date.issued","2016"],["dc.description.abstract","Background: Mechanical ventilation with a tidal volume (V-T) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (P-plat) lower than 30 cmH(2)O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low VT combined with extracorporeal carbon dioxide removal (ECCO2R). Methods: In fifteen patients with moderate ARDS, VT was reduced from baseline to 4 mL/kg PBW while PEEP was increased to target a plateau pressure - (Pplat) between 23 and 25 cmH(2)O. Low-flow ECCO2R was initiated when respiratory acidosis developed (pH < 7.25, PaCO2 > 60 mmHg). Ventilation parameters (VT, respiratory rate, PEEP), respiratory compliance (C-RS), driving pressure (DeltaP = V-T/C-RS), arterial blood gases, and ECCO2R system operational characteristics were collected during the period of ultra-protective ventilation. Patients were weaned from ECCO2R when PaO2/FiO(2) was higher than 200 and could tolerate conventional ventilation settings. Complications, mortality at day 28, need for prone positioning and extracorporeal membrane oxygenation, and data on weaning from both MV and ECCO2R were also collected. Results: During the 2 h run in phase, VT reduction from baseline (6.2 mL/kg PBW) to approximately 4 mL/kg PBW caused respiratory acidosis (pH < 7.25) in all fifteen patients. At steady state, ECCO2R with an average blood flow of 435 mL/min and sweep gas flow of 10 L/min was effective at correcting pH and PaCO2 to within 10 % of baseline values. PEEP values tended to increase at V-T of 4 mL/kg from 12.2 to 14.5 cmH(2)O, but this change was not statistically significant. Driving pressure was significantly reduced during the first two days compared to baseline (from 13.9 to 11.6 cmH(2)O; p < 0.05) and there were no significant differences in the values of respiratory system compliance. Rescue therapies for life threatening hypoxemia such as prone position and ECMO were necessary in four and two patients, respectively. Only two study-related adverse events were observed (intravascular hemolysis and femoral catheter kinking). Conclusions: The low-flow ECCO2R system safely facilitates a low volume, low pressure ultra-protective mechanical ventilation strategy in patients with moderate ARDS."],["dc.description.sponsorship","ALung Technologies, Inc."],["dc.identifier.doi","10.1186/s13054-016-1211-y"],["dc.identifier.isi","000369912900002"],["dc.identifier.pmid","26861596"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13484"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/41401"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1364-8535"],["dc.relation.issn","1466-609X"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome"],["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","1203"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","Journal of Clinical Medicine"],["dc.bibliographiccitation.volume","10"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Huber-Petersen, Jan Felix"],["dc.contributor.author","Schaeper, Joern"],["dc.contributor.author","Binder, Claudia"],["dc.contributor.author","Wand, Saskia"],["dc.date.accessioned","2021-06-01T09:42:37Z"],["dc.date.available","2021-06-01T09:42:37Z"],["dc.date.issued","2021"],["dc.description.abstract","Direct complications in patients receiving extracorporeal (veno-venous) membrane oxygenation (vvECMO) are mainly either due to bleeding or thromboembolism. We aimed to evaluate the course of routine coagulation parameters and the activity of different coagulation factors—with special focus on factor XIII (F XIII)—before, during and after vvECMO in acute respiratory distress syndrome (ARDS) patients. The activity of coagulation factors and rotational thrombelastometry were analyzed in 20 ECMO patients before (T-1) and 6 h (T0), one (T1), three (T3) and seven days (T7) after the implantation, as well as one and three days after the termination of ECMO. F XIII activity was already severely decreased to 37% (30/49) before ECMO. F XIII activity was the only coagulation factor continuously declining during vvECMO, being significantly decreased at T3 (31% (26/45) vs. 24% (18/42), p = 0.0079) and T7 (31% (26/45) vs. 23% (17/37), p = 0.0037) compared to T0. Three days after termination of vvECMO, platelet count and fibrinogen nearly doubled and factors II, V, XI and XIII showed spontaneous significant increases. Severe ARDS patients showed a considerably diminished factor XIII activity before vvECMO initiation and its activity continuously declined later on. Thus, incorporation of F XIII monitoring into the regular hemostaseologic routine during vvECMO therapy seems advisable. Due to the potential development of a hypercoagulatory state after the termination of vvECMO, tight hemostasiologic monitoring should persist in the initial phase after ECMO termination."],["dc.description.sponsorship","Fonds de dotation CSL Behring pour la recherche"],["dc.identifier.doi","10.3390/jcm10061203"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/85301"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-425"],["dc.publisher","MDPI"],["dc.relation.eissn","2077-0383"],["dc.rights","https://creativecommons.org/licenses/by/4.0/"],["dc.title","Factor XIII Activity Might Already Be Impaired before Veno-Venous ECMO in ARDS Patients: A Prospective, Observational Single-Center Cohort Study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","1020"],["dc.bibliographiccitation.issue","7"],["dc.bibliographiccitation.journal","Journal of Clinical Medicine"],["dc.bibliographiccitation.volume","8"],["dc.contributor.author","Harnisch, Lars-Olav"],["dc.contributor.author","Riech, Sebastian"],["dc.contributor.author","Mueller, Marion"],["dc.contributor.author","Gramueller, Vanessa"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Moerer, Onnen"],["dc.date.accessioned","2019-07-16T09:02:51Z"],["dc.date.available","2019-07-16T09:02:51Z"],["dc.date.issued","2019"],["dc.description.abstract","Neurologic complications following acute respiratory distress syndrome (ARDS) are well described, however, information on the neurologic outcome regarding peripheral nervous system complications in critically ill ARDS patients, especially those who received extracorporeal membrane oxygenation (ECMO) are lacking. In this prospective observational study 28 ARDS patients who survived after ECMO or conventional nonECMO treatment were examined for neurological findings. Nine patients had findings related to cranial nerve innervation, which di ered between ECMO and nonECMO patients (p = 0.031). ECMO patients had severely increased patella tendon reflex (PTR) reflex levels (p = 0.027 vs. p = 0.125) as well as gastrocnemius tendon reflex (GTR) (p = 0.041 right, p = 0.149 left) were a ected on the right, but not on the left side presumably associated with ECMO cannulation. Paresis (14.3% of patients) was only found in the ECMO group (p = 0.067). Paresthesia was frequent (nonECMO 53.8%, ECMO 62.5%; p = 0.064), in nonECMO most frequently due to initial trauma and polyneuropathy, in the ECMO group mainly due to impairments of N. cutaneus femoris lateralis (4 vs. 0; p = 0.031). Besides well-known central neurologic complications, more subtle complications were detected by thorough clinical examination. These findings are su cient to hamper activities of daily living and impair quality of life and psychological health and are presumably directly related to ECMO therapy."],["dc.identifier.doi","10.3390/jcm8071020"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16283"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/61555"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.publisher","MDPI"],["dc.relation.eissn","2077-0383"],["dc.relation.issn","2077-0383"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Longtime Neurologic Outcome of Extracorporeal Membrane Oxygenation and Non Extracorporeal Membrane Oxygenation Acute Respiratory Distress Syndrome Survivors"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","295"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Critical Care"],["dc.bibliographiccitation.volume","25"],["dc.contributor.author","Magunia, Harry"],["dc.contributor.author","Lederer, Simone"],["dc.contributor.author","Verbuecheln, Raphael"],["dc.contributor.author","Gilot, Bryant J."],["dc.contributor.author","Koeppen, Michael"],["dc.contributor.author","Haeberle, Helene A."],["dc.contributor.author","Mirakaj, Valbona"],["dc.contributor.author","Hofmann, Pascal"],["dc.contributor.author","Marx, Gernot"],["dc.contributor.author","Bickenbach, Johannes"],["dc.contributor.author","Nohe, Boris"],["dc.contributor.author","Lay, Michael"],["dc.contributor.author","Spies, Claudia"],["dc.contributor.author","Edel, Andreas"],["dc.contributor.author","Schiefenhövel, Fridtjof"],["dc.contributor.author","Rahmel, Tim"],["dc.contributor.author","Putensen, Christian"],["dc.contributor.author","Sellmann, Timur"],["dc.contributor.author","Koch, Thea"],["dc.contributor.author","Brandenburger, Timo"],["dc.contributor.author","Kindgen-Milles, Detlef"],["dc.contributor.author","Brenner, Thorsten"],["dc.contributor.author","Berger, Marc"],["dc.contributor.author","Zacharowski, Kai"],["dc.contributor.author","Adam, Elisabeth"],["dc.contributor.author","Posch, Matthias"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Scheer, Christian S."],["dc.contributor.author","Sedding, Daniel"],["dc.contributor.author","Weigand, Markus A."],["dc.contributor.author","Fichtner, Falk"],["dc.contributor.author","Nau, Carla"],["dc.contributor.author","Prätsch, Florian"],["dc.contributor.author","Wiesmann, Thomas"],["dc.contributor.author","Koch, Christian"],["dc.contributor.author","Schneider, Gerhard"],["dc.contributor.author","Lahmer, Tobias"],["dc.contributor.author","Straub, Andreas"],["dc.contributor.author","Meiser, Andreas"],["dc.contributor.author","Weiss, Manfred"],["dc.contributor.author","Jungwirth, Bettina"],["dc.contributor.author","Wappler, Frank"],["dc.contributor.author","Meybohm, Patrick"],["dc.contributor.author","Herrmann, Johannes"],["dc.contributor.author","Malek, Nisar"],["dc.contributor.author","Kohlbacher, Oliver"],["dc.contributor.author","Biergans, Stephanie"],["dc.contributor.author","Rosenberger, Peter"],["dc.date.accessioned","2021-11-25T11:13:27Z"],["dc.date.accessioned","2022-08-18T12:40:20Z"],["dc.date.available","2021-11-25T11:13:27Z"],["dc.date.available","2022-08-18T12:40:20Z"],["dc.date.issued","2021-08-17"],["dc.date.updated","2022-07-29T12:18:15Z"],["dc.description.abstract","Abstract\r\n \r\n Background\r\n Intensive Care Resources are heavily utilized during the COVID-19 pandemic. However, risk stratification and prediction of SARS-CoV-2 patient clinical outcomes upon ICU admission remain inadequate. This study aimed to develop a machine learning model, based on retrospective & prospective clinical data, to stratify patient risk and predict ICU survival and outcomes.\r\n \r\n \r\n Methods\r\n A Germany-wide electronic registry was established to pseudonymously collect admission, therapeutic and discharge information of SARS-CoV-2 ICU patients retrospectively and prospectively. Machine learning approaches were evaluated for the accuracy and interpretability of predictions. The Explainable Boosting Machine approach was selected as the most suitable method. Individual, non-linear shape functions for predictive parameters and parameter interactions are reported.\r\n \r\n \r\n Results\r\n 1039 patients were included in the Explainable Boosting Machine model, 596 patients retrospectively collected, and 443 patients prospectively collected. The model for prediction of general ICU outcome was shown to be more reliable to predict “survival”. Age, inflammatory and thrombotic activity, and severity of ARDS at ICU admission were shown to be predictive of ICU survival. Patients’ age, pulmonary dysfunction and transfer from an external institution were predictors for ECMO therapy. The interaction of patient age with D-dimer levels on admission and creatinine levels with SOFA score without GCS were predictors for renal replacement therapy.\r\n \r\n \r\n Conclusions\r\n Using Explainable Boosting Machine analysis, we confirmed and weighed previously reported and identified novel predictors for outcome in critically ill COVID-19 patients. Using this strategy, predictive modeling of COVID-19 ICU patient outcomes can be performed overcoming the limitations of linear regression models.\r\n Trial registration “ClinicalTrials” (clinicaltrials.gov) under NCT04455451."],["dc.identifier.citation","Critical Care. 2021 Aug 17;25(1):295"],["dc.identifier.doi","10.1186/s13054-021-03720-4"],["dc.identifier.pii","3720"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/93542"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/112980"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-455"],["dc.publisher","BioMed Central"],["dc.relation.eissn","1364-8535"],["dc.rights","CC BY 4.0"],["dc.rights.holder","The Author(s)"],["dc.subject","COVID-19"],["dc.subject","Critical care"],["dc.subject","ARDS"],["dc.subject","Outcome"],["dc.subject","Prognostic models"],["dc.title","Machine learning identifies ICU outcome predictors in a multicenter COVID-19 cohort"],["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","33"],["dc.bibliographiccitation.journal","Annals of Clinical Microbiology and Antimicrobials"],["dc.bibliographiccitation.volume","14"],["dc.contributor.author","Kunze, Nils"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Steinmetz, Nicolas"],["dc.contributor.author","Schulze, M. H."],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Perl, Thorsten"],["dc.date.accessioned","2018-11-07T09:55:53Z"],["dc.date.available","2018-11-07T09:55:53Z"],["dc.date.issued","2015"],["dc.description.abstract","Background: The early beginning of an adequate antibiotic therapy is crucial in hospital-acquired pneumonia (HAP), but depends on the results of conventional microbiological diagnostics (cMD). It was the aim of this study to evaluate the performance and turnaround times of a new point-of-care multiplex polymerase chain reaction (mPCR) system for rapid identification of pathogens and antibiotic resistance markers. We assessed the applicability of the system under real-life conditions in critical ill patients with HAP. Methods: We enrolled forty critical ill patients with clinical signs for HAP into an observational study. Two samples of respiratory secretions were collected during one course of aspiration and cMD and mPCR testing (Unyvero, Curetis AG, Holzgerlingen, Germany) were performed immediately. The mPCR device was operated as a point-of-care system at the intensive care unit. We compared turnaround times, results of pathogen identification and results of antibiotic resistance testing of both methods. Results: Mean turnaround times (min-max) were 6.5 h (4.7-18.3 h) for multiplex PCR and 71 h (37.2-217.8 h) for conventional microbiology (final cMD results, incomplete results neglected). 60 % (n = 24) of the mPCR tests were completely valid. Complete test failure occurred in 10 % (n = 4) and partial test failure occurred in 30 % (n = 12). We found concordant results in 45 % (n = 18) and non-concordant results in 45 % (n = 18) of all patients. 55 % (n = 16) of the results were concordant in patients with a clinical pulmonary infection score (CPIS) > 5 (n = 29). Concordant results included three cases of multidrug resistant bacteria. MPCR frequently detected antibiotic resistance markers that were not found by cMD. Conclusions: Unyvero allowed point-of-care microbial testing with short turnaround times. The performance of the system was poor. However, an improved system with a more reliable performance and an extended microbial panel could be a useful addition to cMD in intensive care medicine."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2015"],["dc.identifier.doi","10.1186/s12941-015-0091-3"],["dc.identifier.isi","000356592600001"],["dc.identifier.pmid","26071191"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13460"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/36848"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Biomed Central Ltd"],["dc.relation.issn","1476-0711"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Point-of-care multiplex PCR promises short turnaround times for microbial testing in hospital-acquired pneumonia - an observational pilot study in critical ill patients"],["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","699"],["dc.bibliographiccitation.issue","5"],["dc.bibliographiccitation.journal","Intensive Care Medicine"],["dc.bibliographiccitation.lastpage","711"],["dc.bibliographiccitation.volume","42"],["dc.contributor.author","Bein, Thomas"],["dc.contributor.author","Grasso, Salvatore"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Guerin, Claude"],["dc.contributor.author","Deja, Maria"],["dc.contributor.author","Brondani, Anita"],["dc.contributor.author","Mehta, Sangeeta"],["dc.date.accessioned","2018-11-07T10:15:16Z"],["dc.date.available","2018-11-07T10:15:16Z"],["dc.date.issued","2016"],["dc.description.abstract","Severe ARDS is often associated with refractory hypoxemia, and early identification and treatment of hypoxemia is mandatory. For the management of severe ARDS ventilator settings, positioning therapy, infection control, and supportive measures are essential to improve survival. A precise definition of life-threating hypoxemia is not identified. Typical clinical determinations are: arterial partial pressure of oxygen < 60 mmHg and/or arterial oxygenation < 88 % and/or the ratio of PaO2/FIO2 < 100. For mechanical ventilation specific settings are recommended: limitation of tidal volume (6 ml/kg predicted body weight), adequate high PEEP (> 12 cmH(2)O), a recruitment manoeuvre in special situations, and a 'balanced' respiratory rate (20-30/min). Individual bedside methods to guide PEEP/recruitment (e.g., transpulmonary pressure) are not (yet) available. Prone positioning [early (a parts per thousand currency sign 48 hrs after onset of severe ARDS) and prolonged (repetition of 16-hr-sessions)] improves survival. An advanced infection management/control includes early diagnosis of bacterial, atypical, viral and fungal specimen (blood culture, bronchoalveolar lavage), and of infection sources by CT scan, followed by administration of broad-spectrum anti-infectives. Neuromuscular blockage (Cisatracurium a parts per thousand currency sign 48 hrs after onset of ARDS), as well as an adequate sedation strategy (score guided) is an important supportive therapy. A negative fluid balance is associated with improved lung function and the use of hemofiltration might be indicated for specific indications. A specific standard of care is required for the management of severe ARDS with refractory hypoxemia."],["dc.identifier.doi","10.1007/s00134-016-4325-4"],["dc.identifier.isi","000374176700012"],["dc.identifier.pmid","27040102"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/14342"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/40778"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","1432-1238"],["dc.relation.issn","0342-4642"],["dc.rights","CC BY-NC 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/4.0"],["dc.title","The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia"],["dc.type","review"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1615"],["dc.bibliographiccitation.issue","9"],["dc.bibliographiccitation.journal","Intensive Care Medicine"],["dc.bibliographiccitation.lastpage","1623"],["dc.bibliographiccitation.volume","34"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Beck, Jennifer"],["dc.contributor.author","Brander, Lukas"],["dc.contributor.author","Costa, Roberta"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Slutsky, Arthur S."],["dc.contributor.author","Brunet, Fabrice"],["dc.contributor.author","Sinderby, Christer"],["dc.date.accessioned","2018-11-07T11:11:31Z"],["dc.date.available","2018-11-07T11:11:31Z"],["dc.date.issued","2008"],["dc.description.abstract","Objective: Patient-ventilator synchrony during non-invasive pressure support ventilation with the helmet device is often compromised when conventional pneumatic triggering and cycling-off were used. A possible solution to this shortcoming is to replace the pneumatic triggering with neural triggering and cycling-off-using the diaphragm electrical activity (EA(di)). This signal is insensitive to leaks and to the compliance of the ventilator circuit. Design: Randomized, single-blinded, experimental study. Setting: University Hospital. Participants and subjects: Seven healthy human volunteers. Interventions: Pneumatic triggering and cycling-off were compared to neural triggering and cycling-off during NIV delivered with the helmet. Measurements and results: Triggering and cycling-off delays, wasted efforts, and breathing comfort were determined during restricted breathing efforts (< 20% of voluntary maximum EA(di)) with various combinations of pressure support (PSV) (5, 10, 20 cm H2O) and respiratory rates (10, 20, 30 breath/min). During pneumatic triggering and cycling-off, the subject-ventilator synchrony was progressively more impaired with increasing respiratory rate and levels of PSV (p < 0.001). During neural triggering and cycling-off, effect of increasing respiratory rate and levels of PSV on subject-ventilator synchrony was minimal. Breathing comfort was higher during neural triggering than during pneumatic triggering (p < 0.001). Conclusions: The present study demonstrates in healthy subjects that subject-ventilator synchrony, trigger effort, and breathing comfort with a helmet interface are considerably less impaired during increasing levels of PSV and respiratory rates with neural triggering and cycling-off, compared to conventional pneumatic triggering and cycling-off."],["dc.identifier.doi","10.1007/s00134-008-1163-z"],["dc.identifier.isi","000258562800011"],["dc.identifier.pmid","18512045"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?goescholar/3108"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53454"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","0342-4642"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Subject-ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation"],["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.journal","Frontiers in Immunology"],["dc.bibliographiccitation.volume","12"],["dc.contributor.affiliation","Abusukhun, Murad; \r\n1\r\nDepartment of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany"],["dc.contributor.affiliation","Winkler, Martin S.; \r\n3\r\nDepartment of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany"],["dc.contributor.affiliation","Pöhlmann, Stefan; \r\n4\r\nInfection Biology Unit, German Primate Center-Leibniz Institute for Primate Research, Göttingen, Germany"],["dc.contributor.affiliation","Moerer, Onnen; \r\n3\r\nDepartment of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany"],["dc.contributor.affiliation","Meissner, Konrad; \r\n3\r\nDepartment of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany"],["dc.contributor.affiliation","Tampe, Björn; \r\n6\r\nDepartment of Nephrology, University of Göttingen, Göttingen, Germany"],["dc.contributor.affiliation","Hofmann-Winkler, Heike; \r\n4\r\nInfection Biology Unit, German Primate Center-Leibniz Institute for Primate Research, Göttingen, Germany"],["dc.contributor.affiliation","Bauer, Michael; \r\n1\r\nDepartment of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany"],["dc.contributor.affiliation","Gräler, Markus H.; \r\n1\r\nDepartment of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany"],["dc.contributor.affiliation","Claus, Ralf A.; \r\n1\r\nDepartment of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany"],["dc.contributor.author","Abusukhun, Murad"],["dc.contributor.author","Winkler, Martin S."],["dc.contributor.author","Pöhlmann, Stefan"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Meissner, Konrad"],["dc.contributor.author","Tampe, Björn"],["dc.contributor.author","Hofmann-Winkler, Heike"],["dc.contributor.author","Bauer, Michael"],["dc.contributor.author","Gräler, Markus H."],["dc.contributor.author","Claus, Ralf A."],["dc.date.accessioned","2022-02-01T10:31:39Z"],["dc.date.available","2022-02-01T10:31:39Z"],["dc.date.issued","2021"],["dc.date.updated","2022-02-09T13:20:12Z"],["dc.description.abstract","Effective treatment strategies for severe coronavirus disease (COVID-19) remain scarce. Hydrolysis of membrane-embedded, inert sphingomyelin by stress responsive sphingomyelinases is a hallmark of adaptive responses and cellular repair. As demonstrated in experimental and observational clinical studies, the transient and stress-triggered release of a sphingomyelinase, SMPD1, into circulation and subsequent ceramide generation provides a promising target for FDA-approved drugs. Here, we report the activation of sphingomyelinase-ceramide pathway in 23 intensive care patients with severe COVID-19. We observed an increase of circulating activity of sphingomyelinase with subsequent derangement of sphingolipids in serum lipoproteins and from red blood cells (RBC). Consistent with increased ceramide levels derived from the inert membrane constituent sphingomyelin, increased activity of acid sphingomyelinase (ASM) accurately distinguished the patient cohort undergoing intensive care from healthy controls. Positive correlational analyses with biomarkers of severe clinical phenotype support the concept of an essential pathophysiological role of ASM in the course of SARS-CoV-2 infection as well as of a promising role for functional inhibition with anti-inflammatory agents in SARS-CoV-2 infection as also proposed in independent observational studies. We conclude that large-sized multicenter, interventional trials are now needed to evaluate the potential benefit of functional inhibition of this sphingomyelinase in critically ill patients with COVID-19."],["dc.description.abstract","Effective treatment strategies for severe coronavirus disease (COVID-19) remain scarce. Hydrolysis of membrane-embedded, inert sphingomyelin by stress responsive sphingomyelinases is a hallmark of adaptive responses and cellular repair. As demonstrated in experimental and observational clinical studies, the transient and stress-triggered release of a sphingomyelinase, SMPD1, into circulation and subsequent ceramide generation provides a promising target for FDA-approved drugs. Here, we report the activation of sphingomyelinase-ceramide pathway in 23 intensive care patients with severe COVID-19. We observed an increase of circulating activity of sphingomyelinase with subsequent derangement of sphingolipids in serum lipoproteins and from red blood cells (RBC). Consistent with increased ceramide levels derived from the inert membrane constituent sphingomyelin, increased activity of acid sphingomyelinase (ASM) accurately distinguished the patient cohort undergoing intensive care from healthy controls. Positive correlational analyses with biomarkers of severe clinical phenotype support the concept of an essential pathophysiological role of ASM in the course of SARS-CoV-2 infection as well as of a promising role for functional inhibition with anti-inflammatory agents in SARS-CoV-2 infection as also proposed in independent observational studies. We conclude that large-sized multicenter, interventional trials are now needed to evaluate the potential benefit of functional inhibition of this sphingomyelinase in critically ill patients with COVID-19."],["dc.identifier.doi","10.3389/fimmu.2021.784989"],["dc.identifier.eissn","1664-3224"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/98916"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-517"],["dc.publisher","Frontiers Media S.A."],["dc.relation.eissn","1664-3224"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0/"],["dc.title","Activation of Sphingomyelinase-Ceramide-Pathway in COVID-19 Purposes Its Inhibition for Therapeutic Strategies"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","126"],["dc.bibliographiccitation.issue","2"],["dc.bibliographiccitation.journal","CRITICAL CARE"],["dc.bibliographiccitation.volume","13"],["dc.contributor.author","Quintel, Michael"],["dc.contributor.author","Moerer, Onnen"],["dc.date.accessioned","2018-11-07T08:34:17Z"],["dc.date.available","2018-11-07T08:34:17Z"],["dc.date.issued","2009"],["dc.description.abstract","Extracorporeal lung-supporting procedures open the possibility of staying within widely accepted margins of 'protective' mechanical ventilation (tidal volume of less than 6 mL per kg of predicted ideal body weight and plateau pressure of less than 30 cm H(2)O) in most any case of respiratory failure or even of further reducing ventilator settings while still providing adequate gas exchange. There is evidence that, at least in some patients, a further reduction in tidal volumes might be beneficial. Extracorporeal procedures to support the lungs have undergone tremendous technical developments, thus reducing the procedure-related risks. However, what is true for ventilator settings should also be true for extracorporeal procedures: studies will have to demonstrate a convincing risk-benefit ratio. In addition, a simple reduction of the tidal volume will certainly not be the right answer. If extracorporeal support largely influences gas exchange, the 'optimal' tidal volume/positive end-expiratory pressure ratio keeping stress and strain low and avoiding alveolar derecruitment will still have to be individually defined."],["dc.identifier.doi","10.1186/cc7738"],["dc.identifier.isi","000266638500038"],["dc.identifier.pmid","19435467"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/5951"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/17775"],["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","Is smaller high enough? Another piece in the puzzle of stress, strain, size, and systems"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dc.type.subtype","letter_note"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]