Harnisch, Lars-Olav

[["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","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.firstpage","3844"],["dc.bibliographiccitation.issue","12"],["dc.bibliographiccitation.journal","Journal of Clinical Medicine"],["dc.bibliographiccitation.volume","9"],["dc.contributor.author","Harnisch, Lars-Olav"],["dc.contributor.author","Moerer, Onnen"],["dc.date.accessioned","2021-04-14T08:24:35Z"],["dc.date.available","2021-04-14T08:24:35Z"],["dc.date.issued","2020"],["dc.identifier.doi","10.3390/jcm9123844"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/17670"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/81344"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-399"],["dc.notes.intern","Merged from goescholar"],["dc.publisher","MDPI"],["dc.relation.eissn","2077-0383"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","The Specific Bile Acid Profile of Shock: A Hypothesis Generating Appraisal of the Literature"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","4705042"],["dc.bibliographiccitation.firstpage","1"],["dc.bibliographiccitation.journal","Pulmonary Medicine"],["dc.bibliographiccitation.lastpage","8"],["dc.bibliographiccitation.volume","2020"],["dc.contributor.author","Harnisch, L. O."],["dc.contributor.author","Olgemoeller, U."],["dc.contributor.author","Mann, J."],["dc.contributor.author","Quintel, M."],["dc.contributor.author","Moerer, O."],["dc.date.accessioned","2020-07-22T09:10:14Z"],["dc.date.accessioned","2021-10-27T13:22:15Z"],["dc.date.available","2020-07-22T09:10:14Z"],["dc.date.available","2021-10-27T13:22:15Z"],["dc.date.issued","2020"],["dc.description.abstract","Background. Noninvasive neurally adjusted ventilatory assist (NAVA) has been shown to improve patient-ventilator interaction in many settings. There is still scarce data with regard to postoperative patients indicated for noninvasive ventilation (NIV) which this study elates. The purpose of this trial was to evaluate postoperative patients for synchrony and comfort in noninvasive pressure support ventilation (NIV-PSV) vs. NIV-NAVA. Methods. Twenty-two subjects received either NIV-NAVA or NIV-PSV in an object-blind, prospective, randomized, crossover fashion (observational trial). We evaluated blood gases and ventilator tracings throughout as well as comfort of ventilation at the end of each ventilation phase. Results. There was an effective reduction in ventilator delays (p<0.001) and negative pressure duration in NIV-NAVA as compared to NIV-PSV (p<0.001). Although we used optimized settings in NIV-PSV, explaining the overall low incidence of asynchrony, NIV-NAVA led to reductions in the NeuroSync-index (p<0.001) and all types of asynchrony except for double triggering that was significantly more frequent in NIV-NAVA vs. NIV-PSV (p=0.02); ineffective efforts were reduced to zero by use of NIV-NAVA. In our population of previously lung-healthy subjects, we did not find differences in blood gases and patient comfort between the two modes. Conclusion. In the postoperative setting, NIV-NAVA is well suitable for use and effective in reducing asynchronies as well as a surrogate for work of breathing. Although increased synchrony was not transferred into an increased comfort, there was an advantage with regard to patient-ventilator interaction. The trial was registered at the German clinical Trials Register (DRKS no.: DRKS00005408)."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2020"],["dc.identifier.doi","10.1155/2020/4705042"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/17448"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/92079"],["dc.language.iso","en"],["dc.notes.intern","Migrated from goescholar"],["dc.relation.eissn","2090-1844"],["dc.relation.issn","2090-1836"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.title","Noninvasive Neurally Adjusted Ventilator Assist Ventilation in the Postoperative Period Produces Better Patient-Ventilator Synchrony but Not Comfort"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","584"],["dc.bibliographiccitation.issue","8"],["dc.bibliographiccitation.journal","Membranes"],["dc.bibliographiccitation.volume","11"],["dc.contributor.author","Harnisch, Lars-Olav"],["dc.contributor.author","Moerer, Onnen"],["dc.date.accessioned","2021-10-01T09:58:29Z"],["dc.date.available","2021-10-01T09:58:29Z"],["dc.date.issued","2021"],["dc.description.abstract","(1) Background: Extracorporeal membrane oxygenation (ECMO) is increasingly used for acute respiratory failure with few absolute but many relative contraindications. The provider in charge often has a difficult time weighing indications and contraindications to anticipate if the patient will benefit from this treatment, a decision that often decides life and death for the patient. To assist in this process in coming to a good evidence-based decision, we reviewed the available literature. (2) Methods: We performed a systematic review through a literature search of the MEDLINE database of former and current absolute and relative contraindications to the initiation of ECMO treatment. (3) Results: The following relative and absolute contraindications were identified in the literature: absolute—refusal of the use of extracorporeal techniques by the patient, advanced stage of cancer, fatal intracerebral hemorrhage/cerebral herniation/intractable intracranial hypertension, irreversible destruction of the lung parenchyma without the possibility of transplantation, and contraindications to lung transplantation; relative—advanced age, immunosuppressed patients/pharmacological immunosuppression, injurious ventilator settings > 7 days, right-heart failure, hematologic malignancies, especially bone marrow transplantation and graft-versus-host disease, SAPS II score ≥ 60 points, SOFA score > 12 points, PRESERVE score ≥ 5 points, RESP score ≤ −2 points, PRESET score ≥ 6 points, and “do not attempt resuscitation” order (DN(A)R status). (4) Conclusions: We provide a simple-to-follow algorithm that incorporates absolute and relative contraindications to the initiation of ECMO treatment. This algorithm attempts to weigh pros and cons regarding the benefit for an individual patient and hopefully assists caregivers to make better, informed decisions."],["dc.description.abstract","(1) Background: Extracorporeal membrane oxygenation (ECMO) is increasingly used for acute respiratory failure with few absolute but many relative contraindications. The provider in charge often has a difficult time weighing indications and contraindications to anticipate if the patient will benefit from this treatment, a decision that often decides life and death for the patient. To assist in this process in coming to a good evidence-based decision, we reviewed the available literature. (2) Methods: We performed a systematic review through a literature search of the MEDLINE database of former and current absolute and relative contraindications to the initiation of ECMO treatment. (3) Results: The following relative and absolute contraindications were identified in the literature: absolute—refusal of the use of extracorporeal techniques by the patient, advanced stage of cancer, fatal intracerebral hemorrhage/cerebral herniation/intractable intracranial hypertension, irreversible destruction of the lung parenchyma without the possibility of transplantation, and contraindications to lung transplantation; relative—advanced age, immunosuppressed patients/pharmacological immunosuppression, injurious ventilator settings > 7 days, right-heart failure, hematologic malignancies, especially bone marrow transplantation and graft-versus-host disease, SAPS II score ≥ 60 points, SOFA score > 12 points, PRESERVE score ≥ 5 points, RESP score ≤ −2 points, PRESET score ≥ 6 points, and “do not attempt resuscitation” order (DN(A)R status). (4) Conclusions: We provide a simple-to-follow algorithm that incorporates absolute and relative contraindications to the initiation of ECMO treatment. This algorithm attempts to weigh pros and cons regarding the benefit for an individual patient and hopefully assists caregivers to make better, informed decisions."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2021"],["dc.identifier.doi","10.3390/membranes11080584"],["dc.identifier.pii","membranes11080584"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/90072"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-469"],["dc.relation.eissn","2077-0375"],["dc.relation.orgunit","Klinik für Anästhesiologie"],["dc.rights","CC BY 4.0"],["dc.title","Contraindications to the Initiation of Veno-Venous ECMO for Severe Acute Respiratory Failure in Adults: A Systematic Review and Practical Approach Based on the Current Literature"],["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","2356"],["dc.bibliographiccitation.issue","12"],["dc.bibliographiccitation.journal","Diagnostics"],["dc.bibliographiccitation.volume","11"],["dc.contributor.affiliation","Harnisch, Lars-Olav; 1Department of Anesthesiology, University of Goettingen Medical Center, Robert-Koch-Str. 40, 37075 Goettingen, Germany; sophie.baumann@med.uni-goettingen.de (S.B.); omoerer@med.uni-goettingen.de (O.M.); mquintel@gwdg.de (M.Q.)"],["dc.contributor.affiliation","Baumann, Sophie; 1Department of Anesthesiology, University of Goettingen Medical Center, Robert-Koch-Str. 40, 37075 Goettingen, Germany; sophie.baumann@med.uni-goettingen.de (S.B.); omoerer@med.uni-goettingen.de (O.M.); mquintel@gwdg.de (M.Q.)"],["dc.contributor.affiliation","Mihaylov, Diana; 2Institute of Clinical Chemistry and Laboratory Medicine of the University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany; diana.mihaylov@med.uni-jena.de (D.M.); michael.kiehntopf@med.uni-jena.de (M.K.)"],["dc.contributor.affiliation","Kiehntopf, Michael; 2Institute of Clinical Chemistry and Laboratory Medicine of the University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany; diana.mihaylov@med.uni-jena.de (D.M.); michael.kiehntopf@med.uni-jena.de (M.K.)"],["dc.contributor.affiliation","Bauer, Michael; 3Department of Anesthesiology, University Hospital Jena, Bachstr. 18, 07743 Jena, Germany; michael.bauer@med.uni-jena.de"],["dc.contributor.affiliation","Moerer, Onnen; 1Department of Anesthesiology, University of Goettingen Medical Center, Robert-Koch-Str. 40, 37075 Goettingen, Germany; sophie.baumann@med.uni-goettingen.de (S.B.); omoerer@med.uni-goettingen.de (O.M.); mquintel@gwdg.de (M.Q.)"],["dc.contributor.affiliation","Quintel, Michael; 1Department of Anesthesiology, University of Goettingen Medical Center, Robert-Koch-Str. 40, 37075 Goettingen, Germany; sophie.baumann@med.uni-goettingen.de (S.B.); omoerer@med.uni-goettingen.de (O.M.); mquintel@gwdg.de (M.Q.)"],["dc.contributor.author","Harnisch, Lars-Olav"],["dc.contributor.author","Baumann, Sophie"],["dc.contributor.author","Mihaylov, Diana"],["dc.contributor.author","Kiehntopf, Michael"],["dc.contributor.author","Bauer, Michael"],["dc.contributor.author","Moerer, Onnen"],["dc.contributor.author","Quintel, Michael"],["dc.date.accessioned","2022-01-11T14:05:56Z"],["dc.date.available","2022-01-11T14:05:56Z"],["dc.date.issued","2021"],["dc.date.updated","2022-02-09T13:20:00Z"],["dc.description.abstract","Background: Impaired liver function and cholestasis are frequent findings in critically ill patients and are associated with poor outcomes. We tested the hypothesis that hypoxic liver injury and hypoxic cholangiocyte injury are detectable very early in patients with ARDS, may depend on the severity of hypoxemia, and may be aggravated by the use of rescue therapies (high PEEP level and prone positioning) but could be attenuated by extracorporeal membrane oxygenation (ECMO). Methods: In 70 patients with ARDS, aspartate-aminotransferase (AST), alanin-aminotransferase (ALT) and gamma glutamyltransferase (GGT) were measured on the day of the diagnosis of ARDS and three more consecutive days (day 3, day 5, day 10), total bile acids were measured on day 0, 3, and 5. Results: AST levels increased on day 0 and remained constant until day 5, then dropped to normal on day 10 (day 0: 66.5 U/l; day 3: 60.5 U/l; day 5: 63.5 U/l, day 10: 32.1 U/l), ALT levels showed the exact opposite kinetic. GGT was already elevated on day 0 (91.5 U/l) and increased further throughout (day 3: 163.5 U/l, day 5: 213 U/l, day 10: 307 U/l), total bile acids levels increased significantly from day 0 to day 3 (p = 0.019) and day 0 to day 5 (p < 0.001), but not between day 3 and day 5 (p = 0.217). Total bile acids levels were significantly correlated to GGT on day 0 (p < 0.001), day 3 (p = 0.02), and in a trend on day 5 (p = 0.055). PEEP levels were significantly correlated with plasma levels of AST (day 3), ALT (day 5) and GGT (day 10). Biomarker levels were not associated with the use of ECMO, prone position, the cause of ARDS, and paO2. Conclusions: We found no evidence of hypoxic liver injury or hypoxic damage to cholangiocytes being caused by the severity of hypoxemia in ARDS patients during the very early phase of the disease. Additionally, mean PEEP level, prone positioning, and ECMO treatment did not have an impact in this regard. Nevertheless, GGT levels were elevated from day zero and rising, this increase was not related to paO2, prone position, ECMO treatment, or mean PEEP, but correlated to total bile acid levels."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2021"],["dc.identifier.doi","10.3390/diagnostics11122356"],["dc.identifier.eissn","2075-4418"],["dc.identifier.pii","diagnostics11122356"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/97784"],["dc.language.iso","en"],["dc.notes.intern","DOI-Import GROB-507"],["dc.relation.eissn","2075-4418"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0/"],["dc.title","Biomarkers of Cholestasis and Liver Injury in the Early Phase of Acute Respiratory Distress Syndrome and Their Pathophysiological Value"],["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","101130"],["dc.bibliographiccitation.firstpage","1"],["dc.bibliographiccitation.journal","Respiratory Medicine Case Reports"],["dc.bibliographiccitation.lastpage","6"],["dc.bibliographiccitation.volume","30"],["dc.contributor.author","Chakalov, I."],["dc.contributor.author","Harnisch, L.-O."],["dc.contributor.author","Meyer, A.C."],["dc.contributor.author","Moerer, O."],["dc.date.accessioned","2020-07-29T12:07:20Z"],["dc.date.accessioned","2021-10-27T13:22:17Z"],["dc.date.available","2020-07-29T12:07:20Z"],["dc.date.available","2021-10-27T13:22:17Z"],["dc.date.issued","2020"],["dc.description.abstract","This report presents a case of endotracheal metastasis in which elective veno–venous extracorporeal membrane oxygenation (VV ECMO) was used to undergo tracheal laser-surgery prior to establishment of a definitive airway. Specifically, we describe the respiratory and airway management in an adult patient from the preclinical phase throughout elective preoperative ECMO implantation to postoperative ECMO weaning and decannulation in the Intensive Care Unit. This case report lends further supports to the idea that the extracorporeal membrane oxygenation could be electively used to provide safe environment for surgery in situations where the standard maneuvers of sustaining adequate gas exchange are anticipated to fail."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2020"],["dc.identifier.doi","10.1016/j.rmcr.2020.101130"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/17465"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/92081"],["dc.language.iso","en"],["dc.notes.intern","Migrated from goescholar"],["dc.relation.issn","2213-0071"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.relation.orgunit","Klinik für Anästhesiologie"],["dc.relation.orgunit","Klinik für Hals-Nasen-Ohrenheilkunde"],["dc.rights","CC BY-NC-ND 4.0"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.subject.ddc","610"],["dc.title","Preemptive veno-venous ECMO support in a patient with anticipated difficult airway: A case report"],["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"]]