Publications by authors named "Carsten Zeiner"
Article Synopsis
- ARDS is a serious condition, impacting over 10% of ICU patients globally with a high mortality rate, making ECMO a potentially vital, but complex, treatment option.
- Recent research analyzed 283 ARDS patients treated with V-V ECMO in Germany, revealing a median age of 56 and an in-hospital mortality rate of about 50.9%.
- While various scoring systems were evaluated for predicting patient outcomes, the study concluded that none, including the Simplified Acute Physiology Score-II, demonstrated strong predictive value for selecting patients suitable for ECMO.
Background: Current COVID-19 guidelines recommend the early use of systemic corticoids for COVID-19 acute respiratory distress syndrome (ARDS). It remains unknown if high-dose methylprednisolone pulse therapy (MPT) ameliorates refractory COVID-19 ARDS after many days of mechanical ventilation or rapid deterioration with or without extracorporeal membrane oxygenation (ECMO).
Methods: This is a retrospective observational study.
Article Synopsis
- Interhospital transport of ARDS patients using mobile ECMO units does not increase mortality risks for COVID-19 patients compared to those treated at established ECMO centers.
- Overall patient characteristics were similar in terms of age, sex, and health scores, suggesting comparable conditions for both transport groups.
- The study recommends early referral of suitable COVID-19 patients with ARDS to local ECMO centers for optimized care, as transport outcomes align with those treated at specialized facilities.
Critically ill patients in need of specialized diagnostic or therapeutic procedures, but are being cared for in a hospital without such equipment, have to be transferred to appropriate centers without discontinuation of current critical care (interhospital critical care transfer). These transfers are resource intensive, challenging, and require high logistical effort, which must be managed by a specialized and highly trained team, predeployment planning and efficient crew-resource management strategies. If planned adequately, interhospital critical care transfers can be performed safely without frequent adverse events.
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- Critically ill patients sometimes need to be moved from one hospital to another to access specialized care, which requires ongoing critical care during transfer.
- *These transfers are complex, demanding careful planning and a skilled team to minimize risks and ensure patient safety.
- *Additionally, there are unique scenarios, like transfers for quarantine patients or those requiring special equipment, that require adjustments in team structure and resources.