Publications by authors named "Gerald Ihra"
Article Synopsis
- - This study examined how albumin supplementation affects the pharmacokinetics (PK) of the drug piperacillin/tazobactam in severely burned patients in the ICU, focusing on both total and unbound drug concentrations.
- - Seven patients with significant burn injuries were monitored before and after receiving albumin along with their scheduled piperacillin/tazobactam administration, utilizing IV microdialysis and arterial plasma sampling for accurate PK analysis.
- - Results indicated that while there was a slight numerical increase in total and unbound drug exposure after albumin substitution, overall, albumin had little impact on the PK of piperacillin/tazobactam, suggesting that further research is needed for drugs that are more
Background: As a consequence of improved survival rates after burn injury occupational reintegration of burn survivors has gained increasing significance. We aimed to develop a precise patient questionnaire as a tool to evaluate factors contributing to occupational reintegration.
Material And Methods: A questionnaire comprising 20 questions specifically evaluating occupational reintegration was developed under psychological supervision.
Hyperbaric oxygen therapy (HBOT) has been shown to improve tissue hypoxia, neovascularization and ischemia reperfusion injury and reduce pathologic inflammation in various clinical settings and was proposed to be a game changer in treatment of burns. Improved and faster wound healing as well as a reduction of morbidity and mortality after thermal and concomitant carbon monoxide poisoning are expected. In defiance of the observed benefits for burn wounds and carbon monoxide poisoning in animal models and few randomized controlled trials there is an ongoing controversy regarding its use, indications and cost effectiveness.
View Article and Find Full Text PDFObjectives: The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.
Methods: A retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI)≥3, a total burn surface area (TBSA)≥10%, and an ICU stay of at least 24h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray.
Background: Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns.
Methods: A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia.
Background: Gastrointestinal complications occur frequently in intensive care patients with severe burns. Intestinal infarction and its deleterious consequences result in high mortality despite rapid surgical intervention. Our objective was to evaluate the aetiology of gastrointestinal infarction in intensive care patients with severe burns.
View Article and Find Full Text PDFPurpose: To evaluate the development of demographics and outcome of very old (>80 years) critically ill patients admitted to intensive care units.
Setting: All consecutive patients admitted to 41 Austrian intensive care units (ICUs) over an 11-year period.
Methods: We performed a retrospective cohort study of prospectively collected data.
Background: A new device was developed to deliver high-frequency jet ventilation via a laryngeal mask airway (LMA). We investigated its use during flexible fiberoptic bronchoscopy in anesthetized patients.
Methods: Thirty adults were studied during interventional bronchoscopy.
Background: Supraglottic jet ventilation (JV(S)) with injectors above airway stenoses may result in inadvertent high lung pressures. We designed this study to investigate intrinsic positive end-expiratory pressure (PEEP(i)) during jet ventilation via a distant injector in a model of dynamic upper airway obstruction.
Methods: Respiratory pressure-time curves were recorded during JV(S) in a tracheal lung model using a pig's trachea and an embolectomy catheter's air-filled balloon to simulate 60 and 80% airway obstruction.
Considering the measurement of pressures generated during jet ventilation.
Paediatr Anaesth
September 2009
Background: High-frequency jet ventilation (HFJV) can lead to high-airway pressures under certain conditions. In this laboratory study, we evaluated the influence of the injector's position relative to a fixed airway obstruction on peak pressures in a tracheal-lung model.
Methods: We administered HFJV via a metal jet injector at varying distances from connectors simulating laryngotracheal airway stenosis.
Total hip or knee replacement surgeries are common orthopedic interventions that can be performed with spinal anesthesia (SA) or general anesthesia (GA). No study has investigated the economic aspects associated with the two anesthetic techniques for this common surgery. We randomized 40 patients to receive either SA or GA and analyzed the drug and supply costs for anesthesia und recovery.
View Article and Find Full Text PDFSurgical treatment in the skeleton region and its adjacent tissue causes severe pain, demonstrated by the high demand of anaesthetics in the early postoperative phase. In order to offer adequate and individually adapted pain management, the orthopaedic department is working closely with the departments of anaesthesiology and intensive care medicine of the Vienna Medical University at the Vienna's General Hospital. The aim of this cooperation is to start postoperative rehabilitation early, to increase postoperative quality of life and to reduce the length of hospital stay.
View Article and Find Full Text PDFObjective: To quantify the effect of superimposed high-frequency jet ventilation on lung recruitment in adult patients with acute lung injury.
Design And Setting: Prospective clinical study in the intensive care unit of a university teaching hospital.
Patients: Eight adults suffering from acute lung injury with a mean lung injury score of 2.