Publications by authors named "Hackl G"

Article Synopsis
  • In rare cases, patients who are intoxicated may need extracorporeal procedures to help remove toxins from their bodies more effectively.
  • The EXTRIP workgroup provides updated guidelines based on evidence and consensus for using these procedures in critically ill, poisoned patients.
  • The best results for toxin removal occur with substances that have specific properties, and intermittent hemodialysis is the most effective method, while continuous procedures are better for patients with compromised blood flow.
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  • A study analyzed 581 cases of acute poisoning admitted to a medical ICU in Austria from 2007 to 2021, revealing that suicidal intent was the primary cause in nearly half of the cases and that 46.6% involved mixed intoxications.
  • The research utilized various data sources, including ICU records and autopsy reports, and found that while ICU mortality was low at 4.1%, pre-existing psychiatric illnesses had increased significantly among patients over time.
  • Compared to a historical dataset from 1992-1996, there was a notable shift away from gastric lavage as a detoxification method and a rise in alternative techniques, indicating changes in treatment approaches for intoxicated patients.
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Introduction: Soluble urokinase plasminogen activator receptor (suPAR) is a biologically active protein and increased levels are associated with worse outcomes in critically ill patients. suPAR in bronchoalveolar fluid (BALF) may be helpful to differentiate between types of acute respiratory distress syndrome (ARDS) and may have potential for early detection of fungal infection.

Methods: We prospectively investigated levels of suPAR in BALF and serum in critically ill patients who underwent bronchoscopy for any reason at the ICU of the Department of Internal Medicine, Medical University of Graz, Graz, Austria.

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Article Synopsis
  • Carbohydrate-deficient transferrin (CDT) and the Anttila-Index are biomarkers that may indicate heavy alcohol use and could predict delirium and mortality in critically ill patients.
  • In a study of 343 ICU patients, 35% experienced delirium, with those affected showing significantly higher levels of CDT and Anttila-Index upon admission.
  • Higher CDT and Anttila-Index levels were linked to both the occurrence of delirium and longer duration of delirium, as well as increased hospital mortality risk.
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  • Ingestion of leaves from the European yew tree can lead to severe heart issues, including fatal arrhythmias and cardiogenic shock, due to toxic alkaloids blocking important cardiac channels.
  • A case study of a 39-year-old patient who experienced toxic cardiogenic shock from yew poisoning highlights the potential for recovery using venoarterial extracorporeal membrane oxygenation (VA-ECMO).
  • This report underscores the importance of recognizing poisoning as a reversible cause of cardiac arrest and supports the early application of VA-ECMO in similar poisoning cases.
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  • HDL (high-density lipoproteins) may protect against sepsis by aiding steroid production, clearing toxins, and maintaining blood vessel health, but their levels drop sharply during sepsis for unclear reasons.
  • In a study involving ICU patients, significant differences in lipoprotein metabolism enzymes were found; sepsis patients had lower LCAT and CETP activity, higher PLTP and EL, and a 10-fold increase in serum amyloid A (SAA) compared to non-sepsis patients.
  • The study highlights important metabolic changes during sepsis and suggests that enzyme activity, particularly LCAT, may be linked to mortality, opening doors for potential new treatments.
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  • Foodborne intoxications and toxicoinfections are increasing, often causing self-limiting symptoms, but severe cases can require hospitalization, especially those involving resistant toxins like cereulide.
  • A case series is presented involving five healthy adults who became severely ill after consuming fried rice balls contaminated with high levels of cereulide, leading to symptoms ranging from vomiting and diarrhea to acute liver failure.
  • The study highlights the risks of consuming contaminated rice meals that aren't freshly prepared and underscores the need for a comprehensive, multidisciplinary approach to diagnose and manage food poisoning cases effectively.
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Background: The COVID-19 pandemic has occupied the time and resources of health care professionals for more than 1 year. The risk of missed diagnoses has been discussed in the medical literature, mainly for common diseases such as cancer and cardiovascular events. However, rare diseases also need appropriate attention in times of a pandemic.

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Sepsis biomarkers and potential therapeutic targets are urgently needed. With proton nuclear magnetic resonance (H NMR) spectroscopy, several metabolites can be assessed simultaneously. Fifty-three adult medical ICU sepsis patients and 25 ICU controls without sepsis were prospectively enrolled.

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Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker and risk factor for kidney diseases, with a potential prognostic value in critically ill patients. In this monocentric prospective study, we measured plasma suPAR levels immediately after ICU admission in unselected 237 consecutive patients using a turbidimetric assay. Primary objective was the prognostic value for ICU- and 28-day mortality.

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High-density lipoprotein (HDL) plays an essential role in the immune system and shows effective antioxidative properties. We investigated correlations of lipid parameters with the sequential organ failure assessment (SOFA) score and the prognostic association with mortality in sepsis patients admitted to intensive care unit (ICU). We prospectively recruited consecutive adult patients with sepsis and septic shock, according to sepsis-3 criteria as well as non-sepsis ICU controls.

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Background: Poppers are nitrite-containing liquids, which are inhaled for their aphrodisiac and hallucinogenic effects. Despite some cases of severe poisonings, poppers are often perceived as harmless by consumers. Inhalation and ingestion of poppers are well known, but, according to our literature review, intravenous abuse has not been reported before.

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While monitoring and symptomatic care is sufficient for most intoxicated patients, some develop life threatening symptoms. We present recent changes in the recommendations of the treatment in patients with calcium channel blocker, beta blocker and high dose paracetamol intoxications. Additionally, new insights in the efficacy and safety of the use of physostigmine in anticholinergic patients and beta blockers in cocaine intoxication are discussed as well as the specific considerations in the resuscitation of intoxicated patients.

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In medical intensive care units, acute intoxications contribute to a large proportion of all patients. Epidemiology and a basic overview on this topic were presented in part one. The purpose of this second part regarding toxicological biomarkers in the ICU setting focuses on specific poisons and toxins.

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In Europe, more than 50 approved cultivars of fiber hemp (Cannabis sativa L.) are in agricultural production. Their content of psychoactive tetrahydrocannabinol (THC) is legally restricted to <0.

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Acute intoxications account for a significant proportion of the patient population in intensive care units and sedative medications, ethanol, illicit drugs, inhalable poisons and mixed intoxications are the most common causes. The aim of this article is to describe biomarkers for screening and diagnosis of acute intoxications in critically ill patients. For this purpose, a survey of the relevant literature was conducted, and guidelines, case reports, expert assessments, and scientific publications were reviewed.

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A 56-year-old woman was found unconscious and promptly intubated. The electrocardiogram showed ST elevations in I, aVL, V1-V4. Thus, lysis therapy was performed.

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Acute poisonings account for a significant proportion of the patient population presenting to intensive care units, whereby mixed drug overdoses and prescription drug overdoses predominate. The aim of this article was to describe indications for screening, diagnosis and therapy monitoring in acute overdoses in the intensive care unit. To conduct this work, a literature search was carried out and a review was written based on guidelines, case reports, expert opinions and scientific publications.

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Background: Microangiopathic hemolytic anemias and thrombocytopenias in pregnant or postpartum women constitute an interdisciplinary diagnostic and therapeutic challenge in the evaluation of thrombotic microangiopathies (TMA), where urgent care must be considered.

Case Presentation: We here report the case of a 21-year-old Somali woman, who was delivered by emergency caesarean section at 35 weeks of gestational age with acute dyspnea, placental abruption and gross edema due to severe preeclampsia/HELLP syndrome. After delivery, she developed acute kidney failure and thrombotic microangiopathy as revealed by kidney biopsy.

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