Publications by authors named "Sebastian J Klein"
Article Synopsis
- Sepsis-induced DIC is a serious condition with high morbidity and mortality, and factors like endothelial injury and extracellular vesicles (EV) are crucial in its development.
- The study examined the role of E-selectin, EV, tissue factor (TF), and tissue factor pathway inhibitor (TFPI) in identifying sepsis-induced coagulopathy by analyzing plasma samples from 87 sepsis patients.
- Findings indicated that while only TFPI and TF-PCA levels could effectively discriminate between patients with and without DIC, higher levels of TFPI specifically correlated with worsening DIC, suggesting that these markers could enhance diagnosis and treatment strategies in septic patients.
[Erratum to: Hyponatremia : Etiology, diagnosis and acute therapy].
Med Klin Intensivmed Notfmed
February 2024
Introduction: Acute kidney injury is a frequent complication in critically ill patients with and without COVID-19. The aim of this study was to evaluate the incidence of, and risk factors for, acute kidney injury and its effect on clinical outcomes of critically ill COVID-19 patients in Tyrol, Austria.
Methods: This multicenter prospective registry study included adult patients with a SARS-CoV-2 infection confirmed by polymerase chain reaction, who were treated in one of the 12 dedicated intensive care units during the COVID-19 pandemic from February 2020 until May 2022.
Article Synopsis
- * It can be caused by conditions like neoplasms and pneumonia, or triggered by certain medications and excessive fluid intake.
- * Changes in sodium levels can lead to cell swelling or shrinkage, primarily causing neurological symptoms, making timely diagnosis through blood tests and clinical evaluations important.
Article Synopsis
- The COVID-19 pandemic has stressed global healthcare systems, highlighting the need for better methods to allocate treatment and resources in intensive care for critically ill patients.
- Current risk assessment tools like SOFA and APACHE II have shown limited effectiveness in predicting outcomes for severe COVID-19 patients, necessitating additional monitoring tools, especially for those undergoing experimental therapies.
- A study analyzing plasma proteins from critically ill COVID-19 patients identified 14 proteins that could predict survival more accurately than existing methods, achieving high classification accuracy, especially in relation to coagulation and complement processes.
Article Synopsis
- The study analyzed critically ill COVID-19 patients in Tyrol, Austria, comparing two periods of the pandemic to identify changes in patient characteristics and treatment methods.
- During the second wave, patients were older, and treatments like mechanical ventilation and vasopressors were used less frequently, leading to shorter ICU stays.
- However, while ICU mortality rates remained stable, hospital mortality rates increased, indicating the need for further investigation into factors such as age and comorbidities that may predict outcomes.
Article Synopsis
- COVID-19 exhibits a wide range of symptoms, from none at all to severe complications, and this study looked at 139 hospitalized patients to understand its progression through 86 diagnostic measures.
- An initial surge in inflammation was noted, which later gave way to indicators of tissue healing and immune system adjustments.
- The researchers identified specific markers that could help tailor treatment plans and demonstrated that their machine learning models, based on protein data, could be used effectively across different patient groups.
Article Synopsis
- Metabolic alkalosis can occur in critically ill patients receiving continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA), prompting a study to evaluate the effects of changing bicarbonate replacement fluids.* -
- The study analyzed data from 153 patients, focusing on 42 who switched from a higher bicarbonate solution (Phoxilium) to a lower one (Biphozyl), finding significant reductions in serum bicarbonate concentration and base excess within 24 hours after the switch.* -
- Results indicate that using Biphozyl helps lower bicarbonate levels in patients with refractory metabolic alkalosis during CVVH, suggesting a need for further research to confirm these findings and their clinical implications
Background: Critically ill coronavirus disease 2019 (COVID-19) patients present with a hypercoagulable state with high rates of macrovascular and microvascular thrombosis, for which hypofibrinolysis might be an important contributing factor.
Methods: We retrospectively analysed 20 critically ill COVID-19 patients at Innsbruck Medical University Hospital whose coagulation function was tested with ClotPro® and compared with that of 60 healthy individuals at Augsburg University Clinic. ClotPro is a viscoelastic whole blood coagulation testing device.
Article Synopsis
- The first COVID-19 cases in Tyrol, Austria were detected on February 25, 2020, leading to swift preparations for ICU patient care amid the pandemic.
- A study tracked 106 critically ill COVID-19 patients admitted to ICUs in Tyrol between March 9 and July 17, 2020, highlighting key demographics and treatment needs like mechanical ventilation and renal support.
- ICU and hospital mortality rates were approximately 21.7% and 22.6%, respectively, with findings suggesting a high severity of illness but a relatively low overall mortality rate in the ICU setting.
Background: Multi-organ dysfunction in critical illness is common and frequently involves the lungs and kidneys, often requiring organ support such as invasive mechanical ventilation (IMV), renal replacement therapy (RRT) and/or extracorporeal membrane oxygenation (ECMO).
Methods: A consensus conference on the spectrum of lung-kidney interactions in critical illness was held under the auspices of the Acute Disease Quality Initiative (ADQI) in Innsbruck, Austria, in June 2018. Through review and critical appraisal of the available evidence, the current state of research, and both clinical and research recommendations were described on the following topics: epidemiology, pathophysiology and strategies to mitigate pulmonary dysfunction among patients with acute kidney injury and/or kidney dysfunction among patients with acute respiratory failure/acute respiratory distress syndrome.
Oliguria is often observed in critically ill patients. However, different thresholds in urine output (UO) have raised discussion as to the clinical importance of a transiently reduced UO of less than 0.5 ml/kg/h lasting for at least 6 h.
View Article and Find Full Text PDFPurpose: Acute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed evidence synthesis of the available literature to evaluate the value of biomarkers to predict receipt of RRT for AKI.
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