Publications by authors named "Seiler F"

Target values for arterial carbon dioxide tension (PaCO 2 ) in extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) are unknown. We hypothesized that lower PaCO 2 values on ECMO would be associated with lighter sedation. We used data from two independent patient cohorts with ARDS spending 1,177 days (discovery cohort, 69 patients) and 516 days (validation cohort, 70 patients) on ECMO and evaluated the associations between daily PaCO 2 , pH, and bicarbonate (HCO 3 ) with sedation.

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Background: The evidence regarding effects of statins on exacerbation risk in COPD remains controversial. Previous studies often excluded patients with cardiovascular comorbidities despite their high prevalence in COPD and role for exacerbations. Based on the cardioprotective properties of statins, we hypothesised that statins may reduce the risk of exacerbations especially in patients with cardiovascular comorbidities.

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  • 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.
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Background: MRproANP and COPAVP are prognostic markers for mortality in chronic obstructive pulmonary disease (COPD). Furthermore, these biomarkers predict mortality due to cardiovascular diseases, which are important prognostically determining comorbidities in patients with COPD. However, less is known about these biomarkers in recently diagnosed mild to moderate COPD.

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  • ECMO is a life-saving treatment for patients with severe lung injuries, but sometimes it fails to improve low oxygen levels in the blood.
  • Some patients have been treated with a second membrane lung connected either in series (one after the other) or in parallel (side by side) to help with this issue, but it's unclear which method works better.
  • Testing showed that using two lungs in a series configuration was 17% more effective at transferring oxygen compared to a parallel setup, but more research is needed before this approach can be widely adopted due to its invasive nature.
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  • 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.
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  • The m.3243A > G mutation in mitochondrial DNA is a rare cause of hypertrophic cardiomyopathy (HCM) and is linked to various cardiomyopathies within the same family.
  • A 48-year-old male patient with this mutation presented with symptoms like chest pain and dyspnea, along with medical history including hearing loss, prediabetes, and findings from cardiac assessments suggesting non-obstructive HCM.
  • Genetic testing revealed this mutation in several family members, highlighting matrilinear transmission and demonstrating diverse clinical manifestations like deafness, diabetes, and different types of cardiomyopathy.
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There is ongoing debate whether lung physiology of COVID-19-associated acute respiratory distress syndrome (ARDS) differs from ARDS of other origin. : The aim of this study was to analyze and compare how critically ill patients with COVID-19 and Influenza A or B were ventilated in our tertiary care center with or without extracorporeal membrane oxygenation (ECMO). We ask if acute lung failure due to COVID-19 requires different intensive care management compared to conventional ARDS.

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Low flow extracorporeal carbon dioxide removal (ECCO2R) is a promising approach to correct hypercapnic lung failure, facilitate lung protective ventilation in acute respiratory distress syndrome and to possibly prevent the application of invasive ventilation. However, the predominant availability of adult membrane lungs (MLs) at most intensive care units are burdens for low flow ECCO2R that intends to reduce cannula size and promote the mobility of the patients. Herein, in a mock setup, we combine the idea of a low flow ECCO2R and the use of adult MLs by installing a recirculation channel into the circuit and comparing the new setup to an already clinically established setup, "the Homburg lung.

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Introduction: Chronic heart failure (CHF) is associated with elevated total blood volume (BV) and distinct phenotypes of total red cell volume (RCV) and plasma volume (PV) elevations. Especially PV expansion during clinical decompensation is linked with adverse clinical outcomes. The role of PV expansion in compensated CHF patients is less clear.

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  • Early prognosis of COVID-19 severity can be improved using specific biomarkers like TRAIL, IP-10, and CRP for patient care.
  • In a study with 132 COVID-19 patients, it was found that TRAIL levels were significantly lower, while IP-10 and CRP levels were higher compared to healthy controls, indicating potential links to disease severity.
  • Multivariable analysis revealed obesity, CRP, and peak IP-10 levels as independent predictors of mortality in ICU, suggesting their importance in assessing patient outcomes.
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Extracorporeal membrane oxygenation (ECMO) has become an important therapeutic approach in the COVID-19 pandemic. The development and research in this field strongly relies on animal models; however, efforts are being made to find alternatives. In this work, we present a new mock circuit for ECMO that allows measurements of the oxygen transfer rate of a membrane lung at full ECMO blood flow.

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Coronavirus disease 2019 (COVID-19) has drastically increased the number of patients requiring extracorporeal life support. We investigate the efficacy and safety of low-dose recombinant tissue-type plasminogen activator (rtPA) injection into exhausted oxygenators to delay exchange in critically ill COVID-19 patients on veno-venous extracorporeal membrane oxygenation (V-V ECMO). Small doses of rtPA were injected directly into the draining section of a V-V ECMO circuit.

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Balanced pan-class I phosphoinositide 3-kinase inhibition as an approach to cancer treatment offers the prospect of treating a broad range of tumor types and/or a way to achieve greater efficacy with a single inhibitor. Taking buparlisib as the starting point, the balanced pan-class I PI3K inhibitor (NVP-CLR457) was identified with what was considered to be a best-in-class profile. Key to the optimization to achieve this profile was eliminating a microtubule stabilizing off-target activity, balancing the pan-class I PI3K inhibition profile, minimizing CNS penetration, and developing an amorphous solid dispersion formulation.

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  • The study investigates whether cancer patients with severe respiratory failure gain any survival benefits from using veno-venous extracorporeal membrane oxygenation (vv-ECMO).
  • It analyzes data from 297 cancer patients treated with vv-ECMO between 2009 and 2019 across German and Austrian hospitals, revealing a low 60-day overall survival rate of 26.8%.
  • Findings indicate that factors like low platelet count, high lactate levels, and certain disease statuses negatively impact survival, but the study concludes that the overall efficacy of vv-ECMO in these patients remains uncertain, highlighting the need for further research.
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  • Neuraxial labor analgesia has been linked to increased maternal temperature; however, the exact reason for this association is unclear, with suggestions including infection, changes in thermoregulation, and inflammation triggered by local anesthetics.
  • A retrospective study was conducted to compare the incidence of maternal fever between continuous spinal and epidural labor analgesia among women who were nulliparous, analyzing data between June 2012 and March 2020.
  • The study found no significant difference in the rate of maternal fever between the two methods, as 9.9% of women receiving continuous spinal analgesia experienced fever compared to 11.1% in the epidural group, with a statistical analysis indicating no significant difference (P =
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Plasma volume and especially plasma volume excess is a relevant predictor for the clinical outcome of heart failure patients. In recent years, estimated plasma volume based on anthropometric characteristics and blood parameters has been used whilst direct measurement of plasma volume has not entered clinical routine. It is unclear whether the estimation of plasma volume can predict a true plasma volume excess.

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Background: The suitability of laparoscopic varicocelectomy for assisted reproductive technology depends on the improvement of semen parameters. The present study analyzed the improvement of semen parameters following laparoscopic varicocele ligation.

Material And Methods: A retrospective study of the laparoscopic varicocele clippings at the Department of Urology of University Hospital of Kiel between the years 2007 and 2019 was conducted.

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  • In 2020, a novel coronavirus led to the COVID-19 pandemic, causing many cases of ARDS, but other treatable infections should also be considered.
  • A 36-year-old man developed ARDS after flu-like symptoms following a half-marathon; initial treatment aimed at COVID-19 was not effective until a change in therapy based on specific test results.
  • This case highlights the need to follow treatment guidelines closely and consider alternative causes for severe pneumonia or ARDS in patients.
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Background: In systolic chronic heart failure, a heterogeneous blood volume (BV) regulation can be found with plasma volume expansion in many cases, possibly leading to pseudoanemia. Little is known about the volume status after heart transplantation (HTX). So far, anemia of HTX recipients was solely investigated using hemoglobin-concentration that may be misleading in a clinical context.

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  • Extracorporeal carbon dioxide removal (ECCOR) is vital for treating severe lung conditions like COPD and ARDS, and this study compares different membrane lung designs to assess their CO2 removal efficiency.* -
  • The research tested circular and parallel-plated membrane lungs under various gas and blood flow rates, revealing that circular lungs perform better at low gas flow rates (0.5 L/min), while parallel-plated designs excel at medium (2-4 L/min) and high (6 L/min) flow rates.* -
  • Findings suggest that the unique fiber orientation of circular lungs reduces shunting, making them potentially more efficient for low flow situations, which could be important for developing portable ECCOR devices in the future
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Objectives: Patients with chronic obstructive pulmonary disease and lung emphysema may benefit from surgical or endoscopic lung volume reduction (ELVR). Previously reported outcomes of nitinol coil-based ELVR techniques have been ambiguous. The analysis was done to analyse outcomes of ELVR with nitinol coils in patients with severe pulmonary emphysema.

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Background: It has been suggested that COVID-19-associated severe respiratory failure (CARDS) might differ from usual acute respiratory distress syndrome (ARDS) due to failing autoregulation of pulmonary vessels and higher shunt. We sought to investigate pulmonary hemodynamics and ventilation properties in patients with CARDS compared to patients with ARDS of pulmonary origin.

Methods: This was a retrospective analysis of prospectively collected data from consecutive adults with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 patients treated in our ICU in 04/2020 and a comparison of the data to matched controls with ARDS due to respiratory infections treated in our ICU from 01/2014 to 08/2019 for whom pulmonary artery catheter data were available.

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