Fatal heat stroke based on foudroyant irreversible multiple organ dysfunction in German summer.

Objectives: Heat stroke is a serious condition that might lead from moderate organ impairment to multiple organ dysfunction syndrome. Appropriate diagnosis-finding, fast initiation of cooling and intensive care are key measures of the initial treatment. Scientific case report based on i) clinical experiences obtained in the clinical management of a particularly rare case and ii) selected references from the medical scientific literature.

["Drug Interaction Stewardship" (DIS) and Therapeutic Drug Monitoring for Anti-infective Treatment in Intensive Care, a Single Centre Observational Study].

Introduction: Appropriate medication of intensive care patients is complicated by disturbed organ functions and organ failure, pathophysiological changes in severely ill patients as well as possible sepsis, ongoing haemodialysis for renal and hepatic insufficiency, varying pharmacokinetics/-dynamics (PK/PD) of drugs as well as numerous drug interactions.

Aim: Illustration of an interdisciplinary approach in daily clinical practice to optimise regular "polymedication" as well as the ongoing medication of patients prior to surgical interventions as indicated and as part of the appropriate peri- and postoperative intensive care management.

Method: A so-called "drug interaction stewardship" (DIS) is very similar to the already established "antibiotic stewardship" (ABS) during daily clinical routine of an intensive care unit and has been implemented.

[Acute Liver Failure, Acute-On-Chronic Liver Failure, Hepatorenal Syndrome, Hepatopulmonary Syndrome and Portopulmonary Hypertension, Artificial Liver Support on the ICU].

Acute hepatic dysfunction in the form of acute liver failure (ALF) or acute-on-chronic liver failure (ACLF) is a disease with a high risk of mortality and requires interdisciplinary intensive care. This article explains the nomenclature, pathophysiology, prognosis and possible treatment options of ALF and ACLF, including the possibilities of extracorporeal liver support therapy at the point of liver transplantation (LTx). Narrative review with a selective literature review and representative case studies.

Nosocomial Infections and Microbiologic Spectrum after Major Elective Surgery of the Pancreas, Liver, Stomach, and Esophagus.

Background: The majority of infections treated by surgeons are nosocomial infections (NI). The frequency of these infections in relation to the organ operated on as well as the organisms involved are not well defined. Detailed knowledge of these issues is essential for optimal care of surgical patients.

PCR-based rapid sepsis diagnosis effectively guides clinical treatment in patients with new onset of SIRS.

Introduction: Early detection of the causing microorganism and timely therapeutic intervention are crucial for improved outcome of patients with sepsis. Quite recently, we evaluated the technical and diagnostic feasibility of a commercial multiplex real-time polymerase chain reaction (PCR) (LightCycler SeptiFast® assay) for detection of blood stream infections in a cohort of intensive care unit (ICU) patients with the risk of abdominal sepsis.

Results And Findings: The PCR positivity rate showed a high coincidence with systemic inflammatory response syndrome (SIRS; 75.