Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献

[Postextubation dysphagia : Challenges regarding interdisciplinary collaboration in intensive care units]. [拔管后吞咽困难：重症监护病房跨学科合作的挑战]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-07-22 DOI: 10.1007/s00063-025-01304-6

Lena Glißmann, Katrin Bangert-Tobies

{"title":"[Postextubation dysphagia : Challenges regarding interdisciplinary collaboration in intensive care units].","authors":"Lena Glißmann, Katrin Bangert-Tobies","doi":"10.1007/s00063-025-01304-6","DOIUrl":"https://doi.org/10.1007/s00063-025-01304-6","url":null,"abstract":"Background: Postextubation dysphagia (PED) represents a significant morbidity and mortality factor even in nonneurological intensive care units (ICU), potentially prolonging both ICU and overall hospital stays.Methods: A literature review was conducted to access the relevance, diagnostic approaches, and therapeutic options for PED, which were then placed in context using a clinical case study.Results: Although evidence-based guidelines for PED are lacking in the literature, several articles and recommendations addressing multiprofessional treatment strategies were identified. In addition to the necessity of systematic dysphagia screening and early therapeutic interventions, particular attention should be paid to predictors that can be identified early-for example, through the use of checklists-and addressed by a multiprofessional care team.Conclusion: Interdisciplinary collaboration is essential for the effective diagnosis and management of PED with the potential to improve both clinical outcomes and quality of life in affected patients. In particular, early screening, daily activation of orofacial functions within nursing care, targeted swallowing therapy, mobilization, respiratory therapy and device-supported respiratory therapy may contribute to improved patient trajectories following extubation.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Survey of staffing structures and equipment in 176 German emergency departments]. [对176个德国急诊科人员结构和设备的调查]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-07-21 DOI: 10.1007/s00063-025-01299-0

Uwe Janssens, Torben Brod, Florian Hoffmann, Martin Pin, Christian Wrede, Christian Karagiannidis, Felix Walcher, Thomas van den Hooven, Gernot Marx, Christian Waydhas

{"title":"[Survey of staffing structures and equipment in 176 German emergency departments].","authors":"Uwe Janssens, Torben Brod, Florian Hoffmann, Martin Pin, Christian Wrede, Christian Karagiannidis, Felix Walcher, Thomas van den Hooven, Gernot Marx, Christian Waydhas","doi":"10.1007/s00063-025-01299-0","DOIUrl":"https://doi.org/10.1007/s00063-025-01299-0","url":null,"abstract":"Background and research question: Adequate staffing, especially with physicians and emergency nursing staff, is essential for high-quality emergency care. The aim of this study was to compare the current staffing situation in German emergency departments with recommended standards.Methods: A questionnaire was developed based on the minimum standards of the German Interdisciplinary Association for Intensive and Emergency Medicine and the German Society for Interdisciplinary Emergency and Acute Medicine. Both the actual staffing and the perceived adequacy were assessed. The anonymous online survey was sent via the joint emergency department registry to the management of 1008 emergency departments.Results: Between 1 June and 31 July 2023, 176 emergency departments (18% response rate) participated. Annual patient numbers ranged from 17,610 to 37,251 depending on the level of care. Qualified nursing and medical leadership was mostly present (about 90%, medical leadership in level 1: 68%). Continuous physician presence was 76%, specialist presence 50%. Specialists with additional emergency medicine training were available in level 1 (one physician) and in levels 2 and 3 (two physicians each). Only 50% of hospitals offered the full 24-month training period. A nurse-to-patient ratio of 1:1200 was met in 40-63% of departments; triage nurses met requirements in 54% of cases.Conclusion: The survey shows that significant staffing deficits persist in German emergency departments at all levels of care-especially regarding the presence and qualifications of physicians, nursing staff, social services, and case management. At the same time, a positive trend in equipment, infrastructure, and staff qualifications is evident.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Blast injuries - mechanisms and management]. [爆炸伤害-机制和管理]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-07-16 DOI: 10.1007/s00063-025-01298-1

Philipp Quintin, Priyanka Boettger, Henning Lemm, Frederic Bludau, Christian S Brülls, Michael Buerke

引用次数: 0

[Consensus paper on focused transesophageal echocardiography (fTEE) in clinical acute and emergency medicine : From the Commission for Clinical Cardiovascular Medicine of the DGK in cooperation with the DGINA, DGIIN and DGIM]. [聚焦经食管超声心动图（fTEE）在临床急症和急诊医学中的共识论文：来自DGK临床心血管医学委员会与DGINA、DGIIN和DGIM合作]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-07-10 DOI: 10.1007/s00063-025-01309-1

Guido Michels, Roland R Brandt, Hans-Jörg Busch, Katrin Fink, Andreas Franke, Stefan Frantz, Christian Jung, Martin Möckel, Caroline Morbach, Kevin Pilarczyk, Dorothea Sauer, Sebastian Wolfrum, Andreas Helfen

引用次数: 0

[Intensive care diaries to reduce of posttraumatic stress disorder for critical care patients-a systematic review with meta-analysis]. [重症监护日记减少重症监护患者的创伤后应激障碍-荟萃分析的系统回顾]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-07-10 DOI: 10.1007/s00063-025-01296-3

Ella Peschel, Martin Hölzl, Joachim Schulze, Peter Nydahl

{"title":"[Intensive care diaries to reduce of posttraumatic stress disorder for critical care patients-a systematic review with meta-analysis].","authors":"Ella Peschel, Martin Hölzl, Joachim Schulze, Peter Nydahl","doi":"10.1007/s00063-025-01296-3","DOIUrl":"https://doi.org/10.1007/s00063-025-01296-3","url":null,"abstract":"Background: Survivors of critical illness have an increased risk of psychological disorders such as posttraumatic stress disorder (PTSD), anxiety disorders or depression. A possible preventive intervention is an intensive care diary. The effect of intensive care diaries on the prevention of these psychosocial disorders remains unclear.Methods: In May 2024, a literature search with following metaanalysis was performed in PubMed, CINAHL, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) and PsychInfo databases based on the metaanalysis of Nydahl et al. (2018). Studies included were studies on intensive diaries with PTSD as the primary outcome and anxiety and depression as secondary outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool 2 and the metaanalysis was performed with RevMan 5.4.1.Results: After reviewing 539 titles, 10 studies were included. The studies were of low to good quality. A total of three metaanalyses were performed. The metaanalysis for PTSD of intensive care patients (n = 1081; 9 studies) showed a significant reduction (OR 0.52 [95% CI: 0.28-0.98] p = 0.04; I2 = 65%, τ2 = 0.46, p = 0.005). Three studies with 427 patients were included in the metaanalyses of anxiety and depression. These showed no significant reduction in the HADS (anxiety: OR 0.55 [95% CI: 0.14-2.18] p = 0.40; I2 = 74%, τ2 = 1.08, p = 0.02; depression: OR 0.50 [95% CI 0.24-1.07] p = 0.08; I2 = 34%, τ2 = 0.17, p = 0.22).Conclusions: Intensive care diaries may reduce the incidence of PTSD for patients after an ICU stay. However, no significant reduction can currently be shown for anxiety or depression.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Working conditions in German intensive care units-A cross-professional analysis]. [德国重症监护病房的工作条件-跨专业分析]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-30 DOI: 10.1007/s00063-025-01302-8

Anna Carola Hertrich, Janika Briegel, Nadine Weeverink, Jan-Hendrik Naendrup, Julian Hoffmann

{"title":"[Working conditions in German intensive care units-A cross-professional analysis].","authors":"Anna Carola Hertrich, Janika Briegel, Nadine Weeverink, Jan-Hendrik Naendrup, Julian Hoffmann","doi":"10.1007/s00063-025-01302-8","DOIUrl":"https://doi.org/10.1007/s00063-025-01302-8","url":null,"abstract":"Background: Intensive care medicine represents a highly complex and labor-intensive field that entails unique physical, psychological and structural challenges for both physicians and nursing personnel. The aim of this study was to systematically analyze the working conditions in German intensive care units (ICUs), with a particular focus on differences between professional groups, hospital types and individual characteristics, such as gender, professional experience and training level.Method: Using a German language online questionnaire a total of 753 ICU personnel from all professional groups were surveyed regarding working conditions, workload and job satisfaction. Recruitment was conducted via professional societies and social media.Results: The results reveal significant differences in job satisfaction depending on the nurse-to-patient ratio, employment level, professional experience and gender. Nursing personnel with a favorable staffing ratio (1:2) reported higher satisfaction and lower stress levels. Younger and less experienced staff reported insufficient preparation, increased stress and lower satisfaction with training and continuing education. Physicians in training, and especially female staff members, more frequently reported having to perform tasks without adequate preparation. Furthermore, gender-based disparities were observed regarding recognition and assumption of responsibility.Conclusion: The findings highlight the urgent need for structural reformation to improve working conditions in ICUs. Key areas for action include structured onboarding, flexible work schedule models, targeted support for junior staff and gender equity as well as improvements in interprofessional collaboration and staffing levels.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Early warning scores: a rapid umbrella review]. [早期预警分数：快速总括审查]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-27 DOI: 10.1007/s00063-025-01294-5

Peter Nydahl, Marie-Madlen Jeitziner, Susanne Krotsetis, Koroush Kabir, Ralf Kuhlen, Jan-Peter Braun

{"title":"[Early warning scores: a rapid umbrella review].","authors":"Peter Nydahl, Marie-Madlen Jeitziner, Susanne Krotsetis, Koroush Kabir, Ralf Kuhlen, Jan-Peter Braun","doi":"10.1007/s00063-025-01294-5","DOIUrl":"https://doi.org/10.1007/s00063-025-01294-5","url":null,"abstract":"Background: Early warning scores (EWS) are used for monitoring and evaluating vital signs in hospitalized patients. With EWS, escalating measures for monitoring, consultation, and admission to intensive care units (ICU) can be initiated based on point values, potentially improving patient outcomes, (mostly mortality, ICU admission, sepsis, cardiac arrest). It remains unclear in which areas the implementation of EWS is most appropriate.Methods: A rapid umbrella review including systematic reviews and meta-analyses, with searches conducted in CINAHL via EBSCO, OVID via Medline, Cochrane via Cochrane Library and LIVIVO via University Library Cologne, and data extraction in May 2024.Results: A total of 44 systematic reviews and 15 meta-analyses covering 542 individual studies with 57 different EWS versions in various settings/aspects such as methodology, patient outcome (sepsis, emergency departments, obstetrics, pediatrics), implementation, performance, and others were identified. Both the analysis results and the level of evidence from the analyses appear heterogeneous. EWS seem to be most effective in reducing risks in high-risk populations such as in emergency departments, geriatric trauma, medicine, and surgery, and possibly post-ICU patients. However, implementation requires extensive resources in terms of staff, structures, and processes to ensure quality improvement. Electronic aids such as monitoring systems, red flags in electronic patient records, and the use of artificial intelligence could significantly support implementation.Conclusion: There is no general recommendation for or against the widespread introduction of EWS. EWS should first be implemented in high-risk areas, considering available staffing and material resources. Electronic systems could assist in implementation.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Ten key messages from the S3 guideline for evidence-based renal replacement therapy in intensive care medicine]. [来自S3指南关于重症医学循证肾替代治疗的十个关键信息]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-26 DOI: 10.1007/s00063-025-01297-2

Carsten Willam, Michael Joannidis, Achim Jörres, Michael Oppert, Michael Schmitz, Stefan John

引用次数: 0

[Predictability of patient disposition from emergency medical services triage categories: exploratory analysis of routine data]. [从紧急医疗服务分类类别中预测患者处置：常规数据的探索性分析]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-25 DOI: 10.1007/s00063-025-01300-w

Torben Brod, Uta Hillebrand, Christoph Schröder, Andreas Flemming, Nils Schneider, Tanja Schleef

{"title":"[Predictability of patient disposition from emergency medical services triage categories: exploratory analysis of routine data].","authors":"Torben Brod, Uta Hillebrand, Christoph Schröder, Andreas Flemming, Nils Schneider, Tanja Schleef","doi":"10.1007/s00063-025-01300-w","DOIUrl":"https://doi.org/10.1007/s00063-025-01300-w","url":null,"abstract":"Background: Efficient and patient-centered emergency care requires early control of patient flow. It is unclear whether this is already possible in the prehospital phase by emergency medical services (EMS) and whether this can contribute to relieving pressure on emergency departments (EDs).Objectives: To examine the correlation between prehospital triage categories by EMS personnel and patient admission/discharge after treatment in the ED, and to assess the use of hospital resources for patients who remained outpatients.Methods: Retrospective analysis of routine preclinical and clinical data from all patients presenting to the ED of a university hospital by EMS over a 2-week period. Analyses were performed descriptively and using the Mann-Whitney U test and the χ2 test. Positive and negative predictive values were also calculated.Results: During the observation period, 570 EMS patients were seen in the ED, of whom 307 (53.9%) remained as outpatients. For 309 (54.2%) of the patients, the triage category assigned by the EMS corresponded to the type of subsequent care (outpatient/inpatient); in 249 cases (43.7%) the need for inpatient care was overestimated. In addition, 262 patients (85.3%) received at least one diagnostic or therapeutic resource prior to discharge, the most common being X‑rays (118/38.4%).Conclusion: In only about half of the cases was the EMS personnel's prognosis consistent with the subsequent decision to admit or discharge the patient from the ED. Patients who remained as outpatients tended to require further diagnostic and therapeutic resources. Therefore, direct transfer of EMS patients to alternative care structures seems risky in the current environment.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[S3 guideline on renal replacement therapy in intensive care medicine : Evidence-based implementation of renal replacement therapy in critically ill patients]. [S3重症医学肾替代治疗指南：危重患者肾替代治疗的循证实施]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-23 DOI: 10.1007/s00063-025-01293-6

Carsten Willam, Mariam Abu-Tair, Matthias Bayer, Romuald Bellmann, Frank Brunkhorst, Florian Custodis, Jan Galle, Carsten Hermes, Michael Joannidis, Stefan John, Achim Jörres, Thomas Kerz, Detlef Kindgen-Milles, Martin Koczor, Rainer Kram, Martin K Kuhlmann, Michael Oppert, Georg Schlieper, Michael Schmitz, Alexander Zarbock, Melanie Meersch

{"title":"[S3 guideline on renal replacement therapy in intensive care medicine : Evidence-based implementation of renal replacement therapy in critically ill patients].","authors":"Carsten Willam, Mariam Abu-Tair, Matthias Bayer, Romuald Bellmann, Frank Brunkhorst, Florian Custodis, Jan Galle, Carsten Hermes, Michael Joannidis, Stefan John, Achim Jörres, Thomas Kerz, Detlef Kindgen-Milles, Martin Koczor, Rainer Kram, Martin K Kuhlmann, Michael Oppert, Georg Schlieper, Michael Schmitz, Alexander Zarbock, Melanie Meersch","doi":"10.1007/s00063-025-01293-6","DOIUrl":"https://doi.org/10.1007/s00063-025-01293-6","url":null,"abstract":"Besides mechanical ventilation, renal replacement therapy is the most frequently performed organ replacement therapy in intensive care medicine. However, there is a lack of consensus- and evidence-based recommendations for the implementation of renal replacement therapy according to the best current knowledge and evidence. This guideline describes the topics of starting a renal replacement therapy, modality (diffusion or convection, continuous or intermittent procedures), anticoagulation, adequate dose, and criteria for stopping renal replacement therapy. In addition, the current evidence on adequate anti-infective therapy is presented under the special features of acute kidney injury and renal replacement therapy.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0