Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献_第2页

[Yeasts in the lung-colonization or catastrophe? : An infectious disease complication in a patient with acute myeloid leukemia]. [真菌在肺部——定植还是灾难？]急性髓性白血病患者的感染性疾病并发症[j]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-20 DOI: 10.1007/s00063-025-01301-9

Christian Hohmann, Ludwig Abel-Andrée, Dariusz Peszko, Tanja Knoll, Rolf Dembinski

引用次数: 0

[Intraosseous access in infants-development of an anatomical training model]. [婴儿骨内通路-解剖学训练模型的发展]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-19 DOI: 10.1007/s00063-025-01295-4

Dietrich Stoevesandt, Lina Woydt, Joachim Koppenberg, Michael Wolf, Dmitrij Pinekenstein, Stefan Watzke, Thomas Lange, Sascha Kolokowsky, Simone Hettmer, Hartmut Stefani, Franz Stangl, Martin R Fischer

{"title":"[Intraosseous access in infants-development of an anatomical training model].","authors":"Dietrich Stoevesandt, Lina Woydt, Joachim Koppenberg, Michael Wolf, Dmitrij Pinekenstein, Stefan Watzke, Thomas Lange, Sascha Kolokowsky, Simone Hettmer, Hartmut Stefani, Franz Stangl, Martin R Fischer","doi":"10.1007/s00063-025-01295-4","DOIUrl":"https://doi.org/10.1007/s00063-025-01295-4","url":null,"abstract":"Background: Safe intraosseous (i.o) access as an alternative to intravenous (i.v.) access is essential in the treatment of infants and young children in emergency medicine. However, the literature shows high misplacement rates and insufficient training opportunities for potential users. The aim of this study was to analyze malpunctures in postmortem computed tomography (CT) imaging and to develop and evaluate a realistic, cost-effective three-dimensionally (3D) printed training model for i.o. punctures in children under 2 years of age.Materials and methods: The CT data from 25 deceased children under 2 years of age were retrospectively analyzed to document the frequency and type of malpunctures. Based on the findings, a three-part model was produced using filament 3D printing and silicone moulding. The realistic representation of skin, connective tissue, and bone was evaluated by 55 experienced users on a Likert scale.Results: In 40% of the punctures analyzed, there was incorrect placement, often due to inadequate anatomical assessment. The model developed was rated by the interviewees as suitable for beginner training. Suggestions for improvement mainly concerned haptic skin characteristics and the simulation of the loss of resistance after cortical penetration. Material costs for the training model were around 50 cents per puncture.Conclusion: The 3D printed model offers a cost-effective, anatomically precise training option for intraosseous punctures in infants. It can contribute to the improvement of competence and safety during i.o. access, provided it is supplemented by regular training. Future enhancements should further optimize haptic skin characteristics and should provide better feedback on puncture success.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327489","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

[Lipid rescue as a bail-out strategy in a repeatedly resuscitated patient]. [在反复复苏的病人中，脂质拯救是一种救市策略]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-18 DOI: 10.1007/s00063-025-01292-7

Jana Ackmann, Judit Grans-Siebel, Christoph Hüser, Volker Burst, Christoph Adler

引用次数: 0

[Anisocoria in the intensive care unit]. [在加护病房的阿尼索科里亚]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-10 DOI: 10.1007/s00063-025-01283-8

Sebastian Herren, Jowita Bruno, Victor Speidel

引用次数: 0

[Overcoming boundaries-broadening horizons]. [跨越界限，拓宽视野]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-01 Epub Date: 2025-05-26 DOI: 10.1007/s00063-025-01282-9

Georg F Lehner, Michael Joannidis

引用次数: 0

[Multimorbidity as a predictor for inpatient admission in clinical emergency and acute medicine : Single-center cluster analysis]. [临床急诊科住院病人的多病症预测因素：单中心聚类分析]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-01 Epub Date: 2024-09-11 DOI: 10.1007/s00063-024-01180-6

E Grüneberg, R Fliedner, T Beißbarth, C A F von Arnim, S Blaschke

{"title":"[Multimorbidity as a predictor for inpatient admission in clinical emergency and acute medicine : Single-center cluster analysis].","authors":"E Grüneberg, R Fliedner, T Beißbarth, C A F von Arnim, S Blaschke","doi":"10.1007/s00063-024-01180-6","DOIUrl":"10.1007/s00063-024-01180-6","url":null,"abstract":"Background: Parallel to demographic trends, an increase of multimorbid patients in emergency and acute medicine is prominent. To define easily applicable criteria for the necessity of inpatient admission, a hierarchical cluster analysis was performed.Methods: In a retrospective, single-center study data of n = 35,249 emergency cases (01/2016-05/2018) were statistically analyzed. Multimorbidity (MM) was defined by at least five ICD-10-GM diagnoses resulting from treatment. A hierarchical cluster analysis was performed for those diagnoses initially summarized into 112 diagnosis subclusters to determine specific clusters of in- and outpatient cases.Results: Hospital admission was determined in 81.2% of all ED patients (n = 28,633); 54.7% of inpatients (n = 15,652) and 0.97% of outpatient cases (n = 64) met the criteria for multimorbidity and the age difference between them was highly significant (68.7/60.8 years; p < 0.001). Using a hierarchical cluster analysis, 13 clusters with different diagnoses were identified for inpatient multimorbid patients (MP) and 7 clusters with primarily hematological malignancies for outpatient MP. The length of stay in the ED of inpatient MP was more than twice as long (max. 8.3 h) as for outpatient MP (max. 3.2 h.).Conclusions: The combination of diagnoses typical for MM were characterized as clusters in this study. In contrast to single or combined single diagnoses, the statistically determined characterization of clusters allows for a significantly more accurate prediction of ED patients' disposition as well as for economic process allocation.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"419-425"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Treatment with blood products in the intensive care unit]. [在重症监护室用血液制品治疗]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-01 Epub Date: 2025-05-07 DOI: 10.1007/s00063-025-01278-5

Sirak Petros

引用次数: 0

[Overdosing of direct oral anticoagulants]. [直接口服抗凝剂用药过量]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-01 Epub Date: 2024-06-25 DOI: 10.1007/s00063-024-01154-8

Marie Anne-Catherine Neumann, Noëlle Sieg, Jorge Garcia Borrega, Christoph Hüser, Michael Caspers, Alexander Shimabukuro-Vornhagen, Boris Böll, Matthias Kochanek, Dennis A Eichenauer, Jan-Hendrik Naendrup

{"title":"[Overdosing of direct oral anticoagulants].","authors":"Marie Anne-Catherine Neumann, Noëlle Sieg, Jorge Garcia Borrega, Christoph Hüser, Michael Caspers, Alexander Shimabukuro-Vornhagen, Boris Böll, Matthias Kochanek, Dennis A Eichenauer, Jan-Hendrik Naendrup","doi":"10.1007/s00063-024-01154-8","DOIUrl":"10.1007/s00063-024-01154-8","url":null,"abstract":"Background: Direct oral anticoagulants (DOAC) are increasingly used for prophylaxis and treatment of thromboembolic events. Incorrectly dosed DOAC treatment is associated with excess mortality.Purpose: This article aims at raising awareness of DOAC overdosing and its causes as well as presenting a diagnostic and therapeutic work-up.Material and methods: Based on a case presentation, a structured review of the current literature on DOAC overdosing was performed and treatment recommendations were extracted.Results: In addition to wittingly or unwittingly increased DOAC intake, common causes of overdose are inadequate dose adjustment for concomitant medication or comorbidities. Global coagulation testing should be supplemented with DOAC-specific testing. Severe bleeding and the need for invasive diagnostics or urgent surgery represent indications for treating DOAC overdoses. Based on the cause of an DOAC overdose, active charcoal, endoscopic pill rescue, antagonization with idarucizumab or andexanet alfa and the targeted substitution of coagulation factors represent treatment options.Conclusion: The sensitization of clinicians is important to ensure a timely diagnosis and adequate treatment of DOAC overdosing. This report provides an overview of current knowledge on diagnostics and treatment; however, further studies are necessary to improve the existing algorithms.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"426-433"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447394","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

[Representation of women in senior positions in emergency medicine]. [妇女在急诊医学高级职位中的代表性]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-01 Epub Date: 2024-09-24 DOI: 10.1007/s00063-024-01181-5

Nadja Spitznagel, Christine Hidas, Sylvia Schacher

{"title":"[Representation of women in senior positions in emergency medicine].","authors":"Nadja Spitznagel, Christine Hidas, Sylvia Schacher","doi":"10.1007/s00063-024-01181-5","DOIUrl":"10.1007/s00063-024-01181-5","url":null,"abstract":"Background: Gender equality and the empowerment of women is one of the 17 Sustainable Development Goals formulated by the United Nations. Gender-specific inequalities still exist, especially in medicine. Women are particularly lacking in leadership positions and in visible roles outside of patient care, such as at conferences and in scientific journals.Aim: The aim of the study was to analyse the proportion of women in leadership positions in emergency medicine and the visible roles at emergency medicine conferences and scientific journals.Materials and methods: A selective literature search in PubMed and an evaluation of the conference programmes from 2020-2021 as well as the editorial boards of journals were conducted with regard to the proportion of women.Results: Women continue to be significantly underrepresented on the editorial boards of emergency medicine journals and on the boards of leading emergency medicine organisations. Internationally, there are already programmes to increase the proportion of women in field of publications and scientific conferences; to date, there are only a few such programmes for women in emergency medicine in Germany.Conclusion: Women in healthcare in general and in emergency medicine in particular are not equally represented outside of patient care. To date, there are hardly any programmes to promote women in emergency medicine in Germany. Mentoring, collegial support and organisational change are key to increasing the proportion of women in nonpatient care roles in emergency medicine.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"411-418"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308877","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

[Challenges and physiotherapeutic solutions for obese patients in the acute and postacute intensive care setting]. [急诊和急诊后重症监护环境中肥胖患者面临的挑战和物理治疗解决方案]。

IF 1.3 4区医学

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2025-06-01 Epub Date: 2025-03-14 DOI: 10.1007/s00063-025-01263-y

S Nessizius, L Oelinger, N Schmidinger

{"title":"[Challenges and physiotherapeutic solutions for obese patients in the acute and postacute intensive care setting].","authors":"S Nessizius, L Oelinger, N Schmidinger","doi":"10.1007/s00063-025-01263-y","DOIUrl":"10.1007/s00063-025-01263-y","url":null,"abstract":"Physical therapy for obese patients in intensive care units (ICUs) presents a significant challenge. Particularly, class III obesity (body mass index [BMI] ≥ 40, previously called morbid obesity) is associated with specific pathophysiological aspects such as reduced lung compliance, increased intra-abdominal pressure, and impaired respiratory mechanics. These factors complicate both ventilation and early rehabilitation, particularly in the areas of respiratory physiotherapy, exercise therapy, and early mobilization. This article outlines the physiotherapeutic challenges and strategies for dealing with obese patients in ICUs and respiratory intermediate care units (respiratory care units [RCUs]). Special emphasis is placed on the individual positioning of patients, an optimal positive end-expiratory pressure (PEEP) adjustment, and early mobilization. Additionally, the concept of ICU-acquired weakness (ICUAW) is discussed, which is exacerbated in obese patients due to simultaneous inflammation activation and reinforcing immobilization. An exemplary case study illustrates the importance of interdisciplinary collaboration and the use of a structured mobilization concept tailored to the specific needs of obese patients. Particularly, the early initiation of assisted mobilization, the continuous adjustment of ventilation, and the use of innovative techniques to support respiratory physiotherapy contribute to a significant improvement in patient's functionality and quality of life.","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"389-396"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634225","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