Medizinische Klinik-Intensivmedizin Und Notfallmedizin最新文献

{"title":"[Max Reger and his early death: could it have been avoided? : Would he have lived longer with adequate intensive care?]","authors":"Hans-Joachim Trappe","doi":"10.1007/s00063-024-01144-w","DOIUrl":"10.1007/s00063-024-01144-w","url":null,"abstract":"<p><strong>Background: </strong>Max Reger was an organist, university teacher and composer whose life, illnesses, death and dying are not or hardly known to many.</p><p><strong>Objectives: </strong>Which illnesses determined Reger's life and did his lifestyle and illnesses influence his compositional work? Could his early death have been avoided? From today's point of view, could modern intensive care medicine have helped him?</p><p><strong>Material and methods: </strong>A detailed analysis of Reger's diseases was performed using scientific databases (medline, pubmed). All published articles were evaluated and examined in detail.</p><p><strong>Results: </strong>Max Reger was born in Brand in 1873 and received early lessons in violin, piano and organ playing. From 1890 he studied at the conservatory in Sondershausen, later at the conservatory in Wiesbaden. In 1901 he moved to Munich, and in 1907 to Leipzig, where he became university director and professor at the conservatory. Four years later he took over the court chapel in Meiningen, but ended this activity again in 1914. A year later he moved to Jena and wrote his late works in the \"Jenaish style\". Reger suffered from many illnesses, especially bipolar disorder with manic and depressive phases. He had metabolic syndrome with arterial hypertension, was overweight and smoked incredibly heavily. Overeating (\"binge eating\" syndrome) and polydipsia were other prominent findings. Reger's life was characterized by alcohol abuse, often aggravated by professional and/or human crises. In 1916 Reger died suddenly and unexpectedly in Leipzig of cardiovascular failure.</p><p><strong>Discussion: </strong>Reger was an outstanding personality who left behind an extensive oeuvre. Among the highlights of Max Reger's oeuvre are his chorale fantasies such as on \"Ein' feste Burg ist unser Gott\" (op. 27) or also the \"Fantasia and Fugue on B A C H\" (op. 46), but other compositions such as the Mozart Variations (op. 132) and the Clarinet Quintet (op. 146) are also world-famous. His lifestyle certainly favored coronary heart disease, the consequences of which caused Reger's sudden, unexpected and much too early death. Today's modern intensive care medicine could probably have prolonged his life.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"329-336"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861158","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}

{"title":"[Headaches following childbirth-severe ARDS in postpartum eclampsia].","authors":"Fiona Crossey, Lucas Zum Hebel, Daniel Wastl, Burc Bassa","doi":"10.1007/s00063-024-01222-z","DOIUrl":"10.1007/s00063-024-01222-z","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"352-354"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802945","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}

{"title":"[Treatment algorithm: thirst management for critically ill people without artificial airway].","authors":"Franziska Wefer, Lars Krüger, Carsten Hermes, Peter Nydahl, Amrei Mehler-Klamt, Anett Henck, Marina Ufelmann, Jutta Tewesmeier, Jan Gummert, Sascha Köpke","doi":"10.1007/s00063-025-01251-2","DOIUrl":"10.1007/s00063-025-01251-2","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"337-339"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366323","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}

{"title":"[Palliative extubation after ROSC in the emergency setting-a guideline for emergency physicians].","authors":"Christian Volberg, Katharina Politt, Sebastian Passon, Nils Heuser, Elena Hofacker, Hinnerk Wulf","doi":"10.1007/s00063-025-01271-y","DOIUrl":"10.1007/s00063-025-01271-y","url":null,"abstract":"<p><p>In the prehospital emergency setting, resuscitation following cardiac arrest is initiated as soon as possible after arrival of the emergency services in order to minimize the no-flow time, i.e., the period during which there is no blood circulation and therefore no oxygen supply to the organs. There is frequently no opportunity to ask relatives about the prespecified or presumed wishes of the patient, e.g., in the form of a living will, until after initiation of emergency medical interventions. If an advance directive stipulates \"do not resuscitate\" (DNR), then this wish is legally binding for treatment. However, if return of spontaneous circulation (ROSC) has been achieved in the meantime, the treating emergency team faces an ethical dilemma, and patients are often taken to hospital against their prespecified will. This leads to unwanted overtreatment. Based on three case reports, the following article discusses the ethical and legal aspects of palliative extubation after ROSC in patients with a predefined DNR status.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036008","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}

{"title":"[The geriatric syndrome frailty in the context of readmission to the intensive care unit : Study protocol of a mixed-methods study].","authors":"Denise Schindele, Marc Moritz Berger, Irmela Gnass","doi":"10.1007/s00063-025-01280-x","DOIUrl":"https://doi.org/10.1007/s00063-025-01280-x","url":null,"abstract":"<p><strong>Background: </strong>Frailty syndrome is characterized by a decline in physiological reserves and a reduced resistance to internal and external stressors. In addition to a higher mortality rate, patients who are frail are more prone to complications during hospitalization, including admission to an intensive care unit (ICU). Studies indicated that frailty syndrome may serve as a predictor of readmission to the ICU. The impact of frailty syndrome on readmission to an ICU in Germany remains to be elucidated, as extant research primarily originates from non-German-speaking countries and is only partially transferable.</p><p><strong>Aim: </strong>The primary objective of this study is to characterize the syndrome of frailty (measured using the Clinical Frailty Scale [CFS] ≥ 5) as a potential risk factor for readmission to the ICU. Secondly, the study will examine which factors, specifically nursing and medical measures on intermediate care and normal wards, can influence readmissions to the ICU.</p><p><strong>Method: </strong>The study employs an explanatory sequential mixed-methods design, comprising a quantitative and a qualitative research phase. In the quantitative phase, a prospective cohort study will be conducted to investigate the association between frailty syndrome and ICU readmissions (≤ 30 days after discharge or during the same hospital stay) in patients ≥ 65 years of age. Concurrently, a document analysis will be conducted in the qualitative phase to identify care measures that could influence readmission.</p><p><strong>Expected results: </strong>The primary hypothesis of this study is that patients diagnosed with frailty syndrome (CFS ≥ 5) exhibit a higher risk of readmission to the ICU compared to non-frail patients. This inquiry will be conducted in the quantitative phase of the study. The qualitative research component is designed to elucidate non-intensive care measures that may influence readmission.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064676","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}

{"title":"Diaphragm ultrasound monitoring and sequential muscle training for weaning elderly COPD patients from mechanical ventilation.","authors":"Huazuo Liu, Qin Su, Linyuan Zhu","doi":"10.1007/s00063-025-01270-z","DOIUrl":"https://doi.org/10.1007/s00063-025-01270-z","url":null,"abstract":"<p><strong>Background: </strong>Weaning elderly patients with chronic obstructive pulmonary disease (COPD) from mechanical ventilation is a complex and critical process. This study aims to assess the efficacy of ultrasound monitoring of diaphragm function combined with sequential muscle training in predicting and facilitating this weaning process.</p><p><strong>Methods: </strong>In this randomized controlled trial, 100 elderly COPD patients on mechanical ventilation were divided into two groups: an intervention group receiving sequential muscle training and a control group with standard care. The training regimen targeted the diaphragm and accessory respiratory muscles. Diaphragmatic ultrasonography was performed on participants to measure the right diaphragm excursion (DE), contraction velocity, diaphragm thickening fraction (DTF), and respiratory rate (RR)/DTF.</p><p><strong>Results: </strong>The intervention group demonstrated significant improvements in diaphragmatic function, with mean DE increasing to 2.40 ± 0.46 cm, CV to 1.99 ± 0.37 cm/s, DTF to 0.35 ± 0.05, and RR/DTF 61.0 ± 8.0, compared to the control group's DE of 2.06 ± 0.46 cm, CV of 1.54 ± 0.44 cm/s, DTF of 0.30 ± 0.06, and RR/DTF 55.7 ± 7.3. Notably, the weaning success rate was higher in the intervention group (58.33%) compared to the control group (43.75%).</p><p><strong>Conclusion: </strong>Sequential muscle training, alongside standard care, significantly improves diaphragmatic function and increases weaning success rates in elderly COPD patients. These findings suggest that incorporating targeted respiratory muscle training into the care regimen could facilitate the weaning process, highlighting the potential for improving patient outcomes in critical care settings.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023682","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}

{"title":"[Respiratory infection with mucocutaneous lesions : A rare manifestation of a known pathogen].","authors":"Paul Witte, Adriana Sirova, Michael Christ","doi":"10.1007/s00063-025-01277-6","DOIUrl":"https://doi.org/10.1007/s00063-025-01277-6","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041348","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}

{"title":"Mitteilungen der ÖGIAIN.","authors":"","doi":"10.1007/s00063-025-01274-9","DOIUrl":"https://doi.org/10.1007/s00063-025-01274-9","url":null,"abstract":"","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":"120 3","pages":"270"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755443","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}

{"title":"Hospital admissions following emergency medical services in Germany: analysis of 2 million hospital cases in 2022.","authors":"Martin Roessler, Claudia Schulte, Christoph Bobeth, Danny Wende, Christian Karagiannidis","doi":"10.1007/s00063-024-01148-6","DOIUrl":"10.1007/s00063-024-01148-6","url":null,"abstract":"<p><strong>Background: </strong>The use of emergency medical services (EMS) in Germany has increased substantially over the last few decades. While current reform efforts aim to increase effectiveness and efficiency of the German hospital and EMS systems, there is lack of data on characteristics of hospital cases using EMS.</p><p><strong>Objectives: </strong>To analyze and compare the characteristics of cases hospitalized with and without the use of EMS.</p><p><strong>Materials and methods: </strong>The BARMER health insurance data on more than 2 million hospital cases admitted in 2022 were analyzed. The distributions of age, clinical complexity (measured by patient clinical complexity levels, PCCL), main diagnoses, costs for EMS and hospital treatment, and multiple severity indicators were described. The overall severity of hospital cases was classified as \"low or moderate\" or \"high\" based on a combined severity indicator. All analyses were stratified by use of EMS and EMS type.</p><p><strong>Results: </strong>A total of 28% of all included hospital cases used EMS. Relative to hospital cases without use of EMS, hospital cases with use of EMS were older (physician-staffed ambulance: 75 years, interquartile range [IQR] 59-84, double-crewed ambulance: 78 years, IQR 64-85) and had a higher clinical complexity. The severity of more than 30% of the cases using EMS (except for patient transport service ambulance) was classified as \"low or moderate\". The distributions of main diagnoses differed by severity and use of EMS.</p><p><strong>Conclusions: </strong>The high proportion of cases with low or moderate severity using EMS may indicate a substantial potential to avoid the use of EMS in the context of hospital admissions in Germany. Further investigation is required to explore whether the proportion of cases using EMS could be reduced by optimizing preclinical service.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"230-237"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861162","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}

{"title":"[Frequency and barriers to the patient advanced directive and lasting power of attorney: findings from a prospective observation study in palliative care services].","authors":"Benedict Mathias Breen, Claudia Flohr, Heike Wendt, Katharina Chalk, Ulrike Haase, Christiane Hartog, Sascha Tafelski","doi":"10.1007/s00063-024-01149-5","DOIUrl":"10.1007/s00063-024-01149-5","url":null,"abstract":"<p><strong>Background: </strong>The advance directive and lasting power of attorney are instruments to strengthen patients' autonomy. A hospital-based palliative care consultation service can advise patients and family members about these instruments. This study investigates the need for such consultation among patients with life-limiting illness.</p><p><strong>Methods: </strong>This prospective observational study on intensive and non-intensive care units includes patients with a request for palliative care consultation. Patient-related factors were evaluated for their possible association with the presence or absence of advance directives or power of attorney. In addition, focus group interviews with members of the palliative care consultation team were carried out to identify barriers which prevent patients from drawing up such documents.</p><p><strong>Results: </strong>A total of 241 oncological and 53 non-oncological patients were included with a median age of 67 years; 69 (23%) patients were treated in the intensive care unit (ICU). Overall, 98 (33%) patients had advance directives, and 133 (45%) had determined a legal health care proxy in advance. A total of 52 patients died in hospital (17.7%). Only age and relationship status were associated with directives. In interviews, the following barriers were identified: information deficit, concern regarding discontinuation of treatment, loss of autonomy and wish to avoid a burden for the family.</p><p><strong>Conclusion: </strong>The majority in this severely ill patient population lack advance directives. In order to remove barriers, more effective information and counseling is required about such directives. In particular, guidance should include potential clinical situations in which such directives are potentially beneficial.</p>","PeriodicalId":49019,"journal":{"name":"Medizinische Klinik-Intensivmedizin Und Notfallmedizin","volume":" ","pages":"222-229"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917307","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}