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BACKGROUND Despite long-term use of argatroban in clinical practice, no dosing recommendations exist for critically ill patients with multiple organ dysfunction (MODS) and suspected or proven heparin-induced thrombocytopenia (HIT). OBJECTIVE To determine the suitability of argatroban use in critically ill patients with MODS and HIT. METHODS We conducted(More)
BACKGROUND Protective mechanical ventilation strategies using low tidal volume or high levels of positive end-expiratory pressure (PEEP) improve outcomes for patients who have had surgery. The role of the driving pressure, which is the difference between the plateau pressure and the level of positive end-expiratory pressure is not known. We investigated the(More)
To evaluate the effect of extracorporeal gas exchange (ECMO) on mortality of patients referred with severe acute respiratory distress syndrome (ARDS). Prospective observational study in a university hospital ICU. 150 patients with severe ARDS. Multimodal treatment with and without ECMO. We treated 118 patients (78.7%) conservatively and 32 patients with(More)
Objective. To assess the impact of bronchoscopically guided percutaneous dilational tracheostomy (PDT) on oxygenation in patients with severe respiratory failure ventilated with high positive end-expiratory pressure (PEEP). Design. Prospective clinical study. Setting. Anaesthesiological ICU, referral centre for acute respiratory distress syndrome (ARDS)(More)
We hypothesized that 20S proteasome is present and functional in the extracellular alveolar space in humans. Proteasomal activity was measured in bronchoalveolar lavage (BAL) supernatant from eight humans using specific proteasomal fluorogenic substrates and I(125)-albumin with and without specific proteasome inhibitors. Furthermore, gelfiltration, Western(More)
A rupture of the airway due to blunt chest trauma is rare, and treatment can prove challenging. Many surgeons suggest operative management for these kinds of injuries. Nonoperative therapy is reported only in exceptional cases. But there is still a lack of evidence from which to recommend surgical repair of these injuries as the first choice procedure. We(More)
BACKGROUND Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. METHODS(More)
BACKGROUND This study investigates differences in treatment and outcome of ventilated patients with acute respiratory distress syndrome (ARDS) between university and non-university hospitals in Germany. METHODS This subanalysis of a prospective, observational cohort study was performed to identify independent risk factors for mortality by examining:(More)
To evaluate the prevalence of pulmonary hypertension associated with severe acute respiratory distress syndrome (ARDS) and to asses the value of pulmonary artery trunk diameter (PAT) to predict pulmonary hypertension. Prospective study University teaching hospital and ARDS referral center. 103 patients with ARDS, who received both right heart(More)