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BACKGROUND The role of intensive insulin therapy in patients with severe sepsis is uncertain. Fluid resuscitation improves survival among patients with septic shock, but evidence is lacking to support the choice of either crystalloids or colloids. METHODS In a multicenter, two-by-two factorial trial, we randomly assigned patients with severe sepsis to(More)
BACKGROUND Hypercapnic respiratory failure in patients with COPD frequently requires mechanical ventilatory support. Extracorporeal CO2 removal (ECCO2R) techniques have not been systematically evaluated in these patients. METHODS This is a pilot study of a novel ECCO2R device that utilizes a single venous catheter with high CO2 removal rates at low blood(More)
Abstract Objective. To determine the direct costs of severe sepsis patients in German intensive care units (ICUs). Design. Retrospective electronic data analysis. Setting. Three adult intensive care units (surgical/medical) in three university hospitals in Germany. Patients. 385 patients identified by standard definitions as suffering from severe sepsis.(More)
INTRODUCTION Intensive care unit (ICU) costs account for up to 20% of a hospital's costs. We aimed to analyse the individual patient-related cost of intensive care at various hospital levels and for different groups of disease. METHODS Data from 51 ICUs all over Germany (15 primary care hospitals and 14 general care hospitals, 10 maximal care hospitals(More)
INTRODUCTION The purpose of this study was to assess the relation between glycaemic control and the severity of sepsis in a cohort of patients treated with intensive insulin therapy (IIT). METHODS In a prospective, observational study, all patients in the intensive care unit (ICU) (n = 191) with sepsis, severe sepsis or septic shock were treated with IIT(More)
BACKGROUND Noninvasive ventilation (NIV) is increasingly used in intensive care medicine, but only little information is available how different NIV interfaces affect the performance of a ventilatory system. Therefore, we compared delay times, pressure time products (PTPs), and wasted efforts during inspiration among patients receiving invasive ventilation(More)
BACKGROUND Cell-free DNA (cfDNA) from grafts in the circulation of transplant recipients is a potential biomarker of rejection. Its usefulness was investigated after heart transplantation during the maintenance phase by use of microarrays and massive parallel sequencing of donor and recipient DNA. Disadvantages of these methods are high costs, long(More)
To evaluate LOS in developing a concept of borderline ICU LOS for a realistic reimbursement of intensive care. Retrospective analysis of LOS and cost data extracted from patients’ electronic records. Surgical ICU of the University Hospital Göttingen, Germany. All adult ICU admissions with LOS >24 h over a 24-month period (1 January 2000 to 31 December 2001;(More)
OBJECTIVE To simultaneously determine perceived vs. practiced adherence to recommended interventions for the treatment of severe sepsis or septic shock. DESIGN One-day cross-sectional survey. SETTING Representative sample of German intensive care units stratified by hospital size. PATIENTS Adult patients with severe sepsis or septic shock. (More)
During neurally adjusted ventilatory assist (NAVA) the ventilator is driven by the patients electrical activation of the diaphragm (EAdi), detected by a special esophageal catheter. A reliable positioning of the EAdi-catheter is mandatory to trace a representative EAdi signal. We aimed to determine whether a formula that is based on the measurement from(More)