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1. Cardiovascular-Kidney-Metabolic Syndrome: Association with Adverse Events After Major Noncardiac Surgery

Author

Roth, Sebastian, M’Pembele, René, Matute, Purificación, Kotfis, Katarzyna, Larmann, Jan, Lurati Buse, Giovanna, Stroda, Alexandra, Tenge, Theresa, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, van Waes, Judith, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Bolliger, Daniel, Cakar Turhan, Sanem, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans-Jörg, Guzzetti, Luca, Wulf, Hinnerk, Corneci, Dan, Chammartin, Frederique, Howell, Simon J., and Kindgen-Milles, Detlef

Published
2024
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3. Pathological findings associated with the updated European Society of Cardiology 2022 guidelines for preoperative cardiac testing: an observational cohort modelling study

Author

Kemper, Johann, Kohaupt, Lena, Witzler, Jette, Tuzhikov, Michael, Roth, Sebastian, Stroda, Alexandra, M’Pembele, René, Tenge, Theresa, Schultze, Cornelia, Verbarg, Nele, Gehrke, Christian, Klemann, Anna Katharina, Hagebölling, Friederike, Albrecht, Svenja, Stroeder, Jakob, Schubert, Ann-Kristin, Espeter, Florian, Russe, Benedikt, Weigand, Markus A., Bergmann, Lars, Unterberg, Matthias, Bischoff, Petra, Pirzer, Raphael, Rach, Patric Rene, Ott, Klaus, Zarbock, Alexander, Kowark, Ana, Neumann, Claudia, Marchand, Bahareh, Sponholz, Christoph, Rueffert, Henrik, Kramer, Mira, Zacharowski, Kai, Meybohm, Patrick, Lindau, Simone, Carollo, Melissa, Novazzi, Cecilia, Toso, Fiorenza, Bacuzzi, Alessandro, Ragazzi, Riccardo, Volta, Carlo Alberto, De Giorgi, Francesco, Bacer, Barbara, Federico, Antonio, Chiumello, Davide, Vetrugno, Luigi, Castella, Alberto, Tesoro, Simonetta, Cotoia, Antonella, Bignami, Elena, Bellissima, Agrippino, Cortegiani, Andrea, Crisman, Marco, Toninelli, Arturo, Piazza, Ornella, Mirabella, Lucia, Bossolasco, Matteo, Bona, Francesco, Perdomo, Juan Manuel, Coca-Martinez, Miquel, Carramiñana, Albert, Servén, Marta Giné, González, Astrid Batalla, Gil Sánchez, José Maria, Becerra-Bolaños, Ángel, Rodríguez-Pérez, Aurelio, Soler, Anna Artigas, Basso, Morena, Font, Anna Peig, Vernetta, Diana, Santos, Julia Hernando, Muñoz, Enrique Alday, Olivares, Mercedes Cabellos, Marco, Gregorio, Lopez, Maria Bermudez, Barrio, Javier, Forés, María Isabel, Boix, Estefanía, Ayuso, Mercedes, Petre, Bogdan Sorel, Oprea, Ioana Sorina, Latiș, Mihai Dan, Margarit, Simona, Vasian, Horatiu, Tomescu, Dana, Cîndea, Iulia, Dirzu, Dan Sebastian, Copotoiu, Sanda-Maria, Moise, Alida, Bubenek-Turconi, Serban, Valeanu, Liana, Wanner, Patrick Mark, Djurdjevic, Mirjana, Nuth, Sandra, Seeberger, Esther, Goettel, Nicolai, Kamber, Firmin, Ganter, Michael Thomas, Gerber, Thomas Jan, Schneebeli, Daniela, Pregernig, Andreas, Grape, Sina, Tomala, Simon, Pinto, Bernardo Bollen, Żukowski, Maciej, Zegan-Barańska, Małgorzata, Karolak, Igor, Krzych, Lukasz, Czajka, Szymon, Studzińska, Dorota, Kluzik, Anna, Koszel, Tomasz, Pabjańczyk, Izabela, Gajdosz, Anna, Erkoc, Suheyla Karadag, Meco, Basak Ceyda, Koltka, Ahmet Kemalettin, Dincer, Muserref Beril, Ekmekçi, Perihan, Saracoglu, Kemal Tolga, Solmaz, Filiz Alkaya, Ozcelik, Menekse, Arun, Oguzhan, Dilmen, Ozlem Korkmaz, Preckel, Benedikt, Hollmann, Markus W., Hazen, Yannick, Donald de Boer, Hans, Epema, Anne, Koopman, Seppe, Van Lier, Felix, Pinto, Rita, Carrão, André, Ribeiro, Daniel, Mourão, Joana, Coelho, Miguel, Losa, Nuno, Santos, Nuno, Cabral, Luis, Afonso, Diana, Zenha, Sérgio, Ramos, Cristina, Hipólito, Carla, Vasilaki, Maria, Andreeva, Antonia, Zaimi, Donika, Chalkias, Athanasios, Spyraki, Maria, Rekatsina, Martina, Tsaousi, Georgia, Short, Anthony, Meier, Sonja, Madhuri, Thumuluru Kavitha, Latham, Scott, Knock, James, Drummond, Andrew, Ramsden, Fiona, Kubisz-Pudelko, Agnieszka, Walker, James, Moppett, Iain, White, Louise, Jackson, Matthew, Reschreiter, Henrik, Innes, Richard, Chew, Michelle, Kalman, Sigridur, Wallden, Jakob, Schening, Anna, Jonikaite, Lina, Enlund, Anna, De Baerdemaeker, Luc, Morrison, Stuart, Rex, Steffen, Alexis, Alexandros, Khoronenko, Viktoria E., Ovezov, Alexey, Belskii, Vladislav, Kaznacheeva, Kseniya, Gritsan, Alexey, Kuzmanovska, Biljana, Malinovska-Nikolovska, Liljana, Barisin, Stjepan, Poredos, Peter, Arabadzhieva, Daniela, Unic-Stojanovic, Dragana, Golubović, Mladjan, Fleischmann, Edith, Kotzinger, Oskar, Des Deserts, Marc Danguy, Ducrocq, Nicolas, Buggy, Donal J., Bonnet, Jean François, Cusack, Barbara, Calleja, Paul, Hasani, Antigona, Nallbani, Rajmonda, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Ganter, Michael T., Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans-Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Larmann, Jan, Corneci, Dan, Howell, Simon J., and Lurati Buse, Giovanna

Published
2024
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6. Risk assessment for major adverse cardiovascular events after noncardiac surgery using self-reported functional capacity: international prospective cohort study

Author

Lurati, Giovanna, Spadaro, Savino, Matute, Purificación, Ionescu, Daniela, Bolliger, Daniel, Szczeklik, Wojciech, Turhan, Sanem Cakar, van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Howell, Simon J., Gupta, Anil, De Hert, Stefan, Ovezov, Alexey, Tollinche, Luis E., Kuzmanovska, Biljana, Barisin, Stjepan, Poredos, Peter, Arabadzhieva, Daniela, Unic-Stojanovic, Dragana, Fleischmann, Edith, Meistelman, Claude, Buggy, Donal J., Calleja, Paul, Hasani, Antigona, Kemper, Johann, Kohaupt, Lena, Witzler, Jette, Tuzhikov, Michael, Roth, Sebastian, Stroda, Alexandra, Schultze, Cornelia, Verbarg, Nele, Gehrke, Christian, Klemann, Anna Katharina, Hagebölling, Friederike, Albrecht, Svenja, Stroeder, Jakob, Schubert, Ann-Kristin, Espeter, Florian, Russe, Benedikt, Weigand, Markus A., Bergmann, Lars, Unterberg, Matthias, Bischoff, Petra, Pirzer, Raphael, Rach, Patric Rene, Ott, Klaus, Zarbock, Alexander, Kowark, Ana, Neumann, Claudia, Marchand, Bahareh, Sponholz, Christoph, Rueffert, Henrik, Kramer, Mira, Piekarski, Florian, Carollo, Melissa, Novazzi, Cecilia, Toso, Fiorenza, Bacuzzi, Alessandro, Ragazzi, Riccardo, Volta, Carlo Alberto, De Giorgi, Francesco, Bacer, Barbara, Federico, Antonio, Chiumello, Davide, Vetrugno, Luigi, Castella, Alberto, Tesoro, Simonetta, Cotoia, Antonella, Bignami, Elena, Bellissima, Agrippino, Cortegiani, Andrea, Crisman, Marco, Toninelli, Arturo, Piazza, Ornella, Mirabella, Lucia, Bossolasco, Matteo, Bona, Francesco, Perdomo, Juan Manuel, Coca-Martinez, Miquel, Carramiñana, Albert, Servén, Marta Giné, González, Astrid Batalla, Gil Sánchez, José Maria, Becerra-Bolaños, Ángel, Rodríguez-Pérez, Aurelio, Soler, Anna Artigas, Basso, Morena, Font, Anna Peig, Vernetta, Diana, Santos, Julia Hernando, Muñoz, Enrique Alday, Olivares, Mercedes Cabellos, Marco, Gregorio, Lopez, Maria Bermudez, Barrio, Javier, Forés, María Isabel, Boix, Estefanía, Ayuso, Mercedes, Petre, Bogdan Sorel, Oprea, Ioana Sorina, Latiș, Mihai Dan, Margarit, Simona, Vasian, Horatiu, Tomescu, Dana, Cîndea, Iulia, Dirzu, Dan Sebastian, Copotoiu, Sanda-Maria, Moise, Alida, Bubenek-Turconi, Serban, Valeanu, Liana, Wanner, Patrick Mark, Djurdjevic, Mirjana, Nuth, Sandra, Seeberger, Esther, Goettel, Nicolai, Kamber, Firmin, Ganter, Michael Thomas, Gerber, Thomas Jan, Schneebeli, Daniela, Pregernig, Andreas, Grape, Sina, Tomala, Simon, Pinto, Bernardo Bollen, Żukowski, Maciej, Zegan-Barańska, Małgorzata, Karolak, Igor, Krzych, Lukasz, Czajka, Szymon, Studzińska, Dorota, Kluzik, Anna, Koszel, Tomasz, Pabjańczyk, Izabela, Gajdosz, Anna, Erkoc, Suheyla Karadag, Meco, Basak Ceyda, Koltka, Ahmet Kemalettin, Dincer, Muserref Beril, Ekmekçi, Perihan, Saracoglu, Kemal Tolga, Solmaz, Filiz Alkaya, Ozcelik, Menekse, Arun, Oguzhan, Dilmen, Ozlem Korkmaz, Preckel, Benedikt, Hollmann, Markus W., Hazen, Yannick, Donald de Boer, Hans, Epema, Anne, Koopman, Seppe, Van Lier, Felix, Pinto, Rita, Carrão, André, Ribeiro, Daniel, Mourão, Joana, Coelho, Miguel, Losa, Nuno, Santos, Nuno, Cabral, Luis, Afonso, Diana, Zenha, Sérgio, Ramos, Cristina, Hipólito, Carla, Vasilaki, Maria, Andreeva, Antonia, Zaimi, Donika, Chalkias, Athanasios, Spyraki, Maria, Rekatsina, Martina, Tsaousi, Georgia, Short, Anthony, Meier, Sonja, Madhuri, Thumuluru Kavitha, Latham, Scott, Knock, James, Drummond, Andrew, Ramsden, Fiona, Kubisz-Pudelko, Agnieszka, Walker, James, Moppett, Iain, White, Louise, Jackson, Matthew, Reschreiter, Henrik, Innes, Richard, Chew, Michelle, Kalman, Sigridur, Wallden, Jakob, Schening, Anna, Jonikaite, Lina, Enlund, Anna, De Baerdemaeker, Luc, Morrison, Stuart, Rex, Steffen, Alexis, Alexandros, Khoronenko, Viktoria E., Belskii, Vladislav, Kaznacheeva, Kseniya, Gritsan, Alexey, Yeoh, Cindy B., Malinovska-Nikolovska, Liljana, Golubović, Mladjan, Kotzinger, Oskar, Des Deserts, Marc Danguy, Ducrocq, Nicolas, Bonnet, Jean François, Cusack, Barbara, Nallbani, Rajmonda, Daamen, Sylvia, Plichon, Benoit, Harlet, Pierre, Farsi, Slama, Sepehr, Saman Homayun, Espinosa, David, Lurati Buse, Giovanna A., Mauermann, Eckhard, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Gillmann, Hans-Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, and Chammartin-Basnet, Frederique

Published
2023
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9. Establishing standardized immune phenotyping of metastatic melanoma by digital pathology

Author

Sobottka, Bettina, Nowak, Marta, Frei, Anja Laura, Haberecker, Martina, Merki, Samuel, Levesque, Mitchell P., Dummer, Reinhard, Moch, Holger, Koelzer, Viktor Hendrik, Aebersold, Rudolf, Ak, Melike, Al-Quaddoomi, Faisal S., Albinus, Jonas, Alborelli, Ilaria, Andani, Sonali, Attinger, Per-Olof, Bacac, Marina, Baumhoer, Daniel, Beck-Schimmer, Beatrice, Beerenwinkel, Niko, Beisel, Christian, Bernasconi, Lara, Bertolini, Anne, Bodenmiller, Bernd, Bonilla, Ximena, Casanova, Ruben, Chevrier, Stéphane, Chicherova, Natalia, D'Costa, Maya, Danenberg, Esther, Davidson, Natalie, Drăganmoch, Monica-Andreea, Engler, Stefanie, Erkens, Martin, Eschbach, Katja, Esposito, Cinzia, Fedier, André, Ferreira, Pedro, Ficek, Joanna, Frey, Bruno, Goetze, Sandra, Grob, Linda, Gut, Gabriele, Günther, Detlef, Haeuptle, Pirmin, Heinzelmann-Schwarz, Viola, Herter, Sylvia, Holtackers, Rene, Huesser, Tamara, Irmisch, Anja, Jacob, Francis, Jacobs, Andrea, Jaeger, Tim M., Jahn, Katharina, James, Alva R., Jermann, Philip M., Kahles, André, Kahraman, Abdullah, Kuebler, Werner, Kuipers, Jack, Kunze, Christian P., Kurzeder, Christian, Lehmann, Kjong-Van, Lugert, Sebastian, Maass, Gerd, Manz, Markus G., Markolin, Philipp, Mena, Julien, Menzel, Ulrike, Metzler, Julian M., Miglino, Nicola, Milani, Emanuela S., Muenst, Simone, Murri, Riccardo, Ng, Charlotte K.Y., Nicolet, Stefan, Pedrioli, Patrick G.A., Pelkmans, Lucas, Piscuoglio, Salvatore, Prummer, Michael, Ritter, Mathilde, Rommel, Christian, Rosano-González, María L., Rätsch, Gunnar, Santacroce, Natascha, del Castillo, Jacobo Sarabia, Schlenker, Ramona, Schwalie, Petra C., Schwan, Severin, Schär, Tobias, Senti, Gabriela, Singer, Franziska, Sivapatham, Sujana, Snijder, Berend, Sreedharan, Vipin T., Stark, Stefan, Stekhoven, Daniel J., Theocharides, Alexandre P.A., Thomas, Tinu M., Tolnay, Markus, Tosevski, Vinko, Toussaint, Nora C., Tuncel, Mustafa A., Tusup, Marina, Van Drogen, Audrey, Vetter, Marcus, Vlajnic, Tatjana, Weber, Sandra, Weber, Walter P., Wegmann, Rebekka, Weller, Michael, Wendt, Fabian, Wey, Norbert, Wicki, Andreas, Wildschut, Mattheus HE, Wollscheid, Bernd, Yu, Shuqing, Ziegler, Johanna, Zimmermann, Marc, Zoche, Martin, and Zuend, Gregor

Published
2021
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10. Pathological findings associated with the updated European Society of Cardiology 2022 guidelines for preoperative cardiac testing: an observational cohort modelling study

Author

Stroda, Alexandra, primary, Mauermann, Eckhard, additional, Ionescu, Daniela, additional, Szczeklik, Wojciech, additional, De Hert, Stefan, additional, Filipovic, Miodrag, additional, Beck Schimmer, Beatrice, additional, Spadaro, Savino, additional, Matute, Purificación, additional, Ganter, Michael T., additional, Ovezov, Alexey, additional, Turhan, Sanem C., additional, van Waes, Judith, additional, Lagarto, Filipa, additional, Theodoraki, Kassiani, additional, Gupta, Anil, additional, Gillmann, Hans-Jörg, additional, Guzzetti, Luca, additional, Kotfis, Katarzyna, additional, Larmann, Jan, additional, Corneci, Dan, additional, Buggy, Donal J., additional, Howell, Simon J., additional, Lurati Buse, Giovanna, additional, Kemper, Johann, additional, Kohaupt, Lena, additional, Witzler, Jette, additional, Tuzhikov, Michael, additional, Roth, Sebastian, additional, Stroda, Alexandra, additional, M’Pembele, René, additional, Tenge, Theresa, additional, Schultze, Cornelia, additional, Verbarg, Nele, additional, Gehrke, Christian, additional, Klemann, Anna Katharina, additional, Hagebölling, Friederike, additional, Albrecht, Svenja, additional, Stroeder, Jakob, additional, Schubert, Ann-Kristin, additional, Espeter, Florian, additional, Russe, Benedikt, additional, Weigand, Markus A., additional, Bergmann, Lars, additional, Unterberg, Matthias, additional, Bischoff, Petra, additional, Pirzer, Raphael, additional, Rach, Patric Rene, additional, Ott, Klaus, additional, Zarbock, Alexander, additional, Kowark, Ana, additional, Neumann, Claudia, additional, Marchand, Bahareh, additional, Sponholz, Christoph, additional, Rueffert, Henrik, additional, Kramer, Mira, additional, Zacharowski, Kai, additional, Meybohm, Patrick, additional, Lindau, Simone, additional, Carollo, Melissa, additional, Novazzi, Cecilia, additional, Toso, Fiorenza, additional, Bacuzzi, Alessandro, additional, Ragazzi, Riccardo, additional, Volta, Carlo Alberto, additional, De Giorgi, Francesco, additional, Bacer, Barbara, additional, Federico, Antonio, additional, Chiumello, Davide, additional, Vetrugno, Luigi, additional, Castella, Alberto, additional, Tesoro, Simonetta, additional, Cotoia, Antonella, additional, Bignami, Elena, additional, Bellissima, Agrippino, additional, Cortegiani, Andrea, additional, Crisman, Marco, additional, Toninelli, Arturo, additional, Piazza, Ornella, additional, Mirabella, Lucia, additional, Bossolasco, Matteo, additional, Bona, Francesco, additional, Perdomo, Juan Manuel, additional, Coca-Martinez, Miquel, additional, Carramiñana, Albert, additional, Servén, Marta Giné, additional, González, Astrid Batalla, additional, Gil Sánchez, José Maria, additional, Becerra-Bolaños, Ángel, additional, Rodríguez-Pérez, Aurelio, additional, Soler, Anna Artigas, additional, Basso, Morena, additional, Font, Anna Peig, additional, Vernetta, Diana, additional, Santos, Julia Hernando, additional, Muñoz, Enrique Alday, additional, Olivares, Mercedes Cabellos, additional, Marco, Gregorio, additional, Lopez, Maria Bermudez, additional, Barrio, Javier, additional, Forés, María Isabel, additional, Boix, Estefanía, additional, Ayuso, Mercedes, additional, Petre, Bogdan Sorel, additional, Oprea, Ioana Sorina, additional, Latiș, Mihai Dan, additional, Margarit, Simona, additional, Vasian, Horatiu, additional, Tomescu, Dana, additional, Cîndea, Iulia, additional, Dirzu, Dan Sebastian, additional, Copotoiu, Sanda-Maria, additional, Moise, Alida, additional, Bubenek-Turconi, Serban, additional, Valeanu, Liana, additional, Wanner, Patrick Mark, additional, Djurdjevic, Mirjana, additional, Nuth, Sandra, additional, Seeberger, Esther, additional, Goettel, Nicolai, additional, Kamber, Firmin, additional, Ganter, Michael Thomas, additional, Gerber, Thomas Jan, additional, Schneebeli, Daniela, additional, Pregernig, Andreas, additional, Grape, Sina, additional, Tomala, Simon, additional, Pinto, Bernardo Bollen, additional, Żukowski, Maciej, additional, Zegan-Barańska, Małgorzata, additional, Karolak, Igor, additional, Krzych, Lukasz, additional, Czajka, Szymon, additional, Studzińska, Dorota, additional, Kluzik, Anna, additional, Koszel, Tomasz, additional, Pabjańczyk, Izabela, additional, Gajdosz, Anna, additional, Erkoc, Suheyla Karadag, additional, Meco, Basak Ceyda, additional, Koltka, Ahmet Kemalettin, additional, Dincer, Muserref Beril, additional, Ekmekçi, Perihan, additional, Saracoglu, Kemal Tolga, additional, Solmaz, Filiz Alkaya, additional, Ozcelik, Menekse, additional, Arun, Oguzhan, additional, Dilmen, Ozlem Korkmaz, additional, Preckel, Benedikt, additional, Hollmann, Markus W., additional, Hazen, Yannick, additional, Donald de Boer, Hans, additional, Epema, Anne, additional, Koopman, Seppe, additional, Van Lier, Felix, additional, Pinto, Rita, additional, Carrão, André, additional, Ribeiro, Daniel, additional, Mourão, Joana, additional, Coelho, Miguel, additional, Losa, Nuno, additional, Santos, Nuno, additional, Cabral, Luis, additional, Afonso, Diana, additional, Zenha, Sérgio, additional, Ramos, Cristina, additional, Hipólito, Carla, additional, Vasilaki, Maria, additional, Andreeva, Antonia, additional, Zaimi, Donika, additional, Chalkias, Athanasios, additional, Spyraki, Maria, additional, Rekatsina, Martina, additional, Tsaousi, Georgia, additional, Short, Anthony, additional, Meier, Sonja, additional, Madhuri, Thumuluru Kavitha, additional, Latham, Scott, additional, Knock, James, additional, Drummond, Andrew, additional, Ramsden, Fiona, additional, Kubisz-Pudelko, Agnieszka, additional, Walker, James, additional, Moppett, Iain, additional, White, Louise, additional, Jackson, Matthew, additional, Reschreiter, Henrik, additional, Innes, Richard, additional, Chew, Michelle, additional, Kalman, Sigridur, additional, Wallden, Jakob, additional, Schening, Anna, additional, Jonikaite, Lina, additional, Enlund, Anna, additional, De Baerdemaeker, Luc, additional, Morrison, Stuart, additional, Rex, Steffen, additional, Alexis, Alexandros, additional, Khoronenko, Viktoria E., additional, Belskii, Vladislav, additional, Kaznacheeva, Kseniya, additional, Gritsan, Alexey, additional, Kuzmanovska, Biljana, additional, Malinovska-Nikolovska, Liljana, additional, Barisin, Stjepan, additional, Poredos, Peter, additional, Arabadzhieva, Daniela, additional, Unic-Stojanovic, Dragana, additional, Golubović, Mladjan, additional, Fleischmann, Edith, additional, Kotzinger, Oskar, additional, Des Deserts, Marc Danguy, additional, Ducrocq, Nicolas, additional, Bonnet, Jean François, additional, Cusack, Barbara, additional, Calleja, Paul, additional, Hasani, Antigona, additional, and Nallbani, Rajmonda, additional

Published
2024
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11. Early sevoflurane sedation in severe COVID-19-related lung injury patients. A pilot randomized controlled trial

Author

Beck-Schimmer, Beatrice, primary, Schadde, Erik, additional, Pietsch, Urs, additional, Filipovic, Miodrag, additional, Dübendorfer-Dalbert, Seraina, additional, Fodor, Patricia, additional, Hübner, Tobias, additional, Schuepbach, Reto, additional, Steiger, Peter, additional, David, Sascha, additional, Krüger, Bernard D., additional, Neff, Thomas A., additional, and Schläpfer, Martin, additional

Published
2024
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12. Pathological findings associated with the updated European Society of Cardiology 2022 guidelines for preoperative cardiac testing: an observational cohort modelling study

Author

Medische staf Anesthesiologie, Circulatory Health, Stroda, Alexandra, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Ganter, Michael T., Ovezov, Alexey, Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Larmann, Jan, Corneci, Dan, Buggy, Donal J., Howell, Simon J., Lurati Buse, Giovanna, the MET-REPAIR investigators, Medische staf Anesthesiologie, Circulatory Health, Stroda, Alexandra, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Ganter, Michael T., Ovezov, Alexey, Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Larmann, Jan, Corneci, Dan, Buggy, Donal J., Howell, Simon J., Lurati Buse, Giovanna, and the MET-REPAIR investigators

Published
2024

13. Erratum to ‘Association between self-reported functional capacity and general postoperative complications: analysis of predefined outcomes of the MET-REPAIR international cohort study’ (Br J Anaesth 2024; 132: 811–4) (British Journal of Anaesthesia (2024) 132(4) (811–814), (S0007091224000059), (10.1016/j.bja.2024.01.003))

Author

Medische staf Anesthesiologie, Circulatory Health, Roth, Sebastian, M'Pembele, René, Nienhaus, Johannes, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Bolliger, Daniel, Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, Chammartin, Frédérique, Howell, Simon J., Buse, Giovanna L., the MET: Reevaluation for Perioperative Cardiac Risk Investigators, Medische staf Anesthesiologie, Circulatory Health, Roth, Sebastian, M'Pembele, René, Nienhaus, Johannes, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Bolliger, Daniel, Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, Chammartin, Frédérique, Howell, Simon J., Buse, Giovanna L., and the MET: Reevaluation for Perioperative Cardiac Risk Investigators

Published
2024

14. Factors affecting adherence to recommendations on pre-operative cardiac testing: A cohort study

Author

Medische staf Anesthesiologie, Circulatory Health, Stroda, Alexandra, Sulot, Tanja, Roth, Sebastian, M'pembele, René, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Turhan, Sanem Cakar, Van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Larmann, Jan, Corneci, Dan, Howell, Simon J., Lurati Buse, Giovanna, Medische staf Anesthesiologie, Circulatory Health, Stroda, Alexandra, Sulot, Tanja, Roth, Sebastian, M'pembele, René, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Turhan, Sanem Cakar, Van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Larmann, Jan, Corneci, Dan, Howell, Simon J., and Lurati Buse, Giovanna

Published
2024

15. Association between self-reported functional capacity and general postoperative complications: analysis of predefined outcomes of the MET-REPAIR international cohort study

Author

Medische staf Anesthesiologie, Circulatory Health, Roth, Sebastian, M'Pembele, René, Nienhaus, Johannes, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Bolliger, Daniel, Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, Chammartin, Frédérique, Howell, Simon J., Lurati Buse, Giovanna, the MET: Reevaluation for Perioperative Cardiac Risk Investigators, Medische staf Anesthesiologie, Circulatory Health, Roth, Sebastian, M'Pembele, René, Nienhaus, Johannes, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Bolliger, Daniel, Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, Chammartin, Frédérique, Howell, Simon J., Lurati Buse, Giovanna, and the MET: Reevaluation for Perioperative Cardiac Risk Investigators

Published
2024

16. Early sevoflurane sedation in severe COVID-19-related lung injury patients. A pilot randomized controlled trial

Author

Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115, Schadde, Erik; https://orcid.org/0000-0003-4561-6469, Pietsch, Urs; https://orcid.org/0000-0001-6957-2638, Filipovic, Miodrag, Dübendorfer-Dalbert, Seraina, Fodor, Patricia, Hübner, Tobias, Schuepbach, Reto; https://orcid.org/0000-0002-7058-4377, Steiger, Peter; https://orcid.org/0000-0002-3617-5174, David, Sascha; https://orcid.org/0000-0002-8231-0461, Krüger, Bernard D, Neff, Thomas A, Schläpfer, Martin; https://orcid.org/0000-0003-4288-7124, Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115, Schadde, Erik; https://orcid.org/0000-0003-4561-6469, Pietsch, Urs; https://orcid.org/0000-0001-6957-2638, Filipovic, Miodrag, Dübendorfer-Dalbert, Seraina, Fodor, Patricia, Hübner, Tobias, Schuepbach, Reto; https://orcid.org/0000-0002-7058-4377, Steiger, Peter; https://orcid.org/0000-0002-3617-5174, David, Sascha; https://orcid.org/0000-0002-8231-0461, Krüger, Bernard D, Neff, Thomas A, and Schläpfer, Martin; https://orcid.org/0000-0003-4288-7124

Abstract

Background This study aimed to assess a potential organ protective effect of volatile sedation in a scenario of severe inflammation with an early cytokine storm (in particular IL-6 elevation) in patients suffering from COVID-19-related lung injury with invasive mechanical ventilation and sedation. Methods This is a small-scale pilot multicenter randomized controlled trial from four tertiary hospitals in Switzerland, conducted between April 2020 and May 2021. 60 patients requiring mechanical ventilation due to severe COVID-19-related lung injury were included and randomized to 48-hour sedation with sevoflurane vs. continuous intravenous sedation (= control) within 24 h after intubation. The primary composite outcome was determined as mortality or persistent organ dysfunction (POD), defined as the need for mechanical ventilation, vasopressors, or renal replacement therapy at day 28. Secondary outcomes were the length of ICU and hospital stay, adverse events, routine laboratory parameters (creatinine, urea), and plasma inflammatory mediators. Results 28 patients were randomized to sevoflurane, 32 to the control arm. The intention-to-treat analysis revealed no difference in the primary endpoint with 11 (39%) sevoflurane and 13 (41%) control patients (p = 0.916) reaching the primary outcome. Five patients died within 28 days in each group (16% vs. 18%, p = 0.817). Of the 28-day survivors, 6 (26%) and 8 (30%) presented with POD (p = 0.781). There was a significant difference regarding the need for vasopressors (1 (4%) patient in the sevoflurane arm, 7 (26%) in the control one (p = 0.028)). Length of ICU stay, hospital stay, and registered adverse events within 28 days were comparable, except for acute kidney injury (AKI), with 11 (39%) sevoflurane vs. 2 (6%) control patients (p = 0.001). The blood levels of IL-6 in the first few days after the onset of the lung injury were less distinctly elevated than expected. Conclusions No evident benefits were observed with short sev

Published
2024

17. Effect of volatile versus total intravenous anaesthesia on circulating tumour cells after pancreatic adenocarcinoma resection: multicentre randomized clinical trial

Author

Schläpfer, Martin, Schadde, Erik, Braun, Julia, Soll, Christopher, Breitenstein, Stefan, Weber, Markus, Gutknecht, Stefan, Ganter, Michael T, Filipovic, Miodrag, Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115, Schläpfer, Martin, Schadde, Erik, Braun, Julia, Soll, Christopher, Breitenstein, Stefan, Weber, Markus, Gutknecht, Stefan, Ganter, Michael T, Filipovic, Miodrag, and Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115

Published
2024

18. Vitamin B12 status and the risk of developing sepsis in patients with bacterial infection: a prospective observational cohort study.

Author

Pregernig, Andreas, Held, Ulrike, Schläpfer, Martin, and Beck-Schimmer, Beatrice

Subjects
VITAMIN B12 deficiency, MICROBIAL cultures, INDEPENDENT variables, VITAMIN B12, BACTERIAL diseases
Abstract

Background: Data have shown that vitamin B12 has immunomodulatory effects via different pathways, which could influence the pathophysiology of sepsis. The objective of this study was to investigate whether vitamin B12 levels, assessed by the measurement of holotranscobalamin (HTC), total vitamin B12 (B12), and methylmalonic acid (MMA, which accumulates in case of B12 deficiency), are associated with the development of sepsis in patients with onset of bacterial infection. Methods: This was a single-center, prospective observational pilot study. Adult patients who presented to the emergency department with bacterial infection confirmed by a positive microbiological culture result were included in the study and followed up for 6 days to assess whether they developed sepsis or not. The primary objective was to compare HTC concentration in patients who developed sepsis to those who did not develop sepsis. Secondary objectives were the evaluation of B12 and MMA concentrations in those two groups. Multiple logistic regression models were used, with presence of sepsis as the outcome variable, and HTC, B12, and MMA concentrations as predictor variables, separately, and adjusted for potential confounders. Results: From 2019 to 2022, 2131 patients were assessed for eligibility, of whom 100 met the inclusion criteria. One patient was excluded from the analysis due to missing data. Of the 99 patients, 29 developed sepsis. There was no evidence for an association between HTC or B12 concentration and the development of sepsis (OR 0.65, 95% CI 0.31–1.29, p = 0.232, OR 0.84, 95% CI 0.44–1.54, p = 0.584, respectively). There was an association between MMA concentration and the development of sepsis, with a positive effect, i.e. with increasing MMA, the odds for sepsis increased (OR 2.36, 95% CI 1.21–4.87, p = 0.014). This association remained significant when adjusted for confounders (OR 2.72, 95% CI 1.23–6.60, p = 0.018). Conclusions: Our study found an association between elevated MMA concentration and the development of sepsis. We did not find an association between HTC and B12 concentrations and the development of sepsis. Further, larger studies are warranted, as it could lead to interventional trials investigating whether B12 supplementation provides a clinical benefit to patients with infection or sepsis. Trial registration: The study was registered on ClinicalTrials.gov under the identifier NCT04008446 on June 17, 2019. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Association between self-reported functional capacity and general postoperative complications: analysis of predefined outcomes of the MET-REPAIR international cohort study

Author

Roth, Sebastian, primary, M'Pembele, René, additional, Nienhaus, Johannes, additional, Mauermann, Eckhard, additional, Ionescu, Daniela, additional, Szczeklik, Wojciech, additional, De Hert, Stefan, additional, Filipovic, Miodrag, additional, Beck-Schimmer, Beatrice, additional, Spadaro, Savino, additional, Matute, Purificación, additional, Bolliger, Daniel, additional, Turhan, Sanem C., additional, van Waes, Judith, additional, Lagarto, Filipa, additional, Theodoraki, Kassiani, additional, Gupta, Anil, additional, Gillmann, Hans-Jörg, additional, Guzzetti, Luca, additional, Kotfis, Katarzyna, additional, Wulf, Hinnerk, additional, Larmann, Jan, additional, Corneci, Dan, additional, Chammartin, Frédérique, additional, Howell, Simon J., additional, Lurati Buse, Giovanna, additional, Roth, Sebastian, additional, Kemper, Johann, additional, Kohaupt, Lena, additional, Witzler, Jette, additional, Tuzhikov, Michael, additional, Stroda, Alexandra, additional, Tenge, Theresa, additional, Huhn, Ragnar, additional, Schultze, Cornelia, additional, Verbarg, Nele, additional, Gehrke, Christian, additional, Klemann, Anna Katharina, additional, Hagebölling, Friederike, additional, Albrecht, Svenja, additional, Stroeder, Jakob, additional, Schubert, Ann-Kristin, additional, Espeter, Florian, additional, Russe, Benedikt, additional, Weigand, Markus A., additional, Bergmann, Lars, additional, Unterberg, Matthias, additional, Bischoff, Petra, additional, Pirzer, Raphael, additional, Rach, Patric Rene, additional, Ott, Klaus, additional, Zarbock, Alexander, additional, Kowark, Ana, additional, Neumann, Claudia, additional, Marchand, Bahareh, additional, Sponholz, Christoph, additional, Rueffert, Henrik, additional, Kramer, Mira, additional, Piekarski, Florian, additional, Carollo, Melissa, additional, Novazzi, Cecilia, additional, Toso, Fiorenza, additional, Bacuzzi, Alessandro, additional, Ragazzi, Riccardo, additional, Volta, Carlo Alberto, additional, De Giorgi, Francesco, additional, Bacer, Barbara, additional, Federico, Antonio, additional, Chiumello, Davide, additional, Vetrugno, Luigi, additional, Castella, Alberto, additional, Tesoro, Simonetta, additional, Cotoia, Antonella, additional, Bignami, Elena, additional, Bellissima, Agrippino, additional, Cortegiani, Andrea, additional, Crisman, Marco, additional, Toninelli, Arturo, additional, Piazza, Ornella, additional, Mirabella, Lucia, additional, Bossolasco, Matteo, additional, Bona, Francesco, additional, Perdomo, Juan Manuel, additional, Coca-Martinez, Miquel, additional, Carramiñana, Albert, additional, Servén, Marta Giné, additional, González, Astrid Batalla, additional, Gil Sánchez, José Maria, additional, Becerra-Bolaños, Ángel, additional, Rodríguez-Pérez, Aurelio, additional, Soler, Anna Artigas, additional, Basso, Morena, additional, Font, Anna Peig, additional, Vernetta, Diana, additional, Santos, Julia Hernando, additional, Muñoz, Enrique Alday, additional, Olivares, Mercedes Cabellos, additional, Marco, Gregorio, additional, Lopez, Maria Bermudez, additional, Barrio, Javier, additional, Forés, María Isabel, additional, Boix, Estefanía, additional, Ayuso, Mercedes, additional, Petre, Bogdan Sorel, additional, Oprea, Ioana Sorina, additional, Latiș, Mihai Dan, additional, Margarit, Simona, additional, Vasian, Horatiu, additional, Tomescu, Dana, additional, Cîndea, Iulia, additional, Dirzu, Dan Sebastian, additional, Copotoiu, Sanda-Maria, additional, Moise, Alida, additional, Bubenek-Turconi, Serban, additional, Valeanu, Liana, additional, Wanner, Patrick Mark, additional, Djurdjevic, Mirjana, additional, Nuth, Sandra, additional, Seeberger, Esther, additional, Goettel, Nicolai, additional, Kamber, Firmin, additional, Ganter, Michael Thomas, additional, Gerber, Thomas Jan, additional, Schneebeli, Daniela, additional, Pregernig, Andreas, additional, Grape, Sina, additional, Tomala, Simon, additional, Pinto, Bernardo Bollen, additional, Żukowski, Maciej, additional, Zegan-Barańska, Małgorzata, additional, Karolak, Igor, additional, Krzych, Lukasz, additional, Czajka, Szymon, additional, Studzińska, Dorota, additional, Kluzik, Anna, additional, Koszel, Tomasz, additional, Pabjańczyk, Izabela, additional, Gajdosz, Anna, additional, Erkoc, Suheyla Karadag, additional, Meco, Basak Ceyda, additional, Koltka, Ahmet Kemalettin, additional, Dincer, Muserref Beril, additional, Ekmekçi, Perihan, additional, Saracoglu, Kemal Tolga, additional, Solmaz, Filiz Alkaya, additional, Ozcelik, Menekse, additional, Arun, Oguzhan, additional, Dilmen, Ozlem Korkmaz, additional, Preckel, Benedikt, additional, Hollmann, Markus W., additional, Hazen, Yannick, additional, Donald de Boer, Hans, additional, Epema, Anne, additional, Koopman, Seppe, additional, Van Lier, Felix, additional, Pinto, Rita, additional, Carrão, André, additional, Ribeiro, Daniel, additional, Mourão, Joana, additional, Coelho, Miguel, additional, Santos, Nuno, additional, Cabral, Luis, additional, Afonso, Diana, additional, Zenha, Sérgio, additional, Ramos, Cristina, additional, Hipólito, Carla, additional, Vasilaki, Maria, additional, Andreeva, Antonia, additional, Zaimi, Donika, additional, Chalkias, Athanasios, additional, Spyraki, Maria, additional, Rekatsina, Martina, additional, Tsaousi, Georgia, additional, Short, Anthony, additional, Meier, Sonja, additional, Madhuri, Thumuluru Kavitha, additional, Latham, Scott, additional, Knock, James, additional, Drummond, Andrew, additional, Ramsden, Fiona, additional, Kubisz-Pudelko, Agnieszka, additional, Walker, James, additional, Moppett, Iain, additional, White, Louise, additional, Jackson, Matthew, additional, Reschreiter, Henrik, additional, Innes, Richard, additional, Chew, Michelle, additional, Kalman, Sigridur, additional, Wallden, Jakob, additional, Schening, Anna, additional, Jonikaite, Lina, additional, Enlund, Anna, additional, De Baerdemaeker, Luc, additional, Morrison, Stuart, additional, Rex, Steffen, additional, Alexis, Alexandros, additional, Khoronenko, Viktoria E., additional, Ovezov, Alexey, additional, Belskii, Vladislav, additional, Kaznacheeva, Kseniya, additional, Gritsan, Alexey, additional, Kuzmanovska, Biljana, additional, Malinovska-Nikolovska, Liljana, additional, Barisin, Stjepan, additional, Poredos, Peter, additional, Arabadzhieva, Daniela, additional, Unic-Stojanovic, Dragana, additional, Golubović, Mladjan, additional, Fleischmann, Edith, additional, Kotzinger, Oskar, additional, Des Deserts, Marc Danguy, additional, Ducrocq, Nicolas, additional, Buggy, Donal J., additional, Bonnet, Jean François, additional, Cusack, Barbara, additional, Calleja, Paul, additional, Hasani, Antigona, additional, and Nallbani, Rajmonda, additional

Published
2024
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20. Assessment of liver function by gadoxetic acid avidity in MRI in a model of rapid liver regeneration in rats

Author

Heil, Jan, primary, Augath, Mark, additional, Kurtcuoglu, Vartan, additional, Hohmann, Joachim, additional, Bechstein, Wolf O., additional, Olthof, Pim, additional, Schnitzbauer, Andreas A., additional, Seebeck, Petra, additional, Schiesser, Marc, additional, Schläpfer, Martin, additional, Beck-Schimmer, Beatrice, additional, and Schadde, Erik, additional

Published
2023
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22. Effect of volatile versus total intravenous anaesthesia on circulating tumour cells after pancreatic adenocarcinoma resection: multicentre randomized clinical trial

Author

Schläpfer, Martin, primary, Schadde, Erik, additional, Braun, Julia, additional, Soll, Christopher, additional, Breitenstein, Stefan, additional, Weber, Markus, additional, Gutknecht, Stefan, additional, Ganter, Michael T, additional, Filipovic, Miodrag, additional, and Beck-Schimmer, Beatrice, additional

Published
2023
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24. Risk assessment for major adverse cardiovascular events after noncardiac surgery using self-reported functional capacity : international prospective cohort study

Author

Lurati Buse, Giovanna A., Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Bolliger, Daniel, Turhan, Sanem Cakar, van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans-Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, Chammartin-Basnet, Frederique, Howell, Simon J., MET: Reevaluation for Perioperative Cardiac Risk investigators, Jakob, Lurati Buse, Giovanna A., Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Bolliger, Daniel, Turhan, Sanem Cakar, van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans-Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, Chammartin-Basnet, Frederique, Howell, Simon J., and MET: Reevaluation for Perioperative Cardiac Risk investigators, Jakob

Abstract

BACKGROUND: Guidelines endorse self-reported functional capacity for preoperative cardiovascular assessment, although evidence for its predictive value is inconsistent. We hypothesised that self-reported effort tolerance improves prediction of major adverse cardiovascular events (MACEs) after noncardiac surgery. METHODS: This is an international prospective cohort study (June 2017 to April 2020) in patients undergoing elective noncardiac surgery at elevated cardiovascular risk. Exposures were (i) questionnaire-estimated effort tolerance in metabolic equivalents (METs), (ii) number of floors climbed without resting, (iii) self-perceived cardiopulmonary fitness compared with peers, and (iv) level of regularly performed physical activity. The primary endpoint was in-hospital MACE consisting of cardiovascular mortality, non-fatal cardiac arrest, acute myocardial infarction, stroke, and congestive heart failure requiring transfer to a higher unit of care or resulting in a prolongation of stay on ICU/intermediate care (≥24 h). Mixed-effects logistic regression models were calculated. RESULTS: In this study, 274 (1.8%) of 15 406 patients experienced MACE. Loss of follow-up was 2%. All self-reported functional capacity measures were independently associated with MACE but did not improve discrimination (area under the curve of receiver operating characteristic [ROC AUC]) over an internal clinical risk model (ROC AUCbaseline 0.74 [0.71-0.77], ROC AUCbaseline+4METs 0.74 [0.71-0.77], ROC AUCbaseline+floors climbed 0.75 [0.71-0.78], AUCbaseline+fitnessvspeers 0.74 [0.71-0.77], and AUCbaseline+physical activity 0.75 [0.72-0.78]). CONCLUSIONS: Assessment of self-reported functional capacity expressed in METs or using the other measures assessed here did not improve prognostic accuracy compared with clinical risk factors. Caution is needed in the use of self-reported functional capacity to guide clinical decisions resulting from risk assessment in patients undergoing noncardiac sur

Published
2023
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25. NT-proBNP or Self-Reported Functional Capacity in Estimating Risk of Cardiovascular Events After Noncardiac Surgery

Author

Lurati Buse, Giovanna, Larmann, Jan, Gillmann, Hans-Jörg, Kotfis, Katarzyna, Ganter, Michael T, Bolliger, Daniel, Filipovic, Miodrag, Guzzetti, Luca, Chammartin, Frédérique, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Beck-Schimmer, Beatrice, Howell, Simon J, Kemper, Johann, Kohaupt, Lena, Witzler, Jette, Tuzhikov, Michael, Roth, Sebastian, Stroda, Alexandra, MPembele, Rene, Schultze, Cornelia, Verbarg, Nele, Gehrke, Christian, Espeter, Florian, Russe, Benedikt, Weigand, Markus A, Pirzer, Raphael, Rach, Patric Rene, et al, Lurati Buse, Giovanna, Larmann, Jan, Gillmann, Hans-Jörg, Kotfis, Katarzyna, Ganter, Michael T, Bolliger, Daniel, Filipovic, Miodrag, Guzzetti, Luca, Chammartin, Frédérique, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Beck-Schimmer, Beatrice, Howell, Simon J, Kemper, Johann, Kohaupt, Lena, Witzler, Jette, Tuzhikov, Michael, Roth, Sebastian, Stroda, Alexandra, MPembele, Rene, Schultze, Cornelia, Verbarg, Nele, Gehrke, Christian, Espeter, Florian, Russe, Benedikt, Weigand, Markus A, Pirzer, Raphael, Rach, Patric Rene, and et al

Abstract

ImportanceNearly 16 million surgical procedures are conducted in North America yearly, and postoperative cardiovascular events are frequent. Guidelines suggest functional capacity or B-type natriuretic peptides (BNP) to guide perioperative management. Data comparing the performance of these approaches are scarce.ObjectiveTo compare the addition of either N-terminal pro-BNP (NT-proBNP) or self-reported functional capacity to clinical scores to estimate the risk of major adverse cardiac events (MACE).Design, Setting, and ParticipantsThis cohort study included patients undergoing inpatient, elective, noncardiac surgery at 25 tertiary care hospitals in Europe between June 2017 and April 2020. Analysis was conducted in January 2023. Eligible patients were either aged 45 years or older with a Revised Cardiac Risk Index (RCRI) of 2 or higher or a National Surgical Quality Improvement Program, Risk Calculator for Myocardial Infarction and Cardiac (NSQIP MICA) above 1%, or they were aged 65 years or older and underwent intermediate or high-risk procedures.ExposuresPreoperative NT-proBNP and the following self-reported measures of functional capacity were the exposures: (1) questionnaire-estimated metabolic equivalents (METs), (2) ability to climb 1 floor, and (3) level of regular physical activity.Main Outcome and MeasuresMACE was defined as a composite end point of in-hospital cardiovascular mortality, cardiac arrest, myocardial infarction, stroke, and congestive heart failure requiring transfer to a higher unit of care.ResultsA total of 3731 eligible patients undergoing noncardiac surgery were analyzed; 3597 patients had complete data (1258 women [35.0%]; 1463 (40.7%) aged 75 years or older; 86 [2.4%] experienced a MACE). Discrimination of NT-proBNP or functional capacity measures added to clinical scores did not significantly differ (Area under the receiver operating curve: RCRI, age, and 4MET, 0.704; 95% CI, 0.646-0.763; RCRI, age, and 4MET plus floor climbing, 0.702; 95

Published
2023

26. There is no evidence that carbon dioxide-enriched oxygen before apnea affects the time to arterial desaturation, but it might improve cerebral oxygenation in anesthetized obese patients: a single-blinded randomized crossover trial

Author

Schmidt, Marc T; https://orcid.org/0000-0003-0745-2109, Studer, Marc, Kunz, Andres, Studer, Sandro, Bonvini, John M, Bueter, Marco; https://orcid.org/0000-0002-1391-0842, Kook, Lucas, Haile, Sarah R; https://orcid.org/0000-0002-4704-6570, Pregernig, Andreas, Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115, Schläpfer, Martin; https://orcid.org/0000-0003-4288-7124, Schmidt, Marc T; https://orcid.org/0000-0003-0745-2109, Studer, Marc, Kunz, Andres, Studer, Sandro, Bonvini, John M, Bueter, Marco; https://orcid.org/0000-0002-1391-0842, Kook, Lucas, Haile, Sarah R; https://orcid.org/0000-0002-4704-6570, Pregernig, Andreas, Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115, and Schläpfer, Martin; https://orcid.org/0000-0003-4288-7124

Abstract

Purpose Carbon dioxide (CO$_{2}$) increases cerebral perfusion. The effect of CO$_{2}$ on apnea tolerance, such as after anesthesia induction, is unknown. This study aimed to assess if cerebral apnea tolerance can be improved in obese patients under general anesthesia when comparing O$_{2}$/Air (95%O$_{2}$) to O$_{2}$/CO$_{2}$ (95%O$_{2}$/5%CO$_{2}$). Methods In this single-center, single-blinded, randomized crossover trial, 30 patients 18–65 years, with body mass index > 35 kg/m$^{2}$, requiring general anesthesia for bariatric surgery, underwent two apneas that were preceded by ventilation with either O$_{2}$/Air or O$_{2}$/CO$_{2}$ in random order. After anesthesia induction, intubation, and ventilation with O$_{2}$/Air or O$_{2}$/CO$_{2}$ for 10 min, apnea was performed until the cerebral tissue oxygenation index (TOI) dropped by a relative 20% from baseline (primary endpoint) or oxygen saturation (SpO$_{2}$) reached 80% (safety abortion criterion). The intervention was then repeated with the second substance. Results The safety criterion was reached in all patients before cerebral TOI decreased by 20%. The time until SpO$_{2}$ dropped to 80% was similar in the two groups (+ 6 s with O$_{2}$/CO$_{2}$, 95%CI -7 to 19 s, p = 0.37). Cerebral TOI and PaO$_{2}$ were higher after O$_{2}$/CO$_{2}$ (+ 1.5%; 95%CI: from 0.3 to 2.6; p = 0.02 and + 0.6 kPa; 95%CI: 0.1 to 1.1; p = 0.02). Conclusion O$_{2}$/CO$_{2}$ improves cerebral TOI and PaO$_{2}$ in anesthetized bariatric patients. Better apnea tolerance could not be confirmed.

Published
2023

27. Additional file 1 of There is no evidence that carbon dioxide-enriched oxygen before apnea affects the time to arterial desaturation, but it might improve cerebral oxygenation in anesthetized obese patients: a single-blinded randomized crossover trial

Author

Schmidt, Marc T., Studer, Marc, Kunz, Andres, Studer, Sandro, Bonvini, John M., Bueter, Marco, Kook, Lucas, Haile, Sarah R., Pregernig, Andreas, Beck-Schimmer, Beatrice, and Schläpfer, Martin

Abstract

Additional file 1: Supplemental information S1. shows the time difference to reach the lowest tissueoxygenation index (TOI = regional oxygen saturation, SrO2) value inboth treatment arms. Time of the O2/Air treatment has beensubtracted from the corresponding apnea time after O2/CO2treatment. Positive values indicate a longer apnea time to reach the lowest TOIvalue after O2/CO2treatment, negative values indicate ashorter apnea time apnea (A). In the subsequent figures, the course ofTOI during apnea after O2/Air and after application of O2/CO2is depicted for all individuals (B). The red lines indicate O2/Airtreatment, turquoise lines indicate O2/CO2 treatment, thefirst intervention is shown in solid, the second intervention in dashed lines.The blue line indicates the lowest TOI value, that was measured in bothtreatment groups.

Published
2023
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30. Erratum to ‘Association between self-reported functional capacity and general postoperative complications: analysis of predefined outcomes of the MET-REPAIR international cohort study’ (Br J Anaesth 2024; 132: 811–4)

Author

Roth, Sebastian, M'Pembele, René, Nienhaus, Johannes, Mauermann, Eckhard, Ionescu, Daniela, Szczeklik, Wojciech, De Hert, Stefan, Filipovic, Miodrag, Beck-Schimmer, Beatrice, Spadaro, Savino, Matute, Purificación, Bolliger, Daniel, Turhan, Sanem C., van Waes, Judith, Lagarto, Filipa, Theodoraki, Kassiani, Gupta, Anil, Gillmann, Hans-Jörg, Guzzetti, Luca, Kotfis, Katarzyna, Wulf, Hinnerk, Larmann, Jan, Corneci, Dan, Chammartin, Frédérique, Howell, Simon J., and Buse, Giovanna L.

Published
2024
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31. Removal of Circulating Tumor Cells from Blood Samples of Cancer Patients Using Highly Magnetic Nanoparticles: A Translational Research Project

Author

Doswald, Simon, Herzog, Antoine F, Zeltner, Martin, Zabel, Anja, Pregernig, Andreas, Schläpfer, Martin, Siebenhüner, Alexander; https://orcid.org/0000-0002-5404-2383, Stark, Wendelin J, Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115, Doswald, Simon, Herzog, Antoine F, Zeltner, Martin, Zabel, Anja, Pregernig, Andreas, Schläpfer, Martin, Siebenhüner, Alexander; https://orcid.org/0000-0002-5404-2383, Stark, Wendelin J, and Beck-Schimmer, Beatrice; https://orcid.org/0000-0002-0648-6115

Abstract

The count of circulating tumor cells (CTCs) has been associated with a worse prognosis in different types of cancer. Perioperatively, CTCs detach due to mechanical forces. Diagnostic tools exist to detect and isolate CTCs, but no therapeutic technique is currently available to remove CTCs in vivo from unprocessed blood. The aim of this study was to design and test new magnetic nanoparticles to purify whole blood from CTCs. Novel magnetic carbon-coated cobalt (C/Co) nanoparticles conjugated with anti-epithelial cell adhesion molecule (EpCAM) antibodies were synthesized, and their antifouling and separation properties were determined. The newly developed C/Co nanoparticles showed excellent separation and antifouling properties. They efficiently removed tumor cells that were added to healthy subjects’ blood samples, through an anti-EpCAM antibody interaction. The nanoparticles did not interact with other blood components, such as lymphocytes or the coagulation system. In blood samples of carcinoma patients suffering from metastatic disease, on average, ≥68% of CTCs were removed. These nanoparticles could prompt the development of a blood purification technology, such as a dialysis-like device, to perioperatively remove CTCs from the blood of cancer patients in vivo and potentially improve their prognosis.

Published
2022

32. Volatile sedation in sepsis: a promising therapeutic approach or a venture doomed to fail?

Author

Schläpfer, Martin, Beck-Schimmer, Beatrice, Schläpfer, Martin, and Beck-Schimmer, Beatrice

Abstract

Preclinical strategies targeting sepsis often had a single target and could not be translated into the clinical setting. Volatile sedation modulates multiple aspects of inflammation and improves sepsis-related survival in animal models. Whether a similar effect can be achieved in humans is unclear. Only a prospective clinical trial will be able to answer this question. The implementation of such a study in times when volatile anaesthetics are the focus of attention because of their greenhouse effect and their carbon dioxide emission will be a challenge, even though the alternative, i.v. sedation, is still insufficiently investigated in this respect.

Published
2022

33. Interleukin-6 Is an Early Plasma Marker of Severe Postoperative Complications in Thoracic Surgery: Exploratory Results From a Substudy of a Randomized Controlled Multicenter Trial

Author

Neff, Thomas A, Braun, Julia, Rana, Dhanu, Puhan, Milo, Filipovic, Miodrag, Seeberger, Manfred, Stüber, Frank, Neff, Simona B, Beck-Schimmer, Beatrice, Schläpfer, Martin, and University of Zurich

Subjects
Anesthesiology and Pain Medicine, 10216 Institute of Anesthesiology, 610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI)
Published
2022

34. Correction: Early sevoflurane sedation in severe COVID19-related lung injury patients. A pilot randomized controlled trial.

Author

Beck-Schimmer, Beatrice, Schadde, Erik, Pietsch, Urs, Filipovic, Miodrag, Dübendorfer-Dalbert, Seraina, Fodor, Patricia, Hübner, Tobias, Schuepbach, Reto, Steiger, Peter, David, Sascha, Krüger, Bernard D., Neff, Thomas A., and Schläpfer, Martin

Subjects
*SEVOFLURANE, *LUNG injuries, *SEVERITY of illness index, *ANESTHESIA, *COVID-19
Published
2024
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35. Factors affecting adherence to recommendations on pre-operative cardiac testing: A cohort study.

Author

Stroda A, Sulot T, Roth S, M'Pembele R, Mauermann E, Ionescu D, Szczeklik W, De Hert S, Filipovic M, Beck Schimmer B, Spadaro S, Matute P, Turhan SC, van Waes J, Lagarto F, Theodoraki K, Gupta A, Gillmann HJ, Guzzetti L, Kotfis K, Larmann J, Corneci D, Howell SJ, and Lurati Buse G

Subjects
Humans, Male, Female, Aged, Middle Aged, Prospective Studies, Cohort Studies, Europe, Echocardiography, Stress, Echocardiography standards, Practice Guidelines as Topic, Risk Assessment methods, Cardiovascular Diseases diagnosis, Aged, 80 and over, Guideline Adherence, Preoperative Care methods, Preoperative Care standards
Abstract

Background: Cardiac risk evaluation prior to noncardiac surgery is fundamental to tailor peri-operative management to patient's estimated risk. Data on the degree of adherence to guidelines in patients at cardiovascular risk in Europe and factors influencing adherence are underexplored., Objectives: The aim of this analysis was to describe the degree of adherence to [2014 European Society of Cardiology (ESC)/European Society of Anaesthesiology (ESA) guidelines] recommendations on rest echocardiography [transthoracic echocardiography (TTE)] and to stress imaging prior to noncardiac surgery in a large European sample and to assess factors potentially affecting adherence., Design: Secondary analysis of a multicentre, international, prospective cohort study (MET-REPAIR)., Setting: Twenty-five European centres of all levels of care that enrolled patients between 2017 and 2020., Patients: With elevated cardiovascular risk undergoing in-hospital elective, noncardiac surgery., Main Outcome Measures: (Non)adherence to each pre-operative TTE and stress imaging recommendations classified as guideline-adherent, overuse and underuse. We performed descriptive analysis. To explore the impact of patients' sex, age, geographical region, and hospital teaching status, we conducted multivariate multinominal regression analysis., Results: Out of 15 983 patients, 15 529 were analysed (61% men, mean age 72 ± 8 years). Overuse (conduction in spite of class III) and underuse (nonconduction in spite of class I recommendation) for pre-operative TTE amounted to 16.6% (2542/15 344) and 6.6% (1015/15 344), respectively. Stress imaging overuse and underuse amounted to 1.7% (241/14 202) and 0.4% (52/14 202) respectively. Male sex, some age categories and some geographical regions were significantly associated with TTE overuse. Male sex and some regions were also associated with TTE underuse. Age and regions were associated with overuse of stress imaging. Male sex, age, and some regions were associated with stress imaging underuse., Conclusion: Adherence to pre-operative stress imaging recommendation was high. In contrast, adherence to TTE recommendations was moderate. Both patients' and geographical factors affected adherence to joint ESC/ESA guidelines., Trial Registration: NCT03016936., (Copyright © 2024 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.)

Published
2024
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36. Functionalized magnetic nanoparticles remove donor-specific antibodies (DSA) from patient blood in a first ex vivo proof of principle study.

Author

Lauener F, Schläpfer M, Mueller TF, Von Moos S, Janker S, Doswald S, Stark WJ, and Beck-Schimmer B

Subjects
Humans, Kidney Transplantation, Tissue Donors, Female, Proof of Concept Study, Male, Antibodies immunology, Magnetite Nanoparticles chemistry, Isoantibodies immunology, Isoantibodies blood
Abstract

The presence of donor-specific antibodies (DSA) such as antibodies directed against donor class I human leucocyte antigen (e.g., HLA-A) is a major barrier to kidney transplant success. As a proof of concept, functionalized magnetic nanoparticles have been designed to eliminate DSA from saline, blood and plasma of healthy donors and sensitized patients. Specific HLA-A1 protein was covalently bound to functionalized cobalt nanoparticles (fNP), human serum albumin (HSA) as control. fNP were added to anti-HLA class I-spiked saline, spiked volunteers' whole blood, and to whole blood and plasma of sensitized patients ex vivo. Anti-HLA-A1 antibody levels were determined with Luminex technology. Antibodies' median fluorescent intensity (MFI) was defined as the primary outcome. Furthermore, the impact of fNP treatment on blood coagulation and cellular uptake was determined. Treatment with fNP reduced MFI by 97 ± 2% and by 94 ± 4% (p < 0.001 and p = 0.001) in spiked saline and whole blood, respectively. In six known sensitized anti-HLA-A1 positive patients, a reduction of 65 ± 26% (p = 0.002) in plasma and 65 ± 33% (p = 0.012) in whole blood was achieved. No impact on coagulation was observed. A minimal number of nanoparticles was detected in peripheral mononuclear blood cells. The study demonstrates-in a first step-the feasibility of anti-HLA antibody removal using fNP. These pilot data might pave the way for a new personalized DSA removal technology in the future., (© 2024. The Author(s).)

Published
2024
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37. Effect of volatile versus total intravenous anaesthesia on circulating tumour cells after pancreatic adenocarcinoma resection: multicentre randomized clinical trial.

Author

Schläpfer M, Schadde E, Braun J, Soll C, Breitenstein S, Weber M, Gutknecht S, Ganter MT, Filipovic M, and Beck-Schimmer B

Subjects
Humans, Anesthesia, Intravenous, Anesthesia, General, Pancreatic Neoplasms surgery, Adenocarcinoma pathology, Neoplastic Cells, Circulating
Abstract

Competing Interests: Conflict of interest B.B.S. has a patent (04/10/14–20140100278): Injectable formulation for treatment and protection of patients having an inflammatory reaction or an ischemia–reperfusion event; M. Urner, L. K. Limbach, I. K. Herrmann, W. J. Stark, B. Beck-Schimmer, applied as Patent Cooperation Treaty (internationally), July 2009, as well as a patent application on bioconjugates of antibodies and functionalized magnetic nanoparticles. B.B.S. and M.S. received grant money from Sedana Medical (Danderyd, Sweden) as collaborators in a large multicentre study not related to this topic. M.S. and B.B.S. received grant money from Roche Diagnostics International (Rotkreuz, Switzerland) for a clinical trial not related to this topic. The authors declare no other conflict of interest.

Published
2024
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38. Association between self-reported functional capacity measures and postoperative myocardial injury in patients undergoing noncardiac surgeries.

Author

Polok K, Buse GL, Mauermann E, Ionescu D, Fronczek J, De Hert S, Filipovic M, Beck Schimmer B, van Waes J, Gillmann HJ, Schultze C, Kotfis K, Howell SJ, Studzińska D, Espeter F, Jung-König M, Larmann J, Szczeklik W, and Metrepair Investigators T

Subjects
Humans, Female, Male, Middle Aged, Aged, Prospective Studies, Risk Assessment, Troponin T blood, Risk Factors, Self Report, Myocardial Infarction, Postoperative Complications
Abstract

Background: Self-reported functional capacity measures have an uncertain role in the pre-operative cardiovascular risk stratification., Aim: This substudy aimed to evaluate whether self-reported metabolic equivalent (MET) could improve the prediction of postoperative myocardial injury (MI) over other well-established cardiovascular risk factors., Methods: This is a post hoc analysis of an international multicenter prospective cohort study. We recruited patients ≥45 years old who had elective elevated-risk noncardiac surgery in 45 centers across 17 countries between June 2017 and April 2020. The primary outcome was MI defined according to the Fourth Universal Definition of Myocardial Infarction. We measured the proportion of new prognostic information added by self-reported MET using multivariable logistic regression., Results: In total, 860 (41.3%) patients suffered MI. In patients without systematic troponin surveillance, the odds ratio for MI with each 1-point increment in MET equaled 1.03 (95% confidence interval [CI], 0.99-1.07). The new prognostic information, according to the likelihood ratio adequacy index, accounted for 1.5%. Sensitivity analysis, including centers with >90% of patients with routine high-sensitivity troponin T monitoring, showed that MET added 21.8% of new information to the baseline model, and each additional point was associated with a lower risk of MI (odds ratio, 0.86; 95% CI, 0.81-0.91)., Conclusions: In elevated-risk noncardiac surgery, self-reported functional capacity measures do not significantly improve the prediction of MI; however, they add new prognostic information in centers with routine perioperative troponin monitoring.

Published
2024
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39. NT-proBNP or Self-Reported Functional Capacity in Estimating Risk of Cardiovascular Events After Noncardiac Surgery.

Author

Lurati Buse G, Larmann J, Gillmann HJ, Kotfis K, Ganter MT, Bolliger D, Filipovic M, Guzzetti L, Chammartin F, Mauermann E, Ionescu D, Szczeklik W, De Hert S, Beck-Schimmer B, and Howell SJ

Subjects
Child, Preschool, Female, Humans, Biomarkers, Cohort Studies, Postoperative Complications epidemiology, Predictive Value of Tests, Risk Assessment, Self Report, Myocardial Infarction
Abstract

Importance: Nearly 16 million surgical procedures are conducted in North America yearly, and postoperative cardiovascular events are frequent. Guidelines suggest functional capacity or B-type natriuretic peptides (BNP) to guide perioperative management. Data comparing the performance of these approaches are scarce., Objective: To compare the addition of either N-terminal pro-BNP (NT-proBNP) or self-reported functional capacity to clinical scores to estimate the risk of major adverse cardiac events (MACE)., Design, Setting, and Participants: This cohort study included patients undergoing inpatient, elective, noncardiac surgery at 25 tertiary care hospitals in Europe between June 2017 and April 2020. Analysis was conducted in January 2023. Eligible patients were either aged 45 years or older with a Revised Cardiac Risk Index (RCRI) of 2 or higher or a National Surgical Quality Improvement Program, Risk Calculator for Myocardial Infarction and Cardiac (NSQIP MICA) above 1%, or they were aged 65 years or older and underwent intermediate or high-risk procedures., Exposures: Preoperative NT-proBNP and the following self-reported measures of functional capacity were the exposures: (1) questionnaire-estimated metabolic equivalents (METs), (2) ability to climb 1 floor, and (3) level of regular physical activity., Main Outcome and Measures: MACE was defined as a composite end point of in-hospital cardiovascular mortality, cardiac arrest, myocardial infarction, stroke, and congestive heart failure requiring transfer to a higher unit of care., Results: A total of 3731 eligible patients undergoing noncardiac surgery were analyzed; 3597 patients had complete data (1258 women [35.0%]; 1463 (40.7%) aged 75 years or older; 86 [2.4%] experienced a MACE). Discrimination of NT-proBNP or functional capacity measures added to clinical scores did not significantly differ (Area under the receiver operating curve: RCRI, age, and 4MET, 0.704; 95% CI, 0.646-0.763; RCRI, age, and 4MET plus floor climbing, 0.702; 95% CI, 0.645-0.760; RCRI, age, and 4MET plus physical activity, 0.724; 95% CI, 0.672-0.775; RCRI, age, and 4MET plus NT-proBNP, 0.736; 95% CI, 0.682-0.790). Benefit analysis favored NT-proBNP at a threshold of 5% or below, ie, if true positives were valued 20 times or more compared with false positives. The findings were similar for NSQIP MICA as baseline clinical scores., Conclusions and Relevance: In this cohort study of nearly 3600 patients with elevated cardiovascular risk undergoing noncardiac surgery, there was no conclusive evidence of a difference between a NT-proBNP-based and a self-reported functional capacity-based estimate of MACE risk., Trial Registration: ClinicalTrials.gov Identifier: NCT03016936.

Published
2023
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40. Effects of sevoflurane and its metabolite hexafluoroisopropanol on hypoxia/reoxygenation-induced injury and mitochondrial bioenergetics in murine cardiomyocytes.

Author

Roth Z'graggen B, Urner M, Beck-Schimmer B, and Schläpfer M

Abstract

Background: The volatile anaesthetic sevoflurane protects cardiac tissue from reoxygenation/reperfusion. Mitochondria play an essential role in conditioning. We aimed to investigate how sevoflurane and its primary metabolite hexafluoroisopropanol (HFIP) affect necrosis, apoptosis, and reactive oxygen species formation in cardiomyocytes upon hypoxia/reoxygenation injury. Moreover, we aimed to describe the similarities in the mode of action in a mitochondrial bioenergetics analysis., Methods: Murine cardiomyocytes were exposed to hypoxia (0.2% O 2 for 6 h), followed by reoxygenation (air with 5% CO 2 for 2 h) in the presence or absence sevoflurane 2.2% or HFIP 4 mM. Lactate dehydrogenase (LDH) release (necrosis), caspase activation (apoptosis), reactive oxygen species, mitochondrial membrane potential, and mitochondrial function (Seahorse XF analyser) were measured., Results: Hypoxia/reoxygenation increased cell death by 44% (+31 to +55%, P <0.001). Reoxygenation in the presence of sevoflurane 2.2% or HFIP 4 mM increased LDH release only by +18% (+6 to +30%) and 20% (+7 to +32%), respectively. Apoptosis and reactive oxygen species formation were attenuated by sevoflurane and HFIP. Mitochondrial bioenergetics analysis of the two substances was profoundly different. Sevoflurane did not influence oxygen consumption rate (OCR) or extracellular acidification rate (ECAR), whereas HFIP reduced OCR and increased ECAR, an effect similar to oligomycin, an adenosine triphosphate (ATP) synthase inhibitor. When blocking the metabolism of sevoflurane into HFIP, protective effects of sevoflurane - but not of HFIP - on LDH release and caspase were mitigated., Conclusion: Together, our data suggest that sevoflurane metabolism into HFIP plays an essential role in cardiomyocyte postconditioning after hypoxia/reoxygenation injury., (© 2022 The Author(s).)

Published
2022
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