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1. Adverse Events during Prone Positioning of Patients with COVID-19 during a Surge in Hospitalizations—Results of an Observational Study

Author: Nataša Radovanović, Mateja Krajnc, Mario Gorenjak, Alenka Strdin Košir, and Andrej Markota
Subjects: mechanical ventilation, prone positioning, adverse events, COVID-19, removal of catheters and tubes, pressure ulcers, Nursing, RT1-120
Abstract: This study aimed to determine the prevalence of adverse events in mechanically ventilated adults with COVID-19 who have undergone prone positioning. A total of 100 patients were included retrospectively; 60% were males, the mean age was 64.8 ± 9.1 years, and hospital mortality was 47%. In all, we recorded 118 removals of catheters and tubes in 66 patients; 29.6% were removals of a nasogastric tube, 18.6% of an arterial line, 14.4% of a urinary catheter, and 12.7% of a central venous catheter. Reintubation or repositioning of a tracheotomy tube was required in 19 patients (16.1%), and cardiopulmonary resuscitation in 2 patients (1.7%). We recorded a total of 184 pressure ulcers in 79 patients (on anterior face in 38.5%, anterior thorax in 23.3% and any extremity anteriorly in 15.2%). We observed that body weight (p = 0.021; β = 0.09 (CI95: 0.01–0.17)) and the cumulative duration of prone positioning (p = 0.005; β = 0.06 (CI95: 0.02–0.11)) were independently associated with the occurrence of any adverse event. The use of prone positioning in our setting was associated with a greater number of adverse events than previously reported. Body weight and cumulative duration of prone positioning were associated with the occurrence of adverse events; however, other factors during a COVID-19 surge, such as working conditions, staffing, and staff education, could also have contributed to a high prevalence of adverse events.
Published: 2024
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2. Angiotensin II—Real-Life Use and Literature Review

Author: Andreja Möller Petrun and Andrej Markota
Subjects: angiotensin II, vasoplegia, hypotension, distributive shock, immunomodulation, Medicine (General), R5-920
Abstract: Angiotensin II is a recently introduced vasopressor, which has been available since 2017. The novelty and the relatively high cost of angiotensin II currently limit its broader application. It induces vasoconstriction by activating the renin–angiotensin–aldosterone system and is currently the sole vasopressor functioning through this pathway. Beyond vasoconstriction, angiotensin II also affects various other physiological processes. Current evidence supports its use in managing vasoplegic and cardiogenic shock in patients who are unresponsive to catecholamines and vasopressin. However, due to limited data, the optimal timing for initiating therapy with angiotensin II, strategies for combining it with other vasopressors, and strategies for its discontinuation remain unclear. Ongoing and planned studies aim to address some of these uncertainties. This article reviews the physiological and pathophysiological effects of angiotensin II, describes its pharmacology, and provides a narrative review of the current literature.
Published: 2024
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3. Monitoring of Cerebral Blood Flow Autoregulation after Cardiac Arrest

Author: Rok Petrovčič, Martin Rakusa, and Andrej Markota
Subjects: cardiac arrest, cerebral blood flow, autoregulation, monitoring, post-cardiac arrest syndrome, Medicine (General), R5-920
Abstract: Background: Cardiac arrest remains one of the leading causes of death. After successful resuscitation of patients in cardiac arrest, post-cardiac arrest syndrome develops, part of it being an impaired cerebral blood flow autoregulation. Monitoring cerebral blood flow autoregulation after cardiac arrest is important for optimizing patient care and prognosticating patients’ survival, yet remains a challenge. There are still gaps in clinical implications and everyday use. In this article, we present a systematic review of studies with different methods of monitoring cerebral blood flow autoregulation after non-traumatic cardiac arrest. Methods: A comprehensive literature search was performed from 1 June 2024 to 27 June 2024 by using multiple databases: PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials. Inclusion criteria were studies with an included description of the measurement of cerebral blood flow autoregulation in adult patients after non-traumatic cardiac arrest. Results: A total of 16 studies met inclusion criteria. Our data show that the most used methods in the reviewed studies were near-infrared spectroscopy and transcranial Doppler. The most used mathematical methods for calculating cerebral autoregulation were cerebral oximetry index, tissue oxygenation reactivity index, and mean flow index. Conclusions: The use of various monitoring and mathematical methods for calculating cerebral blood flow autoregulation poses a challenge for standardization, validation, and daily use in clinical practice. In the future studies, focus should be considered on clinical validation and transitioning autoregulation monitoring techniques to everyday clinical practice, which could improve the survival outcomes of patients after cardiac arrest.
Published: 2024
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4. The Effect of Body Temperature Changes on the Course of Treatment in Patients With Pneumonia and Sepsis: Results of an Observational Study

Author: Domen Guzelj, Anže Grubelnik, Nina Greif, Petra Povalej Bržan, Jure Fluher, Žiga Kalamar, and Andrej Markota
Subjects: Computer applications to medicine. Medical informatics, R858-859.7, Medical technology, R855-855.5
Abstract: BackgroundTraditionally, patients who are critically ill with infection and fever have been treated with antipyretics or even physically cooled. Presumed benefits of the reduction of body temperature are mostly based on decreased metabolic demands. However, it has been shown that decreasing body temperature in patients who are critically ill is not associated with improvement in treatment outcomes. Additionally, there is some data to support the use of temperature modulation (therapeutic hyperthermia) as an adjuvant treatment strategy in patients with infection. ObjectiveThis study aims to determine the effect of body temperature on the course of intensive care unit (ICU) treatment of patients who are mechanically ventilated with pneumonia, sepsis, and positive tracheal aspirates on admission. MethodsWe performed a single-center retrospective study. Core body temperature was measured in all patients. We analyzed associations between average temperatures in the first 48 hours after admission to ICU and ICU treatment parameters. Additionally, patients were divided into three groups: patients with negative tracheal aspirates 1 week after ICU admission (P-N group), patients with a different pathogen in tracheal aspirates 1 week after ICU admission (P-HAP group), and patients with a persisting pathogen in tracheal aspirates 1 week after ICU admission (P-P group). Differences in body temperature and interventions aimed at temperature modulation were determined. ResultsWe observed a significantly higher average temperature in the first 48 hours after admission to ICU in patients who survived to hospital discharge compared to nonsurvivors (mean 37.2 °C, SD 1 °C vs mean 36.9 °C, SD 1.6 °C; P=.04). We observed no associations between average temperatures in the first 48 hours after ICU admission and days of mechanical ventilation in the first 7 days of treatment (ρ=–0.090; P=.30), the average maximum daily requirement for noradrenaline in the first 7 days of treatment (ρ=–0.029; P=.80), average maximum FiO2 in the first 7 days of ICU treatment (ρ=0.040; P=.70), and requirement for renal replacement therapy in the first 7 days of ICU treatment (mean 37.3 °C, SD 1.4 °C vs mean 37.0 °C, SD 1.3 °C; P=.23). In an additional analysis, we observed a significantly greater use of paracetamol in the P-N group (mean 1.0, SD 1.1 g vs mean 0.4, SD 0.7 g vs mean 0.4, SD 0.8 g; P=.009), a trend toward greater use of active cooling in the first 24 hours after ICU admission in the P-N group (n=11, 44% vs n=14, 33.3% vs n=16, 32%; P=.57), and no other significant differences in parameters of ICU treatment between patient groups. ConclusionsWe observed better survival in patients who developed higher body temperatures in the first 48 hours after admission to the ICU; however, we observed no changes in other treatment parameters. Similarly, we observed greater use of paracetamol in patients with negative tracheal aspirates 1 week after ICU admission. Our results support the strategy of temperature tolerance in patients who are intubated with pneumonia and sepsis.
Published: 2024
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5. Therapeutic hyperthermia for the treatment of infection—a narrative review

Author: Andrej Markota, Žiga Kalamar, Jure Fluher, and Sergej Pirkmajer
Subjects: therapeutic hyperthermia, targeted temperature management, infection, sepsis, intensive care unit, Physiology, QP1-981
Abstract: Modulating body temperature, mostly through the use of antipyretics, is a commonly employed therapeutic intervention in medical practice. However, emerging evidence suggests that hyperthermia could serve as an adjuvant therapy for patients with infection. We performed a narrative review to explore the application of therapeutic hyperthermia in the treatment of infection. A number of studies have been performed in the pre-antibiotic era, enrolling patients with neurosyphilis and gonococcal infections, with reported cure rates at around 60%–80%. We have outlined the potential molecular and immunological mechanisms explaining the possible beneficial effects of therapeutic hyperthermia. For some pathogens increased temperature exerts a direct negative effect on virulence; however, it is presumed that temperature driven activation of the immune system is probably the most important factor affecting microbial viability. Lastly, we performed a review of modern-era studies where modulation of body temperature has been used as a treatment strategy. In trials of therapeutic hypothermia in patients with infection worse outcomes have been observed in the hypothermia group. Use of antipyretics has not been associated with any improvement in clinical outcomes. In modern-era therapeutic hyperthermia achieved by physical warming has been studied in one pilot trial, and better survival was observed in the hyperthermia group. To conclude, currently there is not enough data to support the use of therapeutic hyperthermia outside clinical trials; however, available studies are in favor of at least a temperature tolerance strategy for non-neurocritical patients.
Published: 2023
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6. Addition of Vitamin C Does Not Decrease Neuron-Specific Enolase Levels in Adult Survivors of Cardiac Arrest—Results of a Randomized Trial

Author: Matevž Privšek, Matej Strnad, and Andrej Markota
Subjects: vitamin C, nervous system-specific enolase, out-of-hospital cardiac arrest, return of spontaneous circulation, survival, Medicine (General), R5-920
Abstract: Background and Objectives: Survival with favorable neurologic outcomes after out-of-hospital cardiac arrest (OHCA) remains elusive. Post-cardiac arrest syndrome (PCAS) involves myocardial and neurological injury, ischemia-reperfusion response, and underlying pathology. Neurologic injury is a crucial determinant of survival and functional outcomes, with damage caused by free radicals among the responsible mechanisms. This study explores the feasibility of adding intravenous vitamin C to the treatment of OHCA survivors, aiming to mitigate PCAS. Vitamin C, a nutrient with antioxidative and free radical-scavenging properties, is often depleted in critically ill patients. Materials and Methods: This randomized, double-blinded trial was conducted at a tertiary-level university hospital with adult OHCA survivors. Participants received either standard care or the addition of 1.5 g of intravenous vitamin C every 12 h for eight consecutive doses. Neurologic injury was assessed using neuron-specific enolase (NSE) levels, with additional clinical and laboratory outcomes, such as enhanced neuroprognostication factors, inflammatory markers, and cardiac parameters. Results: NSE levels were non-significantly higher in patients who received vitamin C compared to the placebo group (55.05 µg/L [95% confidence interval (CI) 26.7–124.0] vs. 39.4 µg/L [95% CI 22.6–61.9], p > 0.05). Similarly, a non-significantly greater proportion of patients in the vitamin C group developed myoclonus in the first 72 h. We also observed a non-significantly shorter duration of mechanical ventilation, fewer arrhythmias, and reduced length of stay in the intensive care unit in the group of patients who received vitamin C (p = 0.031). However, caution is warranted in interpretation of our results due to the small number of participants. Conclusions: Our findings suggest that intravenous vitamin C should not be used outside of clinical trials for OHCA survivors. Due to the small sample size and conflicting results, further research is needed to determine the potential role of vitamin C in post-cardiac arrest care.
Published: 2024
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7. A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids

Author: Jure Fluher, Iva Cestar, Katja Jerenec, Žiga Kalamar, Zvonko Baklan, and Andrej Markota
Subjects: leptospirosis, circulatory failure, inflammatory cytokine response, corticosteroid therapy, acute heart failure, case report, Other systems of medicine, RZ201-999
Abstract: Leptospirosis is an ubiquitous zoonosis with significant morbidity and mortality. Approximately 10 percent of human infections evolve into a severe form, with a sepsis-like disease, multiorgan failure, and significant mortality rate. The cornerstone of treatment of severe disease is antibiotic therapy, with the aims of preventing complications, reducing the duration of disease, and ultimately reducing mortality. The initiation of antibiotic chemotherapy can precipitate a febrile inflammatory reaction, also known as a Jarisch–Herxheimer reaction. We present a case report of a patient with severe leptospirosis, complicated by multiorgan failure with severe circulatory failure of distributive and cardiogenic etiology, possibly as a consequence of the Jarisch–Herxheimer reaction. The patient was treated with antimicrobial therapy and other supportive measures along with high-dose corticosteroid therapy, long-term mechanical ventilation, high-dose vasopressor therapy, and continuous veno-venous hemodiafiltration with extracorporeal cytokine removal.With this case, we would like to report on a patient presenting with two neglected diseases in our part of Europe, who was treated with novel therapeutic strategies.
Published: 2022
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8. Weaning from mechanical ventilation with high flow oxygen therapy via tracheal cannula

Author: Kristijan Skok, Jerneja Golub, Damjana Kunej, Andreja Sinkovič, and Andrej Markota
Subjects: intensive care medicine, ventilator weaning, high-flow oxygen therapy, tracheal cannula, nasal cannula, Medicine
Abstract: Introduction: Application of oxygen at high flows via nasal cannula can be used in patients with hypoxemic respiratory failure and to prevent reintubation. It is well tolerated by the patients and has been associated with lower mortality. However, there is very little data on the use of oxygen at high flows connected to tracheal cannula (HFOTC). Case presentation: We present two patients in whom weaning from mechanical ventilation was difficult and we decided to use HFOTC for weaning. Weaning from mechanical ventilation with HFOTC was successful in both patients and they tolerated long term (4 and 2 days, respectively) ventilatory support with HFOTC without adverse effects. Conclusions: HFOTC might be used during weaning from mechanical ventilation, however, more data is needed to determine the optimal use of this treatment option.
Published: 2021
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9. Attitudes towards the Utilization of Intraosseous Access in Prehospital and Emergency Medicine Nursing Personnel

Author: Matjaž Žunkovič, Andrej Markota, and Amadeus Lešnik
Subjects: difficult intravenous access, intraosseous access, medical education, Medicine (General), R5-920
Abstract: Background and Objectives: Insertion of an intraosseous access device enables intravascular access for critically ill patients in a prehospital and emergency department setting even when intravenous access is not possible. The aim of our study was to assess the attitudes of prehospital and emergency department nursing staff towards the utilization of intraosseous access devices. Materials and Methods: We performed quantitative research using a closed-ended structured questionnaire distributed to prehospital unit and associated emergency department nursing staff serving a population of around 200,000 inhabitants. Results: We distributed 140 questionnaires, and 106 were returned and completed. Of these, 69 (65.1%) respondents needed more than three attempts to achieve peripheral intravenous access at least once in the last year and 29 (27.4%) required central venous access because of impossible intravenous access. In the last five years, 8 (7.5%) respondents used endotracheal route for administration of medications. Despite this, only 48 (45.3%) of respondents have ever used the intraosseous route. Also, 79 (74.5%) respondents received at least some training in obtaining IO access; however, 46 (43.4%) answered that education regarding intraosseous access is not sufficient, and 92 (86.8%) answered that they wanted additional training regarding intraosseous access. Conclusions: Prehospital and emergency department nursing staff are aware of the importance of intraosseous access and understand the need for additional education and certification in this field.
Published: 2022
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10. Successful use of combined blood purification techniques in splenectomised patient with septic shock in streptococcus pneumoniae infection – a case report

Author: Andreja Sinkovic, Barbara Kit, and Andrej Markota
Subjects: Sepsis, Septic cardiomyopathy, Septic shock, Combined blood purification techniques, Infectious and parasitic diseases, RC109-216
Abstract: Abstract Background Septic cardiomyopathy represents cardiac impairment in sepsis and is a part of systemic involvement in sepsis. Cytokine storm is responsible for septic shock and for myocardial dysfunction of potentially reversible septic cardiomyopathy. Several case reports and case series demonstrated successful removal of circulating cytokines by combined blood purification techniques. In this way, septic shock and survival of septic patients improved. However, the evidences for reversal of myocardial dysfunction are rare. Case presentation We present a patient with a history of chemotherapy for coat cell lymphoma, splenectomy and autologous bone marrow transplantation, who suffered severe pneumococcal sepsis, septic shock and septic cardiomyopathy, resistant to pharmacological therapy. Combined blood purification techniques 36 h after the start of treatment successfully decreased Interleukin-6 level, lactacidosis, the need for vasopressors to maintain normotension, improved systolic function of the left ventricle and clinical outcome. Conclusions Our case suggests that combined blood purification techniques initiated even 36 h after the start of treatment successfully removed inflammatory cytokines, reversed circulatory failure and improved left ventricular systolic function in pneumococcal sepsis.
Published: 2018
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11. Point-of-care lactate testing in emergency room

Author: Darinka Purg, Andrej Markota, and Matej Berhardt
Subjects: point-of-care testing, triage, lactate, critically ill, Medicine
Abstract: Lactate is a product of anaerobic metabolism, which can be used to detect the critically ill. Rapid recognition, early appropriate treatment and control of treatment success are paramount in that population. Lactate levels need to be available as soon as possible if they are to be of assistance at the bedside. Point-of-care analyzers enable rapid determination of lactate. The role of point-of-care lactate analyzers in the treatment of the critically ill, different analysis techniques and limitations of point-of-care lactate analyzers are presented. The use of point-of-care lactate analyzers is demonstrated in two cases of patients with sepsis. The first patient is a 73-year-old female, where point-of-care lactate was determined immediately. Septic shock with multi-organ failure developed. She was successfully treated and discharged after 14 days to home care. The second patient is a 62-year old male, where elevated lactate was detected after three hours. The patient died after a total of 5 months of treatment in the intensive care unit. Lactate can be an important tool in early recognition and treatment of the critically ill.
Published: 2014

12. Comparison of point-of-care and laboratory troponin I assays

Author: Andrej Markota, Matej Bernhardt, and Miroslav Palfy
Subjects: Medicine
Abstract: BACKGROUND In recent years a number of pointof- care troponin assays have emerged. There have been reports of discrepancies between the results of point-of-care and laboratory assays. We sought to compare the results of point-ofcare and laboratory troponin I assays in patients with suspected acute coronary syndromes. METHODS A retrospective study was performed comparing the results of point-of-care (i-STAT cardiac troponin I test, Abbott Point of Care) and laboratory troponin I analysis in patients with suspected acute coronary syndrome treated in the Internal Medicine Emergency Department, University Medical Centre Maribor, between 23 November and 21 December 2010, who had blood samples drawn simultaneously for pointof- care and laboratory troponin I analysis. RESULTS 112 patients were included in the analysis. There was an agreement between the results of point-of-care and laboratory troponin analysis in 105 (93.8 %) patients. If we consider the laboratory results as »gold standard« (diagnosis was based on laboratory troponin results), then 6 (5.4 %) false negative results and 1 (0.9 %) false positive result were found (sensitivity 81.2 %, specificity 98.7 %). However, there was no statistically significant difference between point-of-care and laboratory troponin I analysis (p = 0.125). CONCLUSIONS We detected lower sensitivity of point-of-care assay, but there was no statistically significant difference between point-of-care and laboratory troponin I analysis. We adopted a strategy of using point-of-care troponin assay primarily in patients at high-risk for acute coronary syndrome without ST elevation.
Published: 2011

13. Evaluation of Mobile Phone Mortality Risk Score Applications Using Data from the Electronic Medical Records.

Author: Nino Fijacko, Lucija Gosak, Primoz Kocbek, Leona Cilar, Andrej Markota, and Gregor Stiglic
Published: 2020
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14. Catheter-directed thrombolytic therapy for lowerextremity deep vein thrombosis: a case report

Author: Aja Pajnik Snoj and Andrej Markota
Abstract: Globoka venska tromboza spodnjih okončin je pogost razlog za obravnavo bolnika v urgentni ambulanti. Kljub temu so napredovale oblike globoke venske tromboze redke (npr. phlegmasia cerulea dolens). Lokalna katetrska tromboliza velja za terapijo izbora pri zdravljenju napredovalih oblik globoke venske tromboze, kot je phlegmasia cerulea dolens. V članku bomo predstavili prvi primer tovrstnega zdravljenja v Univerzitetnem kliničnem centru Maribor (UKC Maribor).
Published: 2022
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15. 1-year survival rate of ICU patients undergoing tracheotomy, a low volume hospital experience

Author: Janez Mohorko, Andrej Markota, and Bogdan Čizmarevič
Abstract: Purpose: Many critically ill patients require a tracheotomy during their ICU (Intensive Care Unit) stay. The aim of this study was to determine how many patients that undergo this procedure survive the hospital stay and are alive 1 year after the procedure. Methods: We retrospectively included 144 patients who had tracheotomies during their ICU stay at the UMC (University Medical Centre) Maribor in 2015 and compared the survival between patients hospitalized in the MICU (Medical Intensive Care Unit) and SICU (Surgical Intensive care unit). Results: This study showed that survival after tracheotomy in critically ill patients is low. Only 9.7% of all patients live without a tracheostomy after 1 year. The differences that were statistically significant between the MICU and SICU were observed only after the discharge from the ICU, with more people survivingthe MICU stay. Conclusions: There is little information involving 1-year survival rates of patients undergoing tracheotomies. We conclude that more studies regarding this issue need to be conducted.
Published: 2021
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16. First treatment with venovenous extracorporeal membrane oxygenation in Maribor

Author: Kristjan Skok, Andrej Markota, Franc Svenšek, and Andreja Sinkovič
Abstract: Purpose: We report on the first patient with refractory hypoxemia treated with venovenous extracorporeal membrane oxygenation (VV ECMO) at the Medical Intensive Care Unit of the University Medical Centre Maribor. Case report: A 52-year-old male was admitted after successful cardiopulmonary resuscitation from out-of-hospital cardiac arrest (first rhythm was ventricular fibrillation, with 40 min to return of spontaneous circulation). The patient underwent primary percutaneous revascularization of the left anterior descendingcoronary artery with insertion of one coronary stent. Hypoxemia was present during patient transportation and the procedure and continued to worsen after admission. Due to refractory hypoxemia caused by aspiration pneumonia, treatment with the VV ECMO was initiated. The ECMO procedure wasperformed without complications and led to improvement in gas exchange and lung mechanics. The patient was then successfully weaned from ECMO, decannulated, and extubated. After extubation, the patient’s course of treatment was complicated by hospital pneumonia and catheter-related blood stream infection.As his state deteriorated, reintubation was necessary. Despite intensive treatment, the patient died on day 30. Conclusions: Response to the VV ECMO treatment of refractory hypoxemia due to aspiration pneumonia was positive and without complications. In spite of initial improvement, the patient died after several weeks due to recurring infection and septic shock.
Published: 2021
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17. The Role of Environmental PM2.5 in Admission Acute Heart Failure in ST-Elevation Myocardial Infarction patients - An Observational Retrospective Study

Author: Manja Krasevec, Martin Marinšek, David Suran, Andreja Sinkovič, and Andrej Markota
Subjects: medicine.medical_specialty, Resuscitation, biology, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, International Journal of General Medicine, Retrospective cohort study, General Medicine, medicine.disease, Troponin, Internal medicine, Diabetes mellitus, Heart failure, biology.protein, medicine, Cardiology, Observational study, Myocardial infarction, business
Abstract: Andreja Sinkovic,1 Andrej Markota,1 Manja Krasevec,2 David Suran,3 Martin Marinsek1 1Department of Medical Intensive Care, University Clinical Centre Maribor, Maribor, Slovenia; 2Medical Faculty of University Maribor, Maribor, Slovenia; 3Department of Cardiology, University Clinical Centre Maribor, Maribor, SloveniaCorrespondence: Andreja SinkovicDepartment of Medical Intensive Care, University Clinical Centre Maribor, Ljubljanska 5, Maribor, 2000, SloveniaTel +38641337822Email andreja.sinkovic@guest.arnes.siBackground: Air pollution with increased concentrations of fine (< 2.5 Î¼m) particulate matter (PM2.5) increases the risk of cardiovascular morbidity and mortality. Even short-term increase of PM2.5 may help trigger ST-elevation myocardial infarction (STEMI) and heart failure (HF) in susceptible individuals, even in areas with good air quality.Purpose: To evaluate the role of PM2.5 levels â¥ 20 Î¼g/m3 in admission acute HF in STEMI patients.Materials and Methods: In 290 STEMI patients with the leading reperfusion strategy primary percutaneous coronary intervention (PPCI), we retrospectively studied independent predictors of admission acute HF and included admission demographic and clinical data as well as ambient PM2.5 levels â¥ 20 Î¼g/m3. We defined admission acute HF in STEMI patients as classes IIâIV by Killip Kimball classification.Results: Acute admission HF was observed in 34.5% of STEMI patients. PPCI was performed in 87.1% of acute admission HF patients and in 94.7% non-HF patients (p= 0.037). Significant independent predictors of acute admission HF were prior diabetes (OR 2.440, 95% CI 1.100 to 5.400, p=0.028), admission LBBB (OR 10.190, 95% CI 1.160 to 89.360, p=0.036), prior resuscitation (OR 2.530, 95% CI 1.010 to 6.340, p=0.048), admission troponin Iâ¥ 5Î¼g/l (OR 3.390, 95% CI 1.740 to 6.620, p< 0.001), admission eGFR levels (0.61, 95% CI 0.52 to 0.72, p < 0.001), and levels of PM2.5 â¥ 20 Î¼g/m3 (OR 2.140, 95% CI 1.005 to 4.560, p=0.049) one day before admission.Conclusion: Temporary short-term increase in PM2.5 levels (â¥ 20 Î¼g/m3) one day prior to admission in an area with mainly good air quality was among significant independent predictors of acute admission HF in STEMI patients.Keywords: admission acute heart failure, ST-elevation myocardial infarction, air pollution, PM2.5
Published: 2021
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18. Weaning from mechanical ventilation with high flow oxygen therapy via tracheal cannula

Author: Andreja Sinkovič, Kristijan Skok, Andrej Markota, Jerneja Golub, and Damjana Kunej
Subjects: Mechanical ventilation, high-flow oxygen therapy, business.industry, medicine.medical_treatment, lcsh:R, lcsh:Medicine, High flow oxygen, intensive care medicine, Cannula, nasal cannula, Anesthesia, medicine, ventilator weaning, Weaning, tracheal cannula, business
Abstract: Introduction: Application of oxygen at high flows via nasal cannula can be used in patients with hypoxemic respiratory failure and to prevent reintubation. It is well tolerated by the patients and has been associated with lower mortality. However, there is very little data on the use of oxygen at high flows connected to tracheal cannula (HFOTC). Case presentation: We present two patients in whom weaning from mechanical ventilation was difficult and we decided to use HFOTC for weaning. Weaning from mechanical ventilation with HFOTC was successful in both patients and they tolerated long term (4 and 2 days, respectively) ventilatory support with HFOTC without adverse effects. Conclusions: HFOTC might be used during weaning from mechanical ventilation, however, more data is needed to determine the optimal use of this treatment option.
Published: 2021
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19. Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study

Author: Peter Wright, Johan Herlitz, Leo Bossaert, Jan Wnent, Violetta Raffay, Vitor H Correia, Hajriz Alihodžić, Joséphine Escutnaire, Nikolaos I. Nikolaou, Scott J. Booth, Roman Burkart, Ari Salo, Jan-Thorsten Gräsner, Pierre Mols, Anatolij Truhlář, Grzegorz Cebula, Anneli Strömsöe, Siobhán Masterson, Mads Wissenberg, Diana Cimpoesu, Ingvild Tjelmeland, Irzal Hadžibegović, Bergthor Steinn Jonsson, Bernd W. Böttiger, Stefan Trenkler, Carlo Clarens, Gavin D. Perkins, Federico Semeraro, Rudolph W. Koster, Andrej Markota, Holger Maurer, Endre Nagy, Rolf Lefering, Marios Ioannides, Fernando Rossell-Ortiz, Maximilian Moertl, Steffie Beesems, Cardiology, ACS - Amsterdam Cardiovascular Sciences, and ACS - Heart failure & arrhythmias
Subjects: Emergency Medical Services, medicine.medical_specialty, Resuscitation, 030204 cardiovascular system & hematology, Emergency Nursing, Return of spontaneous circulation, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, Humans, Prospective Studies, Registries, Out-of-hospital cardiac arrest, Portugal, business.industry, Incidence (epidemiology), Public health, Bystander CPR, Outcome after OHCA, 030208 emergency & critical care medicine, medicine.disease, European registry of cardiac arrest, Cardiopulmonary Resuscitation, 3. Good health, Europe, Ventricular fibrillation, Emergency medicine, Emergency Medicine, Bystander cpr, Human medicine, Cardiology and Cardiovascular Medicine, business
Abstract: Background The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander. Methods This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge. Results All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively). Conclusion In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation. info:eu-repo/semantics/publishedVersion
Published: 2020
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20. Computational modeling of targeted temperature management in post-cardiac arrest patients

Author: Maja Duh, Kristijan Skok, Matjaž Perc, Andrej Markota, and Marko Gosak
Subjects: Hypothermia, Induced, Mechanical Engineering, Modeling and Simulation, Humans, Computer Simulation, Biotechnology, Heart Arrest, Body Temperature, Body Temperature Regulation
Abstract: Our core body temperature is held around [Formula: see text]C by an effective internal thermoregulatory system. However, various clinical scenarios have a more favorable outcome under external temperature regulation. Therapeutic hypothermia, for example, was found beneficial for the outcome of resuscitated cardiac arrest patients due to its protection against cerebral ischemia. Nonetheless, practice shows that outcomes of targeted temperature management vary considerably in dependence on individual tissue damage levels and differences in therapeutic strategies and protocols. Here, we address these differences in detail by means of computational modeling. We develop a multi-segment and multi-node thermoregulatory model that takes into account details related to specific post-cardiac arrest-related conditions, such as thermal imbalances due to sedation and anesthesia, increased metabolic rates induced by inflammatory processes, and various external cooling techniques. In our simulations, we track the evolution of the body temperature in patients subjected to post-resuscitation care, with particular emphasis on temperature regulation via an esophageal heat transfer device, on the examination of the alternative gastric cooling with ice slurry, and on how anesthesia and the level of inflammatory response influence thermal behavior. Our research provides a better understanding of the heat transfer processes and therapies used in post-cardiac arrest patients.
Published: 2022

21. Non-SARS-CoV-2 Coronavirus severe acute respiratory failure

Author: Andrej Markota and Ziga Kalamar
Subjects: Respiratory Distress Syndrome, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, medicine.disease_cause, Virology, Anesthesiology and Pain Medicine, Humans, Medicine, Acute respiratory failure, Respiratory Insufficiency, business, Coronavirus
Published: 2022
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22. Better Control of Body Temperature Is Not Associated with Improved Hemodynamic and Respiratory Parameters in Mechanically Ventilated Patients with Sepsis

Author: Andrej Markota, Kristijan Skok, Žiga Kalamar, Jure Fluher, and Mario Gorenjak
Subjects: thermoregulation, targeted temperature management, sepsis, mechanical ventilation, intensive care unit, hyperthermia, General Medicine
Abstract: The need for temperature modulation (mostly cooling) in critically ill patients is based on the expected benefits associated with decreased metabolic demands. However, evidence-based guidelines for temperature management in a majority of critically ill patients with fever are still lacking. The aim of our retrospective single-site observational study was to determine the differences in ICU treatment between patients in whom their temperature remained within the target temperature range for ≥25% of time (inTT group) and patients in whom their temperature was outside the target temperature range for
Published: 2022

23. The Automated External Defibrillator: Heterogeneity of Legislation, Mapping and Use across Europe. New Insights from the ENSURE Study

Author: Alexei Birkun, Diana Cimpoesu, Enrico Baldi, Olympia Nikolaidou, Violetta Raffay, Julian Ganter, Martin Quinn, Remy Stieglis, Hajriz Alihodžić, Giuseppe Ristagno, Anneli Strömsöe, Ingvild Tjelmeland, Simone Savastano, Jan Wnent, Ari Salo, Fernando Rosell Ortiz, Bernd W. Böttiger, Carlo Clarens, Niccolò Grieco, Stefan Trenkler, Pierre Mols, Valentine Canon, Jan Thorsten Gräsner, Andrej Markota, Ruggero Cresta, HUS Emergency Medicine and Services, Anestesiologian yksikkö, Cardiology, Graduate School, ACS - Heart failure & arrhythmias, and ACS - Amsterdam Cardiovascular Sciences
Subjects: IMPACT, Population, Settore MED/41 - Anestesiologia, Legislation, 030204 cardiovascular system & hematology, legislation, Article, first responders, 03 medical and health sciences, 0302 clinical medicine, DISPATCH, out-of-hospital cardiac arrest (OHCA), medicine, PUBLIC-ACCESS DEFIBRILLATION, Cardiac and Cardiovascular Systems, education, Automated external defibrillator, education.field_of_study, OUTCOMES, Kardiologi, business.industry, HOSPITAL CARDIAC-ARREST, 030208 emergency & critical care medicine, General Medicine, Limiting, medicine.disease, Certificate, LAYPERSONS, COVERAGE, 3. Good health, Mapping system, 3121 General medicine, internal medicine and other clinical medicine, automated external defibrillator (AED) system, SURVIVAL, Medicine, RESUSCITATION COUNCIL GUIDELINES, Medical emergency, business, SYSTEM
Abstract: Introduction: The rapid use of an automated external defibrillator (AED) is crucial for increased survival after an out-of-hospital cardiac arrest (OHCA). Many factors could play a role in limiting the chance of an AED use. We aimed to verify the situation regarding AED legislation, the AED mapping system and first responders (FRs) equipped with an AED across European countries. Methods: We performed a survey across Europe entitled “European Study about AED Use by Lay Rescuers” (ENSURE), asking the national coordinators of the European Registry of Cardiac Arrest (EuReCa) program to complete it. Results: Nineteen European countries replied to the survey request for a population covering 128,297,955 inhabitants. The results revealed that every citizen can use an AED in 15 countries whereas a training certificate was required in three countries. In one country, only EMS personnel were allowed to use an AED. An AED mapping system and FRs equipped with an AED were available in only 11 countries. The AED use rate was 12–59% where AED mapping and FR systems were implemented, which was considerably higher than in other countries (0–7.9%), reflecting the difference in OHCA survival. Conclusions: Our survey highlighted a heterogeneity in AED legislation, AED mapping systems and AED use in Europe, which was reflected in different AED use and survival.
Published: 2021

24. The Role of Environmental PM

Author: Andreja, Sinkovic, Andrej, Markota, Manja, Krasevec, David, Suran, and Martin, Marinsek
Subjects: admission acute heart failure, ST-elevation myocardial infarction, air pollution, PM2.5, Original Research
Abstract: Background Air pollution with increased concentrations of fine (
Published: 2021

25. To ventilate or not to ventilate during bystander CPR — A EuReCa TWO analysis

Author: Jan Wnent, Ingvild Tjelmeland, Rolf Lefering, Rudolph W. Koster, Holger Maurer, Siobhán Masterson, Johan Herlitz, Bernd W. Böttiger, Fernando Rosell Ortiz, Gavin D. Perkins, Leo Bossaert, Maximilian Moertl, Pierre Mols, Irzal Hadžibegović, Anatolij Truhlář, Ari Salo, Valentine Baert, Eniko Nagy, Grzegorz Cebula, Violetta Raffay, Stefan Trenkler, Andrej Markota, Anneli Strömsöe, Jan-Thorsten Gräsner, Hajriz Alihodžić, Marios Ioannides, Mads Wissenberg, Josephine Escutnaire, Nikolaos Nikolaou, Bergthor Steinn Jonsson, Peter Wright, Federico Semeraro, Carlo Clarens, Steffie Beesems, Vitor H. Correia, Diana Cimpoesu, Roman Burkart, Scott Booth, Michael Baubin, Adolf Schinnerl, Gerhard Prause, Thomas Tschoellitsch, Helmut Trimmel, Rene Belz, Wolfgang Fleischmann, Magali Bartiaux, Koenraad Monsieurs, Stephan Wilmin, Mathias Faniel, Marie Vanhove, Pascale Lievens, Dominique Biarent, Marc Van Nuffelen, Ives Hubloue, Jean-Marie Jacques, Michèle Yerna, Robert Leach, Mathieu Jeanmaire, Paule Denoël, Frank Van Trimpont, Francis Desmet, Louise Delhaye, Vincent Van Belleghem, Ken Dewitte, Musa Abbasi, Simon Scheyltjens, Olivier Vermylen, Diane de Longueville, Stéphane Debaize, Silvija Hunyadi Antičević, Slobodanka Keleuva, Milan Lazarević, Radmila Majhen Ujević, Gordana Antić Šego, Branka Bardak, Domagoj Mišković, Monika Praunová, Ondřej Franěk, Jaroslav Kratochvíl, Jan Přikryl, Roman Sýkora, Tomáš Vaňatka, Marek Vašák, Petr Jaššo, Petr Šmejkal, Otomar Kušička, Robin Šín, Eva Smržová, Dorián Pfeifer, Heini Harve-Rytsälä, Pamela Hiltunen, Peter Holmström, Timo Iirola, Katja Jokela, Hetti Kirves, Pekka Korvenoja, Markku Kuisma, Jukka Laine, Markus Lyyra, Sami Länkimäki, Petra Portaankorva, Lasse Raatiniemi, Marko Sainio, Piritta Setälä, Tuukka Toivonen, Jan Uotinen, Jukka Vaahersalo, Taneli Väyrynen, David Hamdan, Jean-Marc Agostinucci, Fabienne Branche, François Revaux, Sébastien Jonquet, Richard Loubert, Marion Boursier, Bruno Simonnet, Jean-Charles Morel, Steven Lagadec, Aurélie Avondo, Emilie Gelin, Emanuel Morel-Maréchal, Cécile Ursat, Laurent Villain-Coquet, Marc Fournier, Romain Tabary, Philippe Le Pimpec, Delphine Hugenschmitt, Diego Abarrategui, Romain Blondet, Aurélie Arnaud, Sonia Sadoune, Julien Segard, Sophie Narcisse, Mélanie Laot, Thomas Pernot, Hubert Courcoux, Coralie Chassin, Benoît Jardel, Jeanne Picart, Franck Garden Brèche, Pierre-Alban Guenier, Renaud Getti, Alexandre Jeziorny, Antoine Leroy, Carine Vanderstraeten, Sébastien Dussoulier, Attila Haja, Dániel Németh, Andrea Válint, Gábor Csató, Gerda Lóczi, Péter Vörös, Zsuzsanna Németh, Ferenc Molnár, Ferenc Nagy, Henrietta Kádár, Julia Duda, Justyna Tęczar, Sylwia Dul, Grażyna Świtacz, Andrzej Raczynski, Zlatko Fiser, Zlatko Babic, Aleksandra Opacic, Kornelija Jaksic Horvat, Snezana Vukelic, Jelena Tijanic, Dusan Milenkovic, Sasa Milic, Deze Babinski, Cedomir Boskovic, Jovanka Koprivica, Erika Terek, Goran Provci, Dragana Jovic Zvijer, Ľubica Bajerovská, Miroslav Chabroň, Danka Pražienková, Renáta Kratochvílová, Radoslav Burian, Martin Dobrík, Juraj Patráš, Vladimír Šteflík, Peter Androvič, František Mičáň, Božena Horáňová, Július Pavčo, Monika Grochová, Táňa Bulíková, Rok Maček, Matej Rubelli Furman, Samo Podhostnik, Miha Oman, Klemen Lipovšek, Špela Baznik, Jurica Ferenčina, Matej Strnad, Edith Žižek, Miha Kodela, Alenka Antolinc Košat, Nina Lotrič, Jonny Lindqvist, Remy Stieglis, Anja Radstok, Cardiology, ACS - Heart failure & arrhythmias, Graduate School, ACS - Amsterdam Cardiovascular Sciences, EuReCa TWO, Supporting clinical sciences, and Emergency Medicine
Subjects: Emergency Medical Services, Resuscitation, medicine.medical_specialty, Chest-compression only CPR, medicine.medical_treatment, EuReCa, Subgroup analysis, 030204 cardiovascular system & hematology, Emergency Nursing, Return of spontaneous circulation, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Full CPR, medicine, Humans, Registries, Cardiopulmonary resuscitation, Survival rate, Out-of-hospital cardiac arrest, business.industry, Bystander CPR, 030208 emergency & critical care medicine, Odds ratio, Cardiopulmonary Resuscitation, Ventilation, Confidence interval, 3. Good health, Survival Rate, Emergency medicine, Emergency Medicine, Bystander cpr, Human medicine, Cardiology and Cardiovascular Medicine, business
Abstract: Background Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). Method In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. Results A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17–1.83). Conclusion In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.
Published: 2021

26. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Author: Labeau, Sonia O, Afonso, Elsa, Benbenishty, Julie, Blackwood, Bronagh, Boulanger, Carole, Brett, Stephen J, Calvino-Gunther, Silvia, Chaboyer, Wendy, Coyer, Fiona, Deschepper, Mieke, François, Guy, Honore, Patrick M, Jankovic, Radmilo, Khanna, Ashish K, Llaurado-Serra, Mireia, Lin, Frances, Rose, Louise, Rubulotta, Francesca, Saager, Leif, Williams, Ged, Blot, Stijn I, Dritan, Muzha, Antoni Margarit Ribas, Fernando, Lipovesty, Cecilia, Loudet, Fiona, Coyer, Philipp, Eller, Nafseen, Mostafa, Patrick, M Honoré, Vanesa Mercado Telleria, Jasmina, Smajic, Paula Cristina Nogueira, Khalid Mahmood Khan Nafees, Romuald, Hentchoya, Louise, Rose, Javiera, Soledad, Frances, Lin, Yenny, Cardenas, Amylkar Garay Reyes, Alan, Sustic, Meropi, Mpouzika, Tamas, Vymazal, Hanne Irene Jensen, Hernan, Aguirre-Bermeo, Liivi, Maddison, Maija, Valta, Silvia, Calvino-Gunther, Frank, Bloos, Faustina Excel Adipa, Vasilios, Koulouras, Judy, Enamorado, Zsuzsann, Ágoston, Hrönn, Birgisdóttir, Amit, Gupta, Mohan, Gurjar, Bram, Kilapong, Seyed Mohammadreza Hashemian, Ignacio, Martin-Loeches, Julie, Benbenishty, Andrea, Cortegiani, Kelly, Fletcher, Yoshiro, Hayashi, Wangari, Waweru-Siika, Khalid, Abidi, Sang-Min, Lee, Burhan, Hadri, Mihails, Dolgusevs, Fayez François Abillama, Tomas, Jovaisa, Cyril, Thix, Muhammed, Elhadi, Basri Mat Nor, Shanti, Ratnam, Mohd Zulfakar Mazlan, Sundaresan, Maiyalagan, Luis, Sánchez-Hurtado, Adrian, Belii, Mendsaikhan, Naranpurev, Prabha, Gautam, Dylan De Lange, Rachael, Parke, Rose Ekama Ilesanmi, Mirjana, Shosholcheva, Antonija, Petosic, Ranveig, Lind, Madiha Hashmi Ffarcsi, Javier, Bogarin, Aaron Mark Hernandez, Malgorzata, Mikaszewska-Sokolewicz, Bruno, Sousa, Dana, Tomescu, Dorel, Sandesc, Theogene, Twagirumugabe, Vitaly, Gusarov, Maie, Ebaid, Radmilo, Jankovic, Gari, Slobodianiuk, Andrea, Martonova, Rihard, Knafelj, Mervyn, Mer, Emilio, Maseda, Bernardo, Panka, Joerg, C Schefold, Eva, Joelsson-Alm, Konlawij, Trongtrakul, Lorna, Merritt-Charles, Lamia Ouanes Besbes, Yalım, Dikmen, Lesia, Zgrzheblovska, Mark, Fielding, Francesca, Rubulotta, Ashish, K Khanna, Leif, Saager, Ingrid von der Osten, Alban, Greca, Alma, Cani, Nordian, Xhindi, Genci, Hyska, Antonio Margarit Ribas, Susana, Pinto, Paulo, Alves, Romina, Esposito, Emanuel, Valgolio, John Thomas Sanchez Minope, Antonio, Abdala, Maria, Ayala, Silvina, Bravo, Ana, Bantar, Patricia, Delgado, Gustavo, Badariotti, Fernando, Lipovestky, Ana, Diaz, Pablo, Saul, Mariano, Setten, Alejandra, Aucapina, Ysica, Acosta, Victor, Gonzalez, Luis, Camputaro, Fernando, Baccaro, Robert, Villa, Marcela, Mastantuono, Emiliano, Dean, Oscar Fernández Rostello, Patricia, Brizuela, Julio Ricardo Bartoli, Matias, Guereschi, Cristian, Quiroga, Sofia, Putruele, Paula, Villegas, Veronica, Curilen, Ruben, Fernandez, Mariangeles Gabriela Nocheretti, Rosana Gabriela Escalante, Cecilia Inés Loudet, Silvia, Fernandez, Ana Laura Gonzalez, Gustavo Andres Alvarez, Federico, Iglesias, Silvia, Chaparro, Graciela, Zakalik, Gonzalo, Pagella, Matías, Baini, Pierina Arias Campos, Ignacio, Sabbag, Armando, Schmukler, Imelda Perdomo Fonseca, Gonzalo Martín Alvarez, Mario, Ramirez, Fernando, Tapia, Carlos Alejandro Bascary, Graciela Del Valle Gimenez, Fernando Pablo Bertoletti, Esteban, Milioto, Pablo Julio Maldonaldo Bonsignore, Maria Alejandra Fernandez, Julie, Smith, Tim, Chimunda, Lorraine, Thompson, Teena, Maguire, Wendy, Chaboyer, Stacey, Watts, Marion, Mitchell, Madeleine, Powell, India, Lye, Leanne, Parsons, Nerilee, Baker, Claire, Reynolds, Amy, Thompson, Kristy, Masters, Kellie, Sosnowski, Lynette, Morrison, Gavin, D Leslie, Ramanathan, Lakshmanan, Alexis, Tabah, Wendy, Brown, Sharon, McDowell-Skaines, Andrea, Mclucas, Chris, Smith, Mandy, Tallot, Sarah, Jones, Michelle, Barakat-Johnson, Thomas, Leong, Rand, Butcher, Kerrie, Martin, Philipp, Douschan, Dirk von Lewinski, René, Schmutz, Uta, Kolussi, Fatema, Salman, Zainab, Ateya, Koen De Decker, Niels Van Regenmortel, Anita, Jans, Patricia, Wijnands, Stefano, Coremans, Patrick, M Honore, David De Bels, Tanja, Depuydt, Caroline, Paillet, Luc-Marie, Jacquet, Walter, Swinnen, Francis, Hannes, Matthia, Mergeay, Stijn Van de Velde, Silvie, Allaert, Pieter, Hoste, Christophe, Borin, Sandrine, Balon, Vincent, Fraipont, Patrick, Biston, Nicolas De Schryver, Thierry, Dugernier, Ilse Van Cotthem, Angelica Olivetto de Almeida, Silvia Angelica Jorge, Delmiro, Becker, Raysa Cristina Schmidt, Evellyn, Oliveira, Aline, Ramalho, Eliane, Mazocoli, Audrey, Fioretti, Elaine, Barros, Leticia, Serpa, Suzana, Bianchini, Ticiane, Campanili, Taís, Pantaleao, Paulo Carlos Garcia, Ana Lucia Vitti Ronchini, Rayanne, Santos, Nurulhuda Binti, A Manap, Sean, Bagshaw, Dominic, Carney, Jon, Davidow, Ella, Rokosh, Andréa Maria Laizner, Samantha, Smith, Megan, Mcquirter, Betty Star Kampayana, René, Favre, Martin, Sills, Julie, Dallaire, Cathy, Becker, Sherissa, Microys, Bonnie, Bowes, Jennifer, Lajeunesse, Rishi, Ghosh, Jacqueline, Baptiste-Savoie, Rose, Raizman, Gabriel, Suen, Noushin, Taghavi, Orla, Smith, Clare, Fielding, Julieta, Canales, Pia, Molina, Javiera, Chaparro, Maria Idalia Sepulveda, Matias Jesús Flamm Zamorano, Pamela, Rocha, Ximena, Villanueva, Paola, Araya, Meneses, Dayan, Fernando, Avalos, Xiaohan, Li, Liu, Yu, Xinxia, Li, Xiaoyan, Chen, Zhixia, Jiang, Jing, Yang, Jingfang, Chen, Lei, Yang, Kefang, Wang, Jie, Gao, Xiuhua, Fang, Ronghua, Zhao, Xinhua, Xia, Hongmei, Liu, Jing, Li, Haiyan, Wang, Gen, Meng, Yanhong, Di, Damei, Wang, Rong Hua Zhao, Li Ping Hu, Peipei, Xu, Qing Feng Jiao, Hai Yun Wang, Chun Jie Xia, Yan, Liu, Mei, Ye, Yan, Wan, Wenmei, Wang, Yajun, Ding, Aiua, Ren, Yan, Gao, Qi, Li, Guifang, Du, Yanling, Shen, Yanming, Ding, Ning, Li, Cui, Yuan, Lei, Tan, Qiang, Lin, Hailing, Guo, Howe, Yan, Xiao, Xu, Wei, Zhang, Jinxian, Liang, Libing, Zhang, Eryun, Tian, Qian, Zhao, Lin, Insu, Jingwen, Dong, Yanmei, Gu, Ying, Liu, Lina, Zhao, Wei, Wang, Hongmei, Qiao, Lili, Tuo, Mengmeng, Lv, Jin Yu Zhu, Jifen, Zhu, Ying, Wei, Man, Liu, Yin, He, Jiyin, Cheng, Jin, Liu, Jia, Na, Dongfang, Wei, Qing, Li, Xiaoying, Wu, Huan, Duan, Dongliang, Lin, Qiong, Liang, Xiaofang, Luo, Yunfeng, Xiong, Rong Fen Huang, Jing, Fu, Tao, Zan, Man, Ye, Zeya, Shi, Yanfei, Long, Yang, Lei, Xiaodi, Liu, Chen, Yumei, Lingling, Wang, Yali, Zhang, Yan, Xu, Cheng, Wang, Zhijuan, Chengxia, Sun, Jinhui, Song, Yingli, Wang, Xiumei, Liu, Yupeng, Liu, Yuxia, Yuan, Qingping, Huang, Fengling, Yang, Yun, Wu, Xianping, Luo, Xiaowu, Bai, Hong, Zheng, Min, Song, Yue, Sun, Zhangshuangzi, Li, Feifei, Luo, Miao, Liu, Li Chuntang Li, Xinjian, Li, Guiping, Zhang, Lina, Xiao, Tingting, Yu, Guangyuan, Gao, Wei, Wei, Fanglan, Wang, Ting, Han, Tingting, Li, Zeng, Qi, Jing Mei Zeng, Yan, Long, Fuqun, Pan, Jing, Wang, Guoxue, He, Haiyan, Chen, Feifei, Zhang, Chao, Yu, Gao, Chunhua, Xiuying, Yao, Dongmei, Bai, Liu, Lu, Xuelian, Xu, Yan, Wang, Xuejuan, Liang, Zhang, Na, Aizhi, Zhang, Xiaochun, Hu, Hui, Zhang, Ruixia, Wang, Poon Shing Tak, Sung Wai Ho, Qun Xia Jiang, Xinran, Ding, Liu, Hong, Limei, Miao, Zhaoxia, Feng, Liping, Huang, Juan, Wu, Yuping, Wang, Jiye, Guo, Baoke, Zhang, Chaoqun, Ma, Han, Yu, Congcong, Liu, Min, Ding, Linlin, Luan, Jing, Zheng, Shanshan, Lv, Shumin, Jiang, Wenzhen, Cao, Xiujuan, Xue, Guangyan, Liu, Xiyan, Wei, Youru, Jiang, Zhiru, Yao, Gao, Li, Jinhua, Li, Wenwen, Zhao, Mei, Jiang, Junping, Hao, Jing, Zhang, Caiju, Song, Feifei, Chen, Shuhui, Wang, Lili, Hu, Deyan, Cao, Jianhong, Wan, Xiaomin, Wang, Hongyan, Shao, Zhenxia, Zhang, Xia, Cui, Jingyu, Liu, Lijuan, Zhao, Xingguo, Li, Limei, Fan, Ling, Zhang, Min, Yu, Biyan, Li, Chunxia, Li, Ling, Liu, Xuelian, Liu, Wenmin, Chen, Yan, Li, Zhang, Zhigang, Yuchen, Wu, Chenghau, Mu, Guoyan, Zhu, Fan, Yang, Qi, Bo, Ling, Li, Meili, Chen, Jing Hua Jiang, Hai, Yin, Xuelian, Pang, Yue Ying Gong, Shunzhu, Yang, Xiaoli, Yan, Xianhong, Zheng, Dehong, Lei, Lei, Lei, Yinhua, Guo, Lihong, Liu, Jing, Yu, Wei, Sun, Aiping, Bi, Weiwei, Li, Yang, Wu, Ji, Li, Dongshu, Ni, Zijing, Wu, Bing, Song, Qin, Fei, Yang, Xiaoyan, Qiong, Ran, Xixi, Li, Xueping, Jiao, Hua, Ji, Sun, Zhiping, Hong, Ma, Jianhong, Mu, Yanhua, Hao, Yin, Li, Ying, Wang, Caihong, Hui, Wenjie, Ju, Yuxia, Huo, Yuxia, Wang, Lei, Chen, Yan, Yan, Qingli, Zhao, Hongjuan, Chen, Guijun, Bao, Ying, Cao, Hong, Li, Hong, Zhang, Ying, Zhang, Lina, Xu, Jia, Guixiang, Ying, Li, Hui Min Zhao, Xia, Huang, Zhaoxing, Dai, Yanman, Jian, Hongsu, Zhang, Zhixia, Tian, Zu Qing Cao, Miao, Li, Yang, Liu, Fei, Ouyang, Fuying, Ma, Wangyan, Jin, Liuyan, Ge, Shifen, Wu, Weilian, Yuan, Tianfei, Chen, Guanxiu, Shi, Zhihong, Chen, Kewei, Liu, Xue, Lin, Yuemen, Ly, Sun, Lijuan, Xiao Fang Tian, Shuo, Wang, Zhangxia, Feng, Xiaozhe, Liu, Yunchun, Dong, Jundi, Zhang, Nie, Bocui, Guoxian, Wang, Yingjuan, Zhao, Xiaojun, Wu, Qiao, Yang, Rongjun Ling Hu, Xue Qin Li, Zhu Jun Yu, Yanlan, Yao, Xiaoqiong, Deng, Yan, Xiao, Yan, Xie, Yanping, Yang, Huai, Yang, Yuming, Zhou, Zhuqing, Li, Min, Xiao, Yongxia, Yang, Yani, Tian, Luz Marina Silva Gama, Juan Sebastian Hernandez, Nestor, Caicedo, Jorge, Marin, Maria-Elena, Ochoa, Monica, Gomez, José, Rojas-Suarez, Jeniffer, Gonzalez, Amylkar José Garay Reyes, Edwin, Chapeta, Estefania, Orozco, Ina, Filipović-Grčić, Anita, Vuković, Suzana, Pečenković, Aleksandar, Šuput, Gordana, Zivanovic-Posilovic, Armanda, Bozena, Nikolina, Udiljak, Morena, Milic, Renata Curic Radivojevic, Slobodan, Mihaljevic, Marijana, Matas, Dinko, Tonkovic, Hemena, Čuljak, Ivana, Herceg, Gordana, Pavlisa, Milena, Dobric, Tatjana, Beker, Višnja Nesek Adam, Tanja, Goranovic, Chrysanthos, Markoulias, Mina, Mathaios, Maria, Mylordou, Eleni, Achilleos, Pavlina, Kleanthous, Veronika, Kotanidi, Maria, Foka, Iwy, Charalabous, Anna, Alexandrou, Marios, Georgiou, Artemis, Patsalos, Sofia, Zepoy, Constantina, Constantinou, Petr, Piza, Tomas, Vymazal, Elisabeth, Wiborg, Louise, Bruhn, Karin, Kaasby, Karin Rehnholt Pedersen, Sanne, Mikkelsen, Marie, Collet, Anne, Langvad, Hanne, Andresen, Susanne, Fischer, Inger Ebbesen Kjærgård, Britta, Jepsen, Birthe, Husted, Morten, Bestle, Anne Marie Kodal, Tina Charlotte Bitsch Hansen, Anne Sofie Bomholt Pedersen, Tina Damgaar Thomsen, Anisette, Hoegenhaven, Mette, From, Tine Melgaard Frandsen, Grit, Henning, Anja, Hansen, Inger Abildgaard Bliksted, Luis Mario Tamayo, Pedro, Mogrovejo, Carolina, Palaez, Diego Rolando Morocho Tutillo, Cintia Valencia Hurtado, Maria Fernanda García, Diana, Alvarez, Fausto, Guerrero, Alexandra, Vasquez, Martin, Kütimets, Kadri, Tamme, Eneli, Anvelt, Lomangisi, Dlamini-Sserumaga, Carita, Löfqvist, Virpi, Lusenius, Outi, Kauppi, Jenni-Katarina, Sakki, Tarja, Tervo-Heikkinen, Ulla, Kesti, Merja, Merilainen, Elina, Karjula, Minna, Peltomaa, Auli, Palmu, Maarit, Ahtiala, Maija Anniina Valta, Hervé, Mentec, Gaëtan, Plantefève, Guillaume, Besch, Sébastien, Pili-Floury, Stanislas, Ledochowski, Marc Danguy des Déserts, Christophe, Giacardi, Cédric, Daubin, Audrey, Massard, Yann Le Guen, Agnès, Blanc, Simon, Mandaroux, Silvia Calvino Günther, Prune, Avogadro, Anthony, Radavidson, Jean, Turc, Sébastien, Jochmans, Hervé, Quintard, Laetitia, Boyer, Cédric, Bruel, François, Philippart, Philippe, Montravers, Enora, Atchade, Nadine, Flessel, Benoît, Chinardet, Léa, Soulisse, Cindy, Pillard, Delphine, Ngo, Benjamin, Bongiorno, Nathalie, Heitzler, Virginie, Souppart, Nathalie, Gautheret, Jean-Francois, Timsit, Fatiha, Essardy, Muriel, Fartoukh, Daisy, Mehay, Fabienne, Etourneau, Jean-Christophe, Farkas, Pascal, Beuret, Gabriel, Preda, Etienne De Montmollin, Vincent, Castelain, Ulrich, Jaschinski, Monika, Rothenfusser, Detlef, Kindgen-Milles, Thomas, Dimski, Christine, Fiedler, Tobias, Heinicke, Patrick, Meybohm, Tobias, Schulze, Marc, Bota, Sabrina, Pelz, Tobias, Odenthal, Martin, Christ, Kathrin, Bösl, Achilleas, Chovas, Sebastian, Stehr, Philipp, Simon, Sarah, Grotheer, Sebastian, Schüppel, Stefan, Schaller, Lea, Albrecht, Andeas, Stübner, Stephan, Graeser, Nina, Kolbe, Martina, Lausch, Anja, Diers, Ulf, Guenther, Reimer, 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Styliani, Kourelea, Aikaterini, Efthimiou, Giannoula, Thoma, Apostolos, Bakas, Konstantinos, Psarulis, Souzana, Anisoglou, Eirini, Papageorgiou, Evangelia, Michailidou, Thomai, Tholioti, Athena, Lavrentieva, Evdokia, Sourla, Anastasia, Spyropoulou, Nikolaos, Pantelas, Kristina Mariana Matei Stalika, Ioannis, Georgakas, Antigoni, Karathanou, Syragoula, Tsikriki, Aikaterini, Dimoula, Sofia, Kanakaki, Aristeidis, Vakalos, Konstantinos, Pagioulas, Judy Enamorado Enamorado, Gabor, Nardai, Fatime, Hawchar, Asbjorn, Blondal, Brynja, Rygvadottir, Rannveig, J Jonasdottir, Hrönn, Birgisdottir, Bhagyesh, Shah, Shuchi, Kaushik, Swagata, Tripathy, Mukta, Singh, Sonika, Agarwal, Manish, Gupta, Meraj, Ahmad, Kishore, Mangal, Vaibhav, Bhargava, Vilas, Kushare, Simant, Jha, Lakshay, Bhakhtiani, Manoj, Kamal, Arvind, Baronia, Ade, Susanti, Mayang Indah Lestari, Zulkifli, Zulkifli, Windu, Baskoro, Farid, Zand, Fatemeh, Zarei, Ata, Mahmoodpoor, Farshad, Heidari, Fateme, Jafaraghaee, Aidan, O'Shea, Fiona, O'Shea, Caroline, O'Donnell, Geraldine, Craig, Gerry, Fitzpatrick, Lisa, Dunne, Jennifer, Hastings, Brian, Marsh, Caitriona, Cody, Elizabeth, Campbell, Deirdre, Doyle, Michelle, Pacturanan, Christine, Sheehan, Annette, Carey, Charlotte, Carter, Regina, Mulvey, Damien O'Connell Rosemary Finn, Catherine, Motherway, Amy, Walsh, Jennifer, Kehoe, Shella, Delossantos, Jennifer, Lalor, Siobhan, O'Nuallain, Helena, Behan, Sandra, Mcpherson, Ailesh, Corcoran, Patricia, Gordon, Glenda, Rooney, Dassy, Levy, Mazal, Azencot, Vladimir, Gurevich, Alinoy, Lavy, Valentina, Bendelari, Romina, Marconi, Antonio, Barone, Chiara, Gatti, Andrea, Giampaoletti, Cinzia, Borgognoni, Davide Massimo Ghioldi, Arena, Raimondo, Giacomo, Castiglione, Anna Vita Bruno, Giorgia, Rubulotta, Antonella, Mo, Amalia, Corso, Salvatore, Girianni, Andrea, Bruni, Eugenio, Garofalo, Salvatore Maurizio Maggiore, Alessandro Di Risio, Italo, Calamai, Rosario, Spina, Savino, Spadaro, Carlo Alberto Volta, Antonella, Cotoia, Lucia, 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Guillén, Josep Trenado Alvarez, Mercedes Del Cotillo, Jesus Emilio Barrueco-Francioni, Belen Burgos Conde, Maria Pilar Sogues Blanco, Maria Luisa Blasco, Ana Isabel Clement, Clara, Hurtado, Luz Coronado Sanz, David, Perez-Torres, Estefanía, Prol-Silva, Jorge, Pereira, Iván Areán González, Anastasio Espejo Cano, Cesar Rodriguez Nuñez, Inmaculada Lorenzo Fernadez, Alejandra Azahara Marguello Fernandez, Rosa Del Bosque Diez, Badiola, Hilario, Begoña, Zalba-Etayo, Ana, Pascual-Bielsa, Preveen, Banwarie, Dick, Nahar, Alisha van Axel, Naraindath, N Boedjawan, Erika Backlund Jansson, Ann-Sofie, Malvemyr, Lotta, Johansson, Ulla, Sandberg, Catarina, Tingsvik, Gunilla, Mattsson, Gun, Löf, Martin, Spångfors, Mona, Ringdal, Sebastian, Geijer, Lotti, Orvelius, Mia, Hylen, Caroline, Lagerhäll, Eva, Åkerman, Viveca Hamback Hellkvist, Ulrica, Mickelsson, Ewa, Wahlbom, Ing-Marie, Larsson, Ewa, Wallin, Filippo, Boroli, Solenne, Ory, Margaret Lynn Jong, Alexander, Dullenkopf, Martin, Lang, Yvan, Fleury, 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Rosie, Reece-Anthony, Luis, Mendes, Marcela, Vizcaychipi, Rhian, Bull, Grace, Lacaden, Eleanor, Santiago, Carlos Castro Delgado, Sarah, Farnell-Ward, Elaine, Thorpe, Justine, Somerville, Anne, Williams, Donna, Cummings, Helen, Derrick, Sarah, Brumwell, Claire, Randell, Nicola, Mccann, Emma, Aves, Gillian, Berry, Tamas, Szakmany, Una, Gunter, Paul, Pulak, Nikki, Sarkar, Kerry, Wright, Vitor, Gomes, Jones, Jo, Ruth, Palfrey, Julie, Camsooksai, Abby, Lewis, Antony, Eneas, Ascanio, Tridente, Louise, Barr, Beverley, Thomas, Emma, Parkin, Daniel, Horner, Christian, Frey, Suzanne, Bench, Rachel, Baumber, Phil, Broadhurst, Matthew, Jackson, Lynne, Williams, Michele, Clark, Jonathan, Paddle, Sarah, Bean, Sarah, Buckley, Christopher, Palfreeman, Sophie, Liu, Nicola, Allison, Ben, Attwood, Penny, Parsons, Victoria, Houghton, Sarah Jane Turner, David, Higgins, Egidija, Bielskute, Nicola, Horrigan, Reni, Jacob, Karen, Habgood, Ahmed, Zaki, Amy, Collins, Jenny, Lord, Charalice, Ramiro, Agnieszka, Kubisz-Pudelko, Michelle, Kotze, Helen, Williams, Ihor, Iovenko, Alexander, Tsarev, Arturo, Briva, Gabriela, Mendez, Lena, Napolitano, Magnus, Teig, Jarone, Lee, Gabriel Enrique Rodriguez, Talia, Ben-Jacob, Christopher, Potestio, Timothy, Eng, Dea, Mahanes, Ashish, Khanna, Abhijit, Duggal, Masakatsu, Nananmori, Manuel, Lois, Anna, Diaz, Kunal, Karamchandani, Cheryl, Bealer, Cindy, Barefield, Dorothy, Terry, Pauline, Fivecoat, Olakunle, Idowu, Juan, Cata, Tara, Clesi, Jessica, Peterson, Kevin, Hatton, Jasdeep, Dhaliwal, Dorothee, Mueller, Jing, Tao, Ashley Szabo Eltorai, Stephen, M Pastores, Natalie, Remor, Janel, Salazar, Diane, Barkas, Aaron, Joffe, Christopher, Barnes, Carrie, Sona, Marilyn, Schallom, Jack, Short, Javier, Lorenzo, Ingrid Von Der Osten, Marta, Borkowska, Mireia, Llaurado-Serra, Liesbet, Demarré, Vincianne, Pleitinckx, Cynthia, Xing, Anne-Sophie, Debue, Stefan, Goller, Elsa, Afonso, Gusarov, V, Eugeniya, Larina, Llaurado-Serra, M, Yalim, Dikmen, DecubICUs Study Team, European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, Muzha, D., Ribas, A.M., Lipovesty, F., Loudet, C., Coyer, F., Eller, P., Mostafa, N., Honoré, P.M., Telleria, V.M., Smajic, J., Nogueira, P.C., Nafees, KMK, Hentchoya, R., Rose, L., Soledad, J., Lin, F., Cardenas, Y., Reyes, A.G., Sustic, A., Mpouzika, M., Vymazal, T., Jensen, H.I., Aguirre-Bermeo, H., Maddison, L., Valta, M., Calvino-Gunther, S., Bloos, F., Adipa, F.E., Koulouras, V., Enamorado, J., Ágoston, Z., Birgisdóttir, H., Gupta, A., Gurjar, M., Kilapong, B., Hashemian, S.M., Martin-Loeches, I., Benbenishty, J., Cortegiani, A., Fletcher, K., Hayashi, Y., Waweru-Siika, W., Abidi, K., Lee, S.M., Hadri, B., Dolgusevs, M., Abillama, F.F., Jovaisa, T., Thix, C., Elhadi, M., Nor, B.M., Ratnam, S., Mazlan, M.Z., Maiyalagan, S., Sánchez-Hurtado, L., Belii, A., Naranpurev, M., Gautam, P., De Lange, D., Parke, R., Ilesanmi, R.E., Shosholcheva, M., Petosic, A., Lind, R., Ffarcsi, M.H., Bogarin, J., Hernandez, A.M., Mikaszewska-Sokolewicz, M., Sousa, B., Tomescu, D., Sandesc, D., Twagirumugabe, T., Gusarov, V., Ebaid, M., Jankovic, R., Slobodianiuk, G., Martonova, A., Knafelj, R., Mer, M., Maseda, E., Panka, B., Schefold, J.C., Joelsson-Alm, E., Trongtrakul, K., Merritt-Charles, L., Besbes, L.O., Dikmen, Y., Zgrzheblovska, L., Fielding, M., Rubulotta, F., Khanna, A.K., Saager, L., von der Osten, I., Greca, A., Cani, A., Xhindi, N., Hyska, G., Pinto, S., Alves, P., Esposito, R., Valgolio, E., Minope, JTS, Abdala, A., Ayala, M., Bravo, S., Bantar, A., Delgado, P., Badariotti, G., Lipovestky, F., Diaz, A., Saul, P., Setten, M., Aucapina, A., Acosta, Y., Gonzalez, V., Camputaro, L., Baccaro, F., Villa, R., Mastantuono, M., Dean, E., Rostello, O.F., Brizuela, P., Bartoli, J.R., Guereschi, M., Quiroga, C., Putruele, S., Villegas, P., Curilen, V., Fernandez, R., Nocheretti, M.G., Escalante, R.G., Loudet, C.I., Fernandez, S., Gonzalez, A.L., Alvarez, G.A., Iglesias, F., Chaparro, S., Zakalik, G., Pagella, G., Baini, M., Campos, P.A., Sabbag, I., Schmukler, A., Fonseca, I.P., Alvarez, G.M., Ramirez, M., Tapia, F., Bascary, C.A., Del Valle Gimenez, G., Bertoletti, F.P., Milioto, E., Bonsignore, PJM, Fernandez, M.A., Smith, J., Chimunda, T., Thompson, L., Maguire, T., Chaboyer, W., Watts, S., Mitchell, M., Powell, M., Lye, I., Parsons, L., Baker, N., Reynolds, C., Thompson, A., Masters, K., Sosnowski, K., Morrison, L., Leslie, G.D., Lakshmanan, R., Tabah, A., Brown, W., McDowell-Skaines, S., McLucas, A., Smith, C., Tallot, M., Jones, S., Barakat-Johnson, M., Leong, T., Butcher, R., Martin, K., Douschan, P., von Lewinski, D., Schmutz, R., Kolussi, U., Salman, F., Ateya, Z., De Decker, K., Van Regenmortel, N., Jans, A., Wijnands, P., Coremans, S., Honore, P.M., De Bels, D., Depuydt, T., Paillet, C., Jacquet, L.M., Swinnen, W., Hannes, F., Mergeay, M., Van de Velde, S., Allaert, S., Hoste, P., Borin, C., Balon, S., Fraipont, V., Biston, P., De Schryver, N., Dugernier, T., Van Cotthem, I., de Almeida, A.O., Jorge, S.A., Becker, D., Schmidt, R.C., Oliveira, E., Ramalho, A., Mazocoli, E., Fioretti, A., Barros, E., Serpa, L., Bianchini, S., Campanili, T., Pantaleao, T., Garcia, P.C., Ronchini, ALV, Santos, R., Manap, NBA, Bagshaw, S., Carney, D., Davidow, J., Rokosh, E., Laizner, A.M., Smith, S., McQuirter, M., Kampayana, B.S., Favre, R., Sills, M., Dallaire, J., Becker, C., Microys, S., Bowes, B., Lajeunesse, J., Ghosh, R., Baptiste-Savoie, J., Raizman, R., Suen, G., Taghavi, N., Smith, O., Fielding, C., Canales, J., Molina, P., Chaparro, J., Sepulveda, M.I., Zamorano, MJF, Rocha, P., Villanueva, X., Araya, P., Dayan, M., Avalos, F., Li, X., Liu, Y., Chen, X., Jiang, Z., Yang, J., Chen, J., Yang, L., Wang, K., Gao, J., Fang, X., Zhao, R., Xia, X., Liu, H., Li, J., Wang, H., Meng, G., Di, Y., Wang, D., Zhao, R.H., Hu, L.P., Peipei, X., Jiao, Q.F., Wang, H.Y., Xia, C.J., Ye, M., Wan, Y., Wang, W., Ding, Y., Ren, A., Gao, Y., Li, Q., Du, G., Shen, Y., Li, N., Yuan, C., Tan, L., Lin, Q., Guo, H., Yan, H., Xu, X., Zhang, W., Liang, J., Zhang, L., Tian, E., Zhao, Q., InSu, L., Dong, J., Gu, Y., Zhao, L., Qiao, H., Tuo, L., Lv, M., Zhu, J.Y., Zhu, J., Wei, Y., Liu, M., He, Y., Cheng, J., Liu, J., Jia, N., Wei, D., Wu, X., Duan, H., Lin, D., Liang, Q., Luo, X., Xiong, Y., Huang, R.F., Fu, J., Zan, T., Shi, Z., Long, Y., Lei, Y., Liu, X., Yumei, C., Wang, L., Zhang, Y., Xu, Y., Cheng, X., Zhijuan, W., Sun, C., Song, J., Wang, Y., Yuan, Y., Huang, Q., Yang, F., Wu, Y., Bai, X., Zheng, H., Song, M., Sun, Y., Li, Z., Luo, F., Li, L.C., Zhang, G., Xiao, L., Yu, T., Gao, G., Wei, W., Wang, F., Han, T., Li, T., Zeng, Q., Zeng, J.M., Pan, F., Wang, J., He, G., Chen, H., Zhang, F., Chao, Y., Chunhua, G., Yao, X., Bai, D., Liu, L., Liang, X., Zhang, N., Zhang, A., Hu, X., Zhang, H., Wang, R., Tak, P.S., Ho, S.W., Jiang, Q.X., Ding, X., Hong, L., Miao, L., Feng, Z., Huang, L., Wu, J., Guo, J., Zhang, B., Ma, C., Han, Y., Liu, C., Ding, M., Luan, L., Zheng, J., Lv, S., Jiang, S., Cao, W., Xue, X., Liu, G., Wei, X., Jiang, Y., Yao, Z., Gao, L., Zhao, W., Jiang, M., Hao, J., Zhang, J., Song, C., Chen, F., Wang, S., Hu, L., Cao, D., Wan, J., Wang, X., Shao, H., Zhang, Z., Cui, X., Fan, L., Yu, M., Li, B., Li, C., Chen, W., Li, Y., Zhigang, Z., Yuchen, W., Mu, C., Zhu, G., Bo, Q., Li, L., Chen, M., Jiang, J.H., Yin, H., Pang, X., Gong, Y.Y., Yang, S., Yan, X., Zheng, X., Lei, D., Lei, L., Guo, Y., Yu, J., Sun, W., Bi, A., Li, W., Ni, D., Wu, Z., Song, B., Fei, Q., Xiaoyan, Y., Ran, Q., Xixi, L., Jiao, X., Ji, H., Zhiping, S., Hong, M., Jianhong, M., Hao, Y., Yin, L., Hui, C., Ju, W., Huo, Y., Chen, L., Yan, Y., Bao, G., Cao, Y., Xu, L., Guixiang, J., Zhao, H.M., Huang, X., Dai, Z., Jian, Y., Tian, Z., Cao, Z.Q., Li, M., Ouyang, F., Ma, F., Jin, W., Ge, L., Wu, S., Yuan, W., Chen, T., Shi, G., Chen, Z., Liu, K., Lin, X., Yuemen, L., Lijuan, S., Tian, X.F., Dong, Y., Bocui, N., Wang, G., Zhao, Y., Yang, Q., Hu, R.L., Li, X.Q., Yu, Z.J., Yao, Y., Deng, X., Xiao, Y., Xie, Y., Yang, Y., Yang, H., Zhou, Y., Xiao, M., Tian, Y., Gama, LMS, Hernandez, J.S., Caicedo, N., Marin, J., Ochoa, M.E., Gomez, M., Rojas-Suarez, J., Gonzalez, J., Reyes, AJG, Chapeta, E., Orozco, E., Filipović-Grčić, I., Vuković, A., Pečenković, S., Šuput, A., Zivanovic-Posilovic, G., Bozena, A., Udiljak, N., Milic, M., Radivojevic, R.C., Mihaljevic, S., Matas, M., Tonkovic, D., Čuljak, H., Herceg, I., Pavlisa, G., Dobric, M., Beker, T., Adam, V.N., Goranovic, T., Markoulias, C., Mathaios, M., Mylordou, M., Achilleos, E., Kleanthous, P., Kotanidi, V., Foka, M., Charalabous, I., Alexandrou, A., Georgiou, M., Patsalos, A., Zepoy, S., Constantinou, C., Piza, P., Wiborg, E., Bruhn, L., Kaasby, K., Pedersen, K.R., Mikkelsen, S., Collet, M., Langvad, A., Andresen, H., Fischer, S., Kjærgård, I.E., Jepsen, B., Husted, B., Bestle, M., Kodal, A.M., Hansen, TCB, Pedersen, ASB, Thomsen, T.D., Hoegenhaven, A., From, M., Frandsen, T.M., Henning, G., Hansen, A., Bliksted, I.A., Tamayo, L.M., Mogrovejo, P., Palaez, C., Tutillo, DRM, Hurtado, C.V., García, M.F., Alvarez, D., Guerrero, F., Vasquez, A., Kütimets, M., Tamme, K., Anvelt, E., Dlamini-Sserumaga, L., Löfqvist, C., Lusenius, V., Kauppi, O., Sakki, J.K., Tervo-Heikkinen, T., Kesti, U., Merilainen, M., Karjula, E., Peltomaa, M., Palmu, A., Ahtiala, M., Valta, M.A., Mentec, H., Plantefève, G., Besch, G., Pili-Floury, S., Ledochowski, S., Déserts, MDD, Giacardi, C., Daubin, C., Massard, A., Le Guen, Y., Blanc, A., Mandaroux, S., Günther, S.C., Avogadro, P., Radavidson, A., Turc, J., Jochmans, S., Quintard, H., Boyer, L., Bruel, C., Philippart, F., Montravers, P., Atchade, E., Flessel, N., Chinardet, B., Soulisse, L., Pillard, C., Ngo, D., Bongiorno, B., Heitzler, N., Souppart, V., Gautheret, N., Timsit, J.F., Essardy, F., Fartoukh, M., Mehay, D., Etourneau, F., Farkas, J.C., Beuret, P., Preda, G., De Montmollin, E., Castelain, V., Jaschinski, U., Rothenfusser, M., Kindgen-Milles, D., Dimski, T., Fiedler, C., Heinicke, T., Meybohm, P., Schulze, T., Bota, M., Pelz, S., Odenthal, T., Christ, M., Bösl, K., Chovas, A., Stehr, S., Simon, P., Grotheer, S., Schüppel, S., Schaller, S., Albrecht, L., Stübner, A., Graeser, S., Kolbe, N., Lausch, M., Diers, A., Guenther, U., Riessen, R., Roller, M., Osei, I.P., Kusi-Appiah, A.C., Yakubu, Y.H., Guadi-Gosh, B., Dragoumanis, C., Christofis, C., Kazakos, N., Bastani, S., Martinos, C., Bekos, V., Papanikolaou, M., Papavasilopoulou, T., Efthymiou, A., Chantziara, V., Kyriakoudi, A., Kakaras, N., Diakaki, C., Flevari, A., Nikolaou, C., Katerina, K., Avramopoulou, L., Tsikritsaki, K., Gkiokas, G., Pantiora, E., Katsenos, C., Patsiou, E.C., Alexandropoulou, P., Koutsodimitropoulos, I., Farmakis, E., Nestora, K., Chatzis, M., Kondili, E., Soundoulounaki, S., Mousafiri, O., Lepida, D., Liarmakopoulou, A., Papathanakos, G., Oikonomou, M., Ioannides, P., Papadopoulos, D., Staikos, I., Stafylaraki, M., Raitsiou, B., Mandis, K., Ravani, I., Kourelea, S., Efthimiou, A., Thoma, G., Bakas, A., Psarulis, K., Anisoglou, S., Papageorgiou, E., Michailidou, E., Tholioti, T., Lavrentieva, A., Sourla, E., Spyropoulou, A., Pantelas, N., Stalika, KMM, Georgakas, I., Karathanou, A., Tsikriki, S., Dimoula, A., Kanakaki, S., Vakalos, A., Pagioulas, K., Enamorado, J.E., Nardai, G., Hawchar, F., Blondal, A., Rygvadottir, B., Jonasdottir, R.J., Birgisdottir, H., Shah, B., Kaushik, S., Tripathy, S., Singh, M., Agarwal, S., Gupta, M., Ahmad, M., Mangal, K., Bhargava, V., Kushare, V., Jha, S., Bhakhtiani, L., Kamal, M., Baronia, A., Susanti, A., Lestari, M.I., Zulkifli, Z., Baskoro, W., Zand, F., Zarei, F., Mahmoodpoor, A., Heidari, F., Jafaraghaee, F., O'Shea, A., O'Shea, F., O'Donnell, C., Craig, G., Fitzpatrick, G., Dunne, L., Hastings, J., Marsh, B., Cody, C., Campbell, E., Doyle, D., Pacturanan, M., Sheehan, C., Carey, A., Carter, C., Mulvey, R., Finn, DOR, Motherway, C., Walsh, A., Kehoe, J., Delossantos, S., Lalor, J., O'Nuallain, S., Behan, H., McPherson, S., Corcoran, A., Gordon, P., Rooney, G., Levy, D., Azencot, M., Gurevich, V., Lavy, A., Bendelari, V., Marconi, R., Barone, A., Gatti, C., Giampaoletti, A., Borgognoni, C., Ghioldi, D.M., Raimondo, A., Castiglione, G., Bruno, A.V., Rubulotta, G., Mo, A., Corso, A., Girianni, S., Bruni, A., Garofalo, E., Maggiore, S.M., Di Risio, A., Calamai, I., Spina, R., Spadaro, S., Volta, C.A., Cotoia, A., Mirabella, L., Maulicino, L., Abregal, G., Donvito, M., D'Ambrosio, P., Binda, F., Adamina, I., Galazzi, A., Negro, A., Vaschetto, R., Capuzzi, F., Boschetto, M., Stivanello, L., Bonaccorso, L., Megna, C., Iozzo, P., Rizzo, A., Scire, G., Taibi, M.R., Tranello, F.P., Manzo, A., Traina, L., Pastore, B., Quaini, A., Giusti, G.D., Montaldi, G., Piergentili, F., Mancini, F., Casaioli, S., Uccelli, F., Guarracino, F., Onelli, A., Di Gravio, V., Cossu, M., Matrona, O., Rocco, M., Alampi, D., Dellafiore, F., Ranalli, F., Bossolasco, M., Brizio, E., Migliorino, P., Cortellazi, P., Rosati, M., D'Ambrosio, F., Quagliotto, C., Roman-Pognuz, E., Peratoner, A., De Rosa, S., Martin, M.A., De Sanctis, F., Ciorba, P., Toppin, P., Harding-Goldson, H., Taito, S., Shime, N., Yamamoto, R., Kanda, F., Hirao, A., Egi, M., Noguchi, A., Hashimoto, S., Aya, U., Sakuramoto, H., Ohuchi, A., Kataoka, J., Maruyama, K., Nakayama, I., Nishime, Y., Fujimoto, K., Takahashi, K., Tsujimoto, M., Shimizu, M., Tole, E., Correia, M.C., Kim, J.H., Park, S., Kim, K.C., Baek, J., Bae, J.M., Park, S.Y., Park, T.S., Lee, H.B., Park, J., Yeon-Joo, L., Young-Jae, C., Jeon, K., Kim, S.C., Lee, J., Chee, H.K., Huh, J.W., Sim, Y.S., Kim, J., Chang, Y., Ahn, J.J., Kang, B.J., Lee, W.Y., Lee, S.J., Baftiu, N., Krastins, I., Stiban, S., Feghaly, M.E., Gharios, E., Merheb, M., Benlamin, M., Khaled, A., Belkhair, W.A., Tabib, M., Ashour, F., Elhadi, A., Tababa, OWE, Khaled, T., Alkhumsi, SIR, Alshrif, A.I., Aboufray, A.A., Alabuzidi, A., Triki, A.R., Elgammudi, M., Zahra, H.B., Soula, E., Al-Alawi, MMS, Ahmed, H., Ghula, MAA, Vosylius, S., Mouton, L., Rastegar, T., Sertznig, C., Martin, G., Theisen, C., Ferretti, C., Gils, F., Gallion, M., Zainudin, A., Bahrin, LKK, Deva, S.R., Rahim, AHA, Wahab, S., Hassan, WNW, Ismail, WNW, Ali, M.N., Khoo, T.M., Samat, N.M., Tong, JMG, Adib, NAN, Nor, MBM, Ismail, N., Sulaiman, S.R., Foong, K.W., Alias, A., Hua, N.P., Zermeno, J.M., Blanco, D., Duran, K., Nava, CLL, Nandyelly, SJR, Sanchez-Hurtado, L.A., Tejeda-Huezo, B., Del Moral Armengol, M., Nava, LPA, Herrera, J.G., de Anda, GFV, Gallegos-Perez, H., Hernandez-Sanchez, N., Hernandez-Ponce, L., Gorordo-Delsol, L., Hernandez-Romero, M., Gomez, S., Molinar, F., Ñamendys-Silva, S.A., Romero-Gonzalez, J.P., Gonzalez, D., Landaverde, A., Sosa, M.Á., Navarro, B., de Molina Serrano, JIR, Iburrigarro, S.R., Ibarra, A., Aguirre, J., Martinez-Gonzalez, M., Padilla, NRC, Pineda, AAV, Villafuerte, MVE, Herrera, MOG, Baasanjav, B., Hachimi, A., Elkhayari, M., Dendane, T., Subedi, N.B., Pathak, S.D., Manandhar, M., Van Gulik, L., Van Den Brink, M., Van Vliet, P., Gerretsen, B., Van Den Berg, L., De Haan, M., Tuinstra, B., Kuijpers, P., Reijntjens, J., Vermeijden, J.W., Rinket, M., Vanroest, M., Reidinga, A., Loef, B., Dieperink, W., Onrust, M., Dormans, T., Bormans, L., Koopmans, M., Gerritsen, R.T., Van Den Elst, A., Evers, M., Oiting, O., Wilting, R., Ramaker, B., van der Kuil, M., Fijen, J.W., Haas, L., Haringman, J., Newby, L., Gilder, E., Hacking, D., Dagooc, R., Song, R., Waibel, H., Dawn, F., Rapley, J., Chadwick, L., Chapman, C., Crone, P., Albrett, J., Marko, P., Goodson, J., Browne, T., Whitticase, R., Davidson, C., Judd, H., Owens, D., Onyeka, T., Ugwu, I., Ilesanmi, R., Adejumo, P.O., Owojuyigbe, A., Adenekan, A., Uba, S., Chime, C., Jibrin, D., Sankey, B.J., Adekola, O., Olanipekun, S., Shosolcheva, M., Gievski, V., Kartalov, A., Naumovski, F., Kuzmanovska, B., Trposak, A., Bogoevska-Miteva, Z., Rosalia, R., Olsen, B.F., Sjobo, B., Jensen, K.D., Sykehus, D., Johansen, B.F., Straede, E., 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Gonzalez D., Landaverde A., Sosa M.A., Navarro B., de Molina Serrano J.I.R., Iburrigarro S.R., Ibarra A., Aguirre J., Martinez-Gonzalez M., Padilla N.R.C., Pineda A.A.V., Villafuerte M.V.E., Herrera M.O.G., Baasanjav B., Hachimi A., Elkhayari M., Dendane T., Subedi N.B., Pathak S.D., Manandhar M., Van Gulik L., Van Den Brink M., Van Vliet P., Gerretsen B., Van Den Berg L., De Haan M., Tuinstra B., Kuijpers P., Reijntjens J., Vermeijden J.W., Rinket M., Vanroest M., Reidinga A., Loef B., Dieperink W., Onrust M., Dormans T., Bormans L., Koopmans M., Gerritsen R.T., Van Den Elst A., Evers M., Oiting O., Wilting R., Ramaker B., van der Kuil M., Fijen J.-W., Haas L., De Lange D., Haringman J., Newby L., Gilder E., Hacking D., Dagooc R., Song R., Waibel H., Dawn F., Rapley J., Chadwick L., Chapman C., Crone P., Albrett J., Marko P., Goodson J., Browne T., Whitticase R., Davidson C., Judd H., Owens D., Onyeka T., Ugwu I., Ilesanmi R., Adejumo P.O., Owojuyigbe A., Adenekan A., Uba S., Chime C., Jibrin D., Sankey B.J., Adekola O., Olanipekun S., Shosolcheva M., Gievski V., Kartalov A., Naumovski F., Kuzmanovska B., Trposak A., Bogoevska-Miteva Z., Rosalia R., Olsen B.F., Sjobo B., Jensen K.D., Sykehus D., Johansen B.F., Straede E., Johansen E., Finnstrom I.J., Toellefsen A., Ostenjo H., Bjorgen H., Bratsberg B., Kristoffersen E., Skorstad E.M., Hansen S., Vullum S., Lunde G.A., Arntsen W., Lund M., Akselsen G.R., Monstad K.R., Stenset A., Haugom H., Monsen B., Hogvall L., Trudvang S., Galaaen B., Malmin S.K., Andersen M.H., Hargott R.F., Andersen Y., Steffenak E., Nyhus M., Meland B., Hashmi M., Rivas N., Maidana E., de Jesus Ortiz A., Cabral D.M.B., Simi M., Aponte C., Rivas J.C., Gill S., Garcia A., Alvarenga G., Cespedes L., Perez H., Moreira M.L., Canete F., Gonzalez R., Monges N., Coman M., Pederzani M., Franco N., Aganon F., Martinez R., Noblezada-Uy D., Ellazar C.G., Cerezo F.D., Palo J.E., Aperocho C.A.J., Isanan M., Tubacka M., Jasiewicz P., Czuczwar M., Borys M., Gutysz-Wojnicka A., Glinka L., Gawda R., Bilawicz J., Cabrita P., Vieira J., Figueiredo M.F., Pinheiro C.M., Antunes N., Pedro L., Ferreira F., Parente I., Varela M., Fernandes F., Martins C., Viveiros A., Cavaco R., Rita C.S., Dias S., Feranandes A.M., Silva P., Nunes C., Cabral J., Pires F., Ferreira H., Santos J., Pinto V.M.V., Bispo B.M., Ferreira A., Molinos E., Lafuente E., Gregorio R., Costa H., Lima A., Ferreira S., Seromenho V., Luis E., Valerio I., Cesar H., Tavares A., Alsheikhly A.S., Mahmood S., Guran C.T., Moise A., Filipescu D.C., Luchian M., Popescu M., Scutariu M.A., Petrisor C., Hagau N., Grigoras I., Patrichi T., Gusarev V., Pivkina A., Kulakov V., Ignatenko O., Kovaleva J., Zhivotneva T., Zhedaeva M., Matiushkov N., Ershova O., Egorova N., Khoronenko V., Baskakov D., Sergeev D., Piradov M., Grishina L., Magomedov M., Zuev E., Gorokhovatsky U., Leonova A., Fadeeva L., Belskiy V., Galishevskiy D., Zubareva N., Tribulev M., Zueva O., Kiselev A., Kamenshchikov N., Tokareva E., Petrushin M., Starchenko I., Nshimyumuremyi I., Muhizi J., Buregeya E., Nzarora J., Assiri A., Ebaid M.S., Almekhlafi G., Mandourah Y., Velickovic J., Velickovic D., Jovanovic B., Hadzibegovic A., Stefanovic B., Misic V., Bumbasirevic V., Rajkovic M., Stojanovic M., Gavrilovic S., Stanojevic M., Yaghi A., Turcan A., Firment P., Rabarova D., Lancaricova D., Vlaovic J., Groznik M., Lukic M., Perme J., Sostaric M., Umek N., Mirkovic T., Dolenc S., Fister M., Zorko N., Markota A., Yeni N.P., Jali P., Schmollgruber S., Syed M.R., Parag N., Wise R., Galiana M., Navarro J.A., De Pablo A.M., Albert P., Martinez P., Mendiara Y., Garcia B., Llinas A.A., Riveiro M., Gallart E., Riera A., Sanz M., Salo S., Lajara M.A.G., Nieto M.V., Garcia R., Pena J.M.G., Gorgolas M.C., Isasi M.A., Sierra R., Gordo F., Conejo I., Salva-Costa V., Garzon-Tovar C., Lospitao S., Gutierrez P., Girona M., Adamuz J., Olivares P.G., de Ceballos J.P.G., Tirado C., De Wit I., Polo A.B.C., del Mar Diaz Salcedo 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Goksu S., Karakurt S., Arikan H., Gul F., Cinel I., Kara I., Undar H.N., Bayraktar Y.S., Celik J.B., Tokur M.E., Aydin D.T., Yildiz I., Ozcan B., Erdivanli B., Eroglu A., Akdag D., Unlu N., Dungca A., Ali A., Thankamma B., Reyes P.E., John S., Rajendran A., Ahmad F.K.E., Smiley K.A., Hojden S., Miller M.T., Das Sasidharan Nair V., Antonio M.G.S., Qawasmeh K.A., Shawish S.A., Twiggs H., Rosado I., Babych V., Morren F., Young C., Vaughan-Jones N., Harris S., Burns K., Georgiev C., Shayamano R., Kerslake I., Creber P., Vochin A., O'Brien C., Caddell P., Hagan S., Hughes M., Torlinski T., Sherwin J., Kannan S., Markham A., Lebon R., Cupitt J., Cranshaw J., White N., Marriott V., Milner W., Groba C.B., Azoia J., Polgarova P., George S., Kapoor R., Lynch C., Fox N., Cranmer K., Llewellym T., Matthews K., Maltby L., Ibao J., Boulton K., Jarman R., Baxter K., Raj A.S., Moghal A., White J., Barrowcliffe S., Pulletz M., Ganeshalingam V., Baruah R., Baker H., Woods J., Ei P.P., Ogbeide V., Hayden 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V., Pena, J. M. G., Gorgolas, M. C., Isasi, M. A., Salva-Costa, V., Garzon-Tovar, C., Olivares, P. G., de Ceballos, J. P. G., Polo, A. B. C., del Mar Diaz Salcedo, M., Alvarez, J. D., Arcas, M. L. B., Gonzalez, J. I. T., de la Ventana, A. B. S., Calleja, P. L. -A., Alvarez, R. G., Zamora, P. S., Guerrero, A. O., Barreiro, E. M., Sanchez, L. C., Diaz, M. G., Muriel, D. S., Alonso, H. F., Fernandez, A. W., Pinan, I. S., Albaiceta, G. M., Fernandez, M. C. I., Abos, F. J. S., Chueca, R. M., Aguirre, L. G., Manosa, S. C., Luque, C. P., Losilla, M. R., Fores, M. T., del Rosario Villar Redondo, M., Arteta Arteta, D. S., Sanchez, M. A. H., Espinosa, C. P., Reyes, L. M., Domenech, L. C., Guillen, C. V., Alvarez, J. T., del Cotillo, M., Barrueco-Francioni, J. E., Conde, B. B., Blanco, M. P. S., Blasco, M. L., Clement, A. I., Sanz, L. C., Gonzalez, I. A., Cano, A. E., Nunez, C. R., Fernadez, I. L., Fernandez, A. A. M., Boedjawan, N. N., Jansson, E. B., Malvemyr, A. -S., Lof, G., Spangfors, M., Lagerhall, C., Akerman, E., Hellkvist, V. H., Larsson, I. -M., Jong, M. L., Hsu, M. Y., Chang, S. C., Mebazaa, M. S., Elhechmi, Y. Z., Kuscu, O. O., Dal, H. C., Calili, D. K., Izdes, S., Gumus, A., Tasdemir, B., Kagnici, A., Ay, S. A., Balbay, A. O., Ozserezli, B., Senturk, E., Serin, S. O., Gul, F., Cinel, I., Undar, H. N., Bayraktar, Y. S., Celik, J. B., Tokur, M. E., Aydin, D. T., Yildiz, I., Ozcan, B., Akdag, D., Unlu, N., Reyes, P. E., Ahmad, F. K. E., Smiley, K. A., Miller, M. T., Antonio, M. G. S., Qawasmeh, K. A., Shawish, S. A., Groba, C. B., Raj, A. S., Ei, P. P., Legorburo, M. S., Welters, I. D., Mcmullen, J., Mcdonnell, A., Rose, B. O., Delgado, C. C., Mccann, N., Turner, S. J., Rodriguez, G. E., Eltorai, A. S., Pastores, S. M., Demarre, L., and Debue, A. -S.
Subjects: Male, Original, medicine.medical_treatment, artificial, Critical Care and Intensive Care Medicine, Medical and Health Sciences, Pressure ulcer, law.invention, Decubitus epidemiology, ICU, Morbidity, Mortality, Outcome, Pressure injury, Risk factors, Adult, Aged, Hospital Mortality, Humans, Patient Discharge, Prevalence, Risk Factors, Intensive Care Units, Respiration, Artificial, 0302 clinical medicine, decubitus epidemiology, pressure injury, pressure ulcer, outcome, risk factors, morbidity, mortality, law, Medicine and Health Sciences, adults, Medicine, Simplified Acute Physiology Score, icu, ziekenhuissterfte, Immunodeficiency, intensive care, European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, mannen, volwassenen, COST, Intensive care unit, STATE, ULCERS, Underweight, medicine.symptom, Life Sciences & Biomedicine, Human, medicine.medical_specialty, risicofactoren, Decubitus epidemiology, ICU, Pressure injury, Pressure ulcer, Outcome, Risk factors, Morbidity, Mortality, pressure injuries, Intensive Care Unit, prevalentie, NO, 1117 Public Health and Health Services, DecubICUs Study Team, 03 medical and health sciences, Critical Care Medicine, Anesthesiology, General & Internal Medicine, Health Sciences, ouderen, Mechanical ventilation, Science & Technology, business.industry, decubitus, Risk Factor, 030208 emergency & critical care medicine, 1103 Clinical Sciences, Odds ratio, medicine.disease, Emergency & Critical Care Medicine, Confidence interval, 030228 respiratory system, Emergency medicine, kunstmatige ademhaling, RISK-FACTORS, business, respiration
Abstract: Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347, Funder: Flemish Society for Critical Care Nurses, Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.
Published: 2021
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27. Inhaled isoflurane via the anaesthetic conserving device versus propofol for sedation of invasively ventilated patients in intensive care units in Germany and Slovenia: an open-label, phase 3, randomised controlled, non-inferiority trial

Author: Andreas Meiser, Thomas Volk, Jan Wallenborn, Ulf Guenther, Tobias Becher, Hendrik Bracht, Konrad Schwarzkopf, Rihard Knafelj, Andreas Faltlhauser, Serge C Thal, Jens Soukup, Patrick Kellner, Matthias Drüner, Heike Vogelsang, Martin Bellgardt, Peter Sackey, Eberhard Barth, Berthold Bein, Paul Biever, Ralph Bogdanski, Sebastian Brandt, Anreas Faltlhauser, Arnim Geise, Adrian Iustin Georgevici, Philipp Gude, Uwe Hamsen, Christian Hönemann, Kerstin Kellner, Azzeddine Kermad, Klaus Kogelmann, Rainer Kram, Andrej Markota, Werner Meermeier, Matej Podbregar, Patrick Schramm, Matthias Schroeder, Christian Waydhas, Norbert Weiler, and Richard Wetzold
Subjects: Pulmonary and Respiratory Medicine, Adult, Sedation, Population, Slovenia, law.invention, law, Intensive care, Germany, Clinical endpoint, Medicine, Humans, Hypnotics and Sedatives, Prospective Studies, education, Prospective cohort study, Propofol, Anesthetics, education.field_of_study, Isoflurane, business.industry, Intensive care unit, Respiration, Artificial, Intensive Care Units, Anesthesia, medicine.symptom, business, medicine.drug
Abstract: Summary Background Previous studies indicate that isoflurane could be useful for the sedation of patients in the intensive care unit (ICU), but prospective studies evaluating isoflurane's efficacy have been small. The aim of this study was to test whether the sedation with isoflurane was non-inferior to sedation with propofol. Methods This phase 3, randomised, controlled, open-label non-inferiority trial evaluated the efficacy and safety of up to 54 h of isoflurane compared with propofol in adults (aged ≥18 years) who were invasively ventilated in ICUs in Germany (21 sites) and Slovenia (three sites). Patients were randomly assigned (1:1) to isoflurane inhalation via the Sedaconda anaesthetic conserving device (ACD; Sedana Medical AB, Danderyd, Sweden; ACD-L [dead space 100 mL] or ACD-S [dead space 50 mL]) or intravenous propofol infusion (20 mg/mL) for 48 h (range 42–54) using permuted block randomisation with a centralised electronic randomisation system. The primary endpoint was percentage of time in Richmond Agitation–Sedation Scale (RASS) range –1 to –4, assessed in eligible participants with at least 12 h sedation (the per-protocol population), five or more RASS measurements, and no major protocol violations, with a non-inferiority margin of 15%. Key secondary endpoints were opioid requirements, spontaneous breathing, time to wake-up and extubation, and adverse events. Safety was assessed in all patients who received at least one dose. The trial is complete and registered with EudraCT, 2016–004551–67. Findings Between July 2, 2017, and Jan 12, 2020, 338 patients were enrolled and 301 (89%) were randomly assigned to isoflurane (n=150) or propofol (n=151). 146 patients (97%) in each group completed the 24-h follow-up. 146 (97%) patients in the isoflurane group and 148 (98%) of patients in the propofol group were included in the per-protocol analysis of the primary endpoint. Least-squares mean percentage of time in RASS target range was 90·7% (95% CI 86·8–94·6) for isoflurane and 91·1% (87·2–95·1) for propofol. With isoflurane sedation, opioid dose intensity was 29% lower than with propofol for the overall sedation period (0·22 [0·12–0·34] vs 0·32 [0·21–0·42] mg/kg per h morphine equivalent dose, p=0·0036) and spontaneous breathing was more frequent on day 1 (odds ratio [OR] 1·72 [1·12–2·64], generalised mixed linear model p=0·013, with estimated rates of 50% of observations with isoflurane vs 37% with propofol). Extubation times were short and median wake-up was significantly faster after isoflurane on day 2 (20 min [IQR 10–30] vs 30 min [11–120]; Cox regression p=0·0011). The most common adverse events by treatment group (isoflurane vs propofol) were: hypertension (ten [7%] of 150 vs two [1%] of 151), delirium (eight [5%] vs seven [5%]), oliguria (seven [5%] vs six [4%]), and atrial fibrillation (five [3%] vs four [3%]). Interpretation These results support the use of isoflurane in invasively ventilated patients who have a clinical need for sedation. Funding Sedana Medical AB.
Published: 2021

28. Temperature management and its role in cardiac arrest patients—a review

Author: Kristijan Skok, Maja Duh, Andrej Markota, and Marko Gosak
Subjects: medicine.medical_specialty, Resuscitation, business.industry, medicine.medical_treatment, Targeted temperature management, Thermoregulation, Hypothermia, Out of hospital cardiac arrest, Thermoregulatory system, Temperature homeostasis, medicine, medicine.symptom, Intensive care medicine, business, Pathological
Abstract: Thermoregulation constitutes one of the most important homeostatic systems of the human body. The human thermoregulatory system is highly complex and intertwined with other regulatory homeostatic systems. Different evolutionary adaptations have evolved to ensure a well-regulated body temperature, encompassing simple behavioural (e.g., seeking shelter, going underground) as well as physiological changes (e.g., vasodilatation, sweating). However, when the heat, cold or other stimuli cause a disruption in the thermoregulatory state and our adaptations can no longer cope with the additional stress, the body enters a pathological state. In such instances other measures must be undertaken. In medicine there are several pathological states associated with disruptions in temperature homeostasis. Consequently, these patients have to be, in broad terms, thermoregulated. Speaking specifically, the most common application of thermoregulation is therapeutic temperature management. A prominent example is the utilisation of this technique in post-cardiac arrest patients, who remain comatose after resuscitation. This technique has been in use for almost 20 years since the first major reports on its benefits in improving out-of-hospital cardiac arrest and in-hospital cardiac arrest survival as well as improving neurological outcome. Recently, the findings from one of the biggest targeted temperature international and multicentre trials to date have been published (TTM2 trial; https://ttm2trial.org/). The study surprisingly showed no difference in mortality between patients after out of hospital cardiac arrest, who underwent normo- or hypothermia. Consequently, we might need to re-evaluate certain guidelines, recommendations, and perspectives. The aim of the current review is to present an overview of targeted temperature management in the field of intensive care medicine and cardiac arrest.
Published: 2021
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29. Tissue adhesives for peripheral intravenous catheter securement: A prospective randomized controlled pilot trial

Author: Andrej Markota, Sandi Žumer, Urška Fekonja, Marko Majhenič, Matevž Toplak, Žarko Mišanović, Anja Podstenšek, Mario Gorenjak, Amadeus Lešnik, and Valerija Zorčič
Subjects: Male, medicine.medical_specialty, Randomization, Peripheral intravenous, Pilot Projects, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Catheters, Indwelling, Catheterization, Peripheral, medicine, Humans, Prospective Studies, Aged, business.industry, Tissue adhesives, Pilot trial, 030208 emergency & critical care medicine, General Medicine, Emergency department, Cannula, Bandages, Surgery, Occlusive dressing, Catheter, Emergency Medicine, Female, Tissue Adhesives, business, Emergency Service, Hospital
Abstract: Background In some patients securing the peripheral intravenous cannula (PIVC) with a standard adhesive dressing can be difficult because of sweat or other body fluids. The aim of our study was to evaluate the use of tissue adhesives alone as a means to secure PIVCs inserted in the emergency department. Methods We performed a prospective interventional pilot study from November 2019 to May 2020 in a medical emergency department of an urban tertiary hospital. Patients were randomized to two groups: tissue adhesives (TA) or adhesive dressing (AD) group. After randomization we followed them until day 4. Results There were no significant differences between TA and AD groups in the rate of unplanned removal of PIVCs in the first 72 h (57.1% vs. 45.8%, p = 0.29), the rate of unplanned removal of PIVCs in the ED (0% vs. 2.1%, p = 1.00), the rate of unplanned removal of PIVC in the first 24 h (42.8% vs. 35.4%, p = 0.52), as well as in the rate of phlebitis (7.1% vs. 14.6%, p = 0.34) and the rate of any blood-stream infection (0% vs. 0%, p = 1.00). Conclusion We did not observe any significant differences when PIVCs inserted in the emergency department were secured with tissue adhesives alone, compared to standard adhesive dressings. We observed a high rate of unplanned removal of PIVCs, necessitating further research to determine more reliable ways of securing PIVCs.
Published: 2020

30. Evaluation of Mobile Phone Mortality Risk Score Applications Using Data from the Electronic Medical Records

Author: Nino, Fijacko, Lucija, Gosak, Primož, Kockek, Leona, Cilar, Andrej, Markota, and Gregor, Štiglic
Subjects: Intensive Care Units, Health Personnel, Electronic Health Records, Humans, Mobile Applications, Cell Phone
Abstract: Various mobile phone apps in the form of medical calculators are available for different prognostic assessments, especially for patients in intensive care units. We performed a systematic review of mobile phone apps in online mobile phone stores to identify apps for mortality risk prediction in intensive care units. Out of 2737 potential mobile phone apps, we included 20 of them in the final content analysis. The most frequently used mortality risk model was Sequential Organ Failure Assessment also known as SOFA. The mobile phone apps were compared based on realistic electronic medical record data. The discrepancies were shown in patients with lower mortality rate. Our results show that this kind of mobile phone apps can be helpful to healthcare professionals and are appropriate for use in clinical practices in most cases.
Published: 2020

31. Thermoregulation: A journey from physiology to computational models and the intensive care unit

Author: Marko Gosak, Andrej Markota, Kristijan Skok, Maja Duh, and Andraž Stožer
Subjects: 0303 health sciences, Computational model, medicine.medical_specialty, business.industry, medicine.medical_treatment, Targeted temperature management, Thermoregulation, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Medicine, business, Intensive care medicine, 030217 neurology & neurosurgery, 030304 developmental biology
Abstract: Thermoregulation plays a vital role in homeostasis. Many species of animals as well as humans have evolved various physiological mechanisms for body temperature control, which are characteristically flexible and enable a fine-tuned spatial and temporal regulation of body temperature in different environmental conditions and circumstances. Human beings normally maintain a core body temperature at around 37°C, and maintenance of this relatively high temperature is critical for survival. Therefore, principles of thermoregulatory control have also important clinical implications. Infections can cause the body temperature to rise internally and several diseases can cause a dysfunction of thermoregulatory mechanisms. Moreover, the utilization of thermotherapies in treating various diseases has been known for thousands of years with a recent resurgence of interest. An increasing amount of research suggests that targeted temperature management is of paramount importance to patient outcomes in certain clinical scenarios. We provide a concise summary of the basic concepts of thermoregulation. Emphasis is given to the principles of thermoregulation in humans in basic pathological states and to targeted temperature management strategies in the clinical environment, with special attention on therapeutic hypothermia in postcardiac arrest patients. Finally, the discussion is focused on the potential offered by computational thermophysiological models for predicting thermal responses of patients in various clinical circumstances, for proposing new perspectives in the design of novel thermal therapies, and to optimize targeted temperature management strategies. This article is categorized under: Cardiovascular Diseases > Cardiovascular Diseases>Computational Models Cardiovascular Diseases > Cardiovascular Diseases>Environmental Factors Cardiovascular Diseases > Cardiovascular Diseases>Biomedical Engineering.
Published: 2020

32. Retrospective Analysis of Esophageal Heat Transfer for Active Temperature Management in Post-cardiac Arrest, Refractory Fever, and Burn Patients

Author: Erik Kulstad, Andrej Markota, Ahmed F. Hegazy, Melissa Naiman, and John Dingley
Subjects: medicine.medical_specialty, Time Factors, Fever, post-cardiac arrest, medicine.medical_treatment, therapeutic hypothermia, Targeted temperature management, targeted temperature management, burns, 03 medical and health sciences, Esophagus, 0302 clinical medicine, Refractory, Intensive care, refractory fever, medicine, Retrospective analysis, Humans, Post cardiac arrest, Adverse effect, Retrospective Studies, business.industry, Public Health, Environmental and Occupational Health, Thermal Conductivity, 030208 emergency & critical care medicine, General Medicine, Hypothermia, Heart Arrest, critical care, Heat transfer, Emergency medicine, Supplement Article, medicine.symptom, business, 030217 neurology & neurosurgery, Body Temperature Regulation
Abstract: Core temperature management is an important aspect of critical care; preventing unintentional hypothermia, reducing fever, and inducing therapeutic hypothermia when appropriate are each tied to positive health outcomes. The purpose of this study is to evaluate the performance of a new temperature management device that uses the esophageal environment to conduct heat transfer. De-identified patient data were aggregated from three clinical sites where an esophageal heat transfer device (EHTD) was used to provide temperature management. The device was evaluated against temperature management guidelines and best practice recommendations, including performance during induction, maintenance, and cessation of therapy. Across all active cooling protocols, the average time-to-target was 2.37 h and the average maintenance phase was 22.4 h. Patients spent 94.9% of the maintenance phase within ±1.0°C and 67.2% within ±0.5°C (574 and 407 measurements, respectively, out of 605 total). For warming protocols, all of the patient temperature readings remained above 36°C throughout the surgical procedure (average 4.66 h). The esophageal heat transfer device met performance expectations across a range of temperature management applications in intensive care and burn units. Patients met and maintained temperature goals without any reported adverse events.
Published: 2018
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33. GPIIb-IIIa Receptor Inhibitors in Acute Coronary Syndrome Patients Presenting With Cardiogenic Shock and/or After Cardiopulmonary Resuscitation

Author: Vojko Kanic, Zlatka Kanic, Meta Penko, Gregor Kompara, Maja Vollrath, and Andrej Markota
Subjects: Male, Pulmonary and Respiratory Medicine, Ticagrelor, medicine.medical_specialty, Acute coronary syndrome, Adenosine, Ticlopidine, Time Factors, Slovenia, Shock, Cardiogenic, Platelet Glycoprotein GPIIb-IIIa Complex, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Cause of Death, Internal medicine, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Acute Coronary Syndrome, Survival rate, Aged, Retrospective Studies, business.industry, Cardiogenic shock, Middle Aged, medicine.disease, Cardiopulmonary Resuscitation, Clopidogrel, Survival Rate, Conventional PCI, Purinergic P2Y Receptor Antagonists, Cardiology, Platelet aggregation inhibitor, Drug Therapy, Combination, Female, Cardiology and Cardiovascular Medicine, business, Prasugrel Hydrochloride, Platelet Aggregation Inhibitors, TIMI, Follow-Up Studies, medicine.drug
Abstract: Background Data on the use of GPIIb-IIIa receptor inhibitors (GPI) in acute coronary syndrome (ACS) patients presenting with cardiogenic shock and/or after cardiopulmonary resuscitation is sparse. The aim of the study was to establish the possible influence of the adjunctive use of GPI on 30-day and 1-year mortality in these high-risk patients. Methods Acute coronary syndrome patients (261), who presented with cardiogenic shock and/or were cardiopulmonary resuscitated on admission, were analysed. Groups receiving (170 patients) and not receiving (91 patients) GPI were compared regarding 30-day and 1-year mortality. Results The unadjusted all-cause 30-day and 1-year mortality were similar in patients receiving GPI and those not receiving GPI [79 patients (46.5%) vs 50 patients (54.9%) at 30 days; ns, 91 patients (53.5%) vs. 55 (61.1%) at 1 year; ns]. After the adjustment for baseline and clinical characteristics, the adjunctive usage of GPI was identified as an independent prognostic factor in lower 30-day mortality (adjusted OR: 0.41; 95%CI: 0.20 to 0.84; p=0.015) and 1-year mortality (HR 0.62; 95%CI 0.39–0.97; p=0.037). Age, left main PCI and major bleeding , were also identified as independent prognostic factors in worse 30-day and 1-year mortality. In addition, Thrombolysis in Myocardial Infarction (TIMI) flow 0/1 pre-percutaneous coronary intervention (PCI) predicted a worse 1-year outcome. Novel oral P2Y12 receptor antagonists predicted better 30-day and 1-year survival. Conclusion Our study suggests that the adjunctive usage of GPI may be beneficial in this high-risk group of patients in whom a delayed onset of action of oral antiplatelet therapy would be expected.
Published: 2018
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34. Comparison between arterial and peripheral-venous blood gases analysis in patients with dyspnoea and/or suspected acute respiratory failure

Author: Mario Gorenjak, Amadeus Lešnik, Eva Žuran Pilinger, Jerneja Golub, and Andrej Markota
Subjects: medicine.medical_specialty, business.industry, Arteries, Venous blood, Carbon Dioxide, Peripheral, Dyspnea, Internal medicine, Internal Medicine, Cardiology, medicine, Humans, Acute respiratory failure, In patient, Gases, Blood Gas Analysis, Respiratory Insufficiency, business
Published: 2020
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35. 1 - Higher post-resuscitation hemoglobin, lower pO2 and lower lactate are associated with survival after cardiac arrest

Author: Sandra Burja and Andrej Markota
Published: 2019
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36. 2 - Association of arterial carbon dioxide and pH with hospital mortality after cardiac arrest

Author: Sandra Burja and Andrej Markota
Published: 2019
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37. 8 - Comparison of time within target range and complications related to temperature management between esophageal temperature management device and surface cooling

Author: Sandra Burja and Andrej Markota
Published: 2019
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38. EuReCa ONE⿿27 Nations, ONE Europe, ONE Registry

Author: Jan-Thorsten Gräsner, Rolf Lefering, Rudolph W. Koster, Siobhán Masterson, Bernd W. Böttiger, Johan Herlitz, Jan Wnent, Ingvild B.M. Tjelmeland, Fernando Rosell Ortiz, Holger Maurer, Michael Baubin, Pierre Mols, Irzal HadžibegoviĿ, Marios Ioannides, Roman Škulec, Mads Wissenberg, Ari Salo, Hervé Hubert, Nikolaos I. Nikolaou, Gerda Lóczi, Hildigunnur Svavarsdóttir, Federico Semeraro, Peter J. Wright, Carlo Clarens, Ruud Pijls, Grzegorz Cebula, Vitor Gouveia Correia, Diana Cimpoesu, Violetta Raffay, Stefan Trenkler, Andrej Markota, Anneli Strömsöe, Roman Burkart, Gavin D. Perkins, Leo L. Bossaert, Marc Kaufmann, Markus Thaler, Martin Maier, Gerhard Prause, Helmut Trimmel, Diane de Longueville, Thierry Preseau, Dominique Biarent, Christian Melot, Nicolas Mpotos, Koen Monsieurs, Patrick Van de Voorde, Marie Vanhove, Pascale Lievens, Mathias Faniel, Slobodanka Keleuva, Milan Lazarevic, Radmila Majhen Ujevic, Mato Devcic, Branka Bardak, Fabijan Barisic, Silvija Hunyadi Anticevic, Marios Georgiou, Anatolij Truhláſ, Jiſí Knor, Eva Smržová, Roman Sviták, Robin Šín, Petr Mokrejš, Freddy K. Lippert, Juhana Hallikainen, Marko Hoikka, Timo Iirola, Timo Jama, Helena Jäntti, Raimo Jokisalo, Milla Jousi, Hetti Kirves, Markku Kuisma, Jukka Laine, Sami Länkimäki, Petri Loikas, Vesa Lund, Teuvo Määttä, Heini Nal, Heimo Niemelä, Petra Portaankorva, Marko Pylkkänen, Marko Sainio, Piritta Setälä, Jerry Tervo, Taneli Väyrynen, Davy Murgue, Anne Champenois, Marc Fournier, Daniel Meyran, Romain Tabary, Aurélie Avondo, Gelin Gelin, Bruno Simonnet, Marc Joly, Isabelle Megy-Michoux, Xavier Paringaux, Yves Duffait, Michael Vial, Julien Segard, Sophie Narcisse, David Hamban, Jonathan Hennache, Sylvain Thiriez, Mathieu Doukhan, Carine Vanderstraeten, Jean-Charles Morel, Gilles Majour, Corinne Michenet, Laurent Tritsch, Marc Dubesset, Olivier Peguet, David Pinero, Fréderic Guillaumee, Patrick Fuster, Jean-François Ciacala, Benoît Jardel, Jean-Yves Letarnec, Frank Goes, Pierre Gosset, Muriel Vergne, Christian Bar, Fabienne Branche, Stevens Prineau, Steven Lagadec, Carole Cornaglia, Cécile Ursat, Philippe Bertrand, Jean-Marc Agostinucci, Pierre Nadiras, Géraldine Gonzales de Linares, Line Jacob, François Revaux, Thomas Pernot, Nathalie Roudiak, Agnès Ricard-Hibon, Laurent Villain-Coquet, Stefan Beckers, Thomas Hanff, Bernd Strickmann, Nicolai Wiegand, Petra Wilke, Harald Sues, Stefan Bogatzki, Wolfgang Baumeier, Kai Pohl, Bert Werner, Hans Fischer, Torsten Zeng, Erik Popp, Andreas Günther, Andreas Hochberg, Alex Lechleuthner, Jens-Christian Schewe, Hans Lemke, Erich Wranze-Bielefeld, Andreas Bohn, Markus Roessler, Frank Naujoks, Frank Sensen, Torben Esser, Matthias Fischer, Martin Messelken, Christopher Rose, Gabriele Schlüter, Wolfgang Lotz, Michael Corzilius, Claus-Martin Muth, Christian Diepenseifen, Björn Tauchmann, Torsten Birkholz, Andreas Flemming, Stefanie Herrmann, Uwe Kreimeier, Clemens Kill, Frank Marx, Ralph Schröder, Wolfgang Lenz, Glykeria Botini, Barakos Grigorios, Nikolaos Giannakoudakis, Michail Zervopoulos, Dimitrios Papangelis, Sofia Petropoulou-Papanastasiou, Themistoklis Liaskos, Spyridon Papanikolaou, Andreas Karabinis, Attila Zentay, Hólmgeir ÿorsteinsson, Anna Gilsdóttir, Svavar A. Birgisson, Fjölnir Freyr Guðmundsson, Hallgrímur Hreiðarsson, Björgvin ÿrnason, Hermann Hermannsson, Gísli Björnsson, Brynjar ÿór Friðriksson, Gunnar Baldursson, ÿrmann Höskuldsson, Jórunn Valgarðsdottir, Matthildur ÿsmundardóttir, Guðmundur Guðmundsson, Hjörtur Kristjánsson, Eyþór Rúnar ÿórarinsson, Jón Guðlaugsson, Sigurður Skarphéðinsson, Alberto Peratoner, Andrea Santarelli, Cesare Sabetta, Giovanni Gordini, Giovanni Sesana, Riccardo Giudici, Simone Savastano, Tommaso Pellis, Jean Beissel, Jean Uhrig, Tom Manderscheid, Marco Klop, Pascal Stammet, Marc Koch, Philippe Welter, Robert Schuman, Wendy Bruins, Hesam Amin, Nina Braa, Staale Bratland, Eirik Alnes Buanes, Tomas Draegni, Knut Roar Johnsen, Wenche Torunn Mathisen, Terje Oedegaarden, Marie Oppedal, Alf Stolt-Nielsen Reksten, Mats Eirik Roedsand, Jon Erik Steen-Hansen, Marta Dyrda, Anna Frejlich, Sſawomir MaciĿg, Sonia Osadnik, Ireneusz Weryk, Eugénio Mendonça, Carlos Freitas, Pinto Cruz, Carmo Caldeira, José Barros, Luis Vale, António Brazão, Nuno Jardim, Fernanda Rocha, Ricardo Duarte, Nicodemos Fernandes, Pedro Ramos, Margarida Jardim, Miguel Reis, Romulo Ribeiro, Sérgio Zenha, Jorge Fernandes, Juan Francisco, David Assis, Fernanda Abreu, Dinarte Freitas, Leonardo Ribeiro, Paulo Azevedo, Débora Calafatinho, Rui Jardim, Aleixo Pestana, Rui Faria, Bogdan Oprita, Alis Grasu, Paul Nedelea, Sorina Sovar, Florin Agapi, Aleksandar KliĿkoviĿ, Aleksandra LaziĿ, Bogdan NikoliĿ, Bogdan Zivanovic, Branislav MartinoviĿ, Dušan MilenkoviĿ, HuseinoviĿ Damir, Jovanka Koprivica, Kornelija Horvat JakšiĿ, Margit Pajor, Saša MiliĿ, Mirko VidoviĿ, Radojka Petrovic Glamoclija, Sladjana Andjelic, Vlajovic Sladjana, Zlatko BabiĿ, Zlatko Fišer, Peter Androvic, Lubica Bajerovska, Miroslav Chabron, Viliam Dobias, Eva Havlikova, Bozena Horanova, Renata Kratochvilova, Dana Kubova, Jan Murgas, Juraj Patras, Ladislav Simak, Vladimir Snarskij, Zuzana Zaviaticova, Marcela Zuffova, Francesc Escalada Roig, Luis Sánchez Santos, Alfredo Echarri Sucunza, Juan A. Cordero Torres, Guadalupe Inza Muñoz, Marta Martínez del Valle, Isabel Ceniceros Rozalen, Enrique Martín Sánchez, María Victoria Raúl Canabal Berlanga, Karlos Ibarguren Olalde, José I. Ruiz Azpiazu, María José García-Ochoa, Rafael Zoyo López-Navarro, José M. Adsuar Quesada, José A. Cortés Ramas, Francisco J. Mellado Vergel, Juan B. López Messa, Patricia Fernández del Valle, Luciano Anselmi, Breganzona Claudio Benvenuti, Nigel Batey, Yorkshire Ambulance, Scott Booth, Patricia Bucher, Charles D. Deakin, Jay Duckett, Chen Ji, Nancy Loughlin, Jenny Lumley-Holmes, Jessica Lynde, Frank Mersom, Carly Ramsey, Clare Robinson, Robert Spaight, Sukhdeep Dosanjh, Gurkamal Virdi, and Andrew Whittington
Subjects: medicine.medical_specialty, resuscitation outcomes, resuscitation, united-states, education, cardiac arrest, 030204 cardiovascular system & hematology, Emergency Nursing, survival, Out of hospital cardiac arrest, resuscitation registry, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, cpr, success, business.industry, sweden, Incidence (epidemiology), association, emergency medicine, europe, 030208 emergency & critical care medicine, defibrillation, 3. Good health, quality, Emergency, Emergency medicine, Emergency Medicine, epidemiology, Cardiology and Cardiovascular Medicine, business, management
Abstract: INTRODUCTION: The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe.METHODS: This was an international, pr ...
Published: 2016
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39. Surface Body Temperature and Thermoregulation After Cardiac Arrest

Author: Sandra Burja, Jernej Mori, Andrej Markota, and Kristijan Skok
Subjects: Adult, Male, medicine.medical_specialty, business.industry, Thermoregulation, Critical Care and Intensive Care Medicine, Body Temperature, Heart Arrest, Anesthesiology and Pain Medicine, Hypothermia, Induced, Internal medicine, Cardiology, Medicine, Humans, Female, Prospective Studies, Coma, Rewarming, business, Surface cooling, Body Temperature Regulation
Abstract: The purpose of our study was to measure surface body temperatures (SBT) and to determine rewarming patterns after surface cooling in adult comatose survivors of cardiac arrest. We performed a prospective study in two phases from April to May 2016 and from December 2017 to March 2018. In the first phase we measured SBT as soon as possible after admission (t0) and 10 minutes later (t10). In the second phase we measured SBT and changes of SBT after local cooling of different regions in the maintenance phase of targeted temperature management. We included six patients to each phase of the study. In the first phase, we observed lower SBT compared with core body temperature (CBT) at t0 and t10, with nonsignificant differences in head and axillary region at t0 (35.2°C ± 1.3°C vs. 36°C ± 0.6°C
Published: 2018

40. Correction to: Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

Author: Sébastien Champion, Christoph Adler, Tahar Chouihed, Batric Popovic, Andrej Markota, Dagmar M. Ouweneel, Mir B Basir, Valentine Léopold, Antoine Kimmoun, Alexandre Mebazaa, Tuukka Tarvasmäki, Gregor Simonis, José P.S. Henriques, Hannes Reuter, Bruno Levy, Faiez Zannad, Johan Lassus, Philippe Gaudard, Romain Pirracchio, Etienne Gayat, Veli-Pekka Harjola, Jindrich Spinar, Horng-Ruey Chua, Rinaldo Bellomo, Philip Urban, Serafina Valente, and Jiri Parenica
Subjects: medicine.medical_specialty, business.industry, Cardiogenic shock, 030208 emergency & critical care medicine, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Epinephrine, Meta-analysis, Internal medicine, Anesthesiology, Cohort, Short term survival, Individual data, medicine, Cardiology, business, medicine.drug
Abstract: Because of a technical error, the code corresponding to the outcome for the Basir et al. cohort was mis-implemented in the original version of our article. Characteristics of the cohort are in fact the followings.
Published: 2018

41. 1 - Changes of Surface Body Temperatures after Local Cooling in Survivors of Cardiac Arrest during the Maintenance Phase of TTM

Author: Kristijan Skok and Andrej Markota
Published: 2018
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42. Mortality, intensive care treatment, and cost evaluation: Role of a polymerase chain reaction assay in patients with sepsis

Author: Andreja Sinkovič and Andrej Markota
Subjects: Male, Research Report, Medicine (General), polymerase chain reaction, Bacteremia, Biochemistry, Gastroenterology, intensive care unit, Procalcitonin, law.invention, 0302 clinical medicine, law, cost, Vasoconstrictor Agents, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, biology, treatment, Standard treatment, General Medicine, Middle Aged, Intensive care unit, Anti-Bacterial Agents, Intensive Care Units, C-Reactive Protein, Female, Calcitonin, DNA, Bacterial, medicine.medical_specialty, Sepsis, 03 medical and health sciences, R5-920, Internal medicine, medicine, Humans, Aged, business.industry, Septic shock, Biochemistry (medical), C-reactive protein, 030208 emergency & critical care medicine, Cell Biology, Length of Stay, medicine.disease, Survival Analysis, mortality, Surgery, biology.protein, business
Abstract: Objective We examined whether patients with a positive SeptiFast (SF) assay (LightCycler SeptiFast; Roche Diagnostics, Basel, Switzerland) developed higher long-term mortality, a more difficult course of treatment, and a higher antimicrobial treatment cost than patients with a negative SF assay. Methods We performed a post-hoc analysis of data collected in a 1-year prospective interventional study of adults with severe sepsis and septic shock. In addition to the standard treatment, an additional 5 ml of blood was obtained for an SF assay, and the antimicrobial treatment was changed according to the SF results. Results We included 57 patients, and the SF assay was positive (SF+) in 10 (17.5%) and negative (SF−) in 47 (82.5%) patients. A trend toward a higher 6-month, 1-year, and 2-year mortality rate was observed in the SF+ group. In the SF+ group, we observed a significantly greater need for second-line vasopressor therapy, a higher initial procalcitonin concentration, and higher maximum C-reactive protein and lactate concentrations. We found no significant differences in cost of antimicrobial treatment between the SF+ and SF− groups. Conclusions We observed a trend toward higher long-term mortality and a more difficult course of treatment but no difference in the cost of antimicrobial treatment.
Published: 2018

43. Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

Author: Sébastien Champion, Andrej Markota, Mir B Basir, Etienne Gayat, Bruno Levy, Tahar Chouihed, José P.S. Henriques, Christoph Adler, Batric Popovic, Philippe Gaudard, Romain Pirracchio, Valentine Léopold, Dagmar M. Ouweneel, Philip Urban, Tuukka Tarvasmäki, Alexandre Mebazaa, Antoine Kimmoun, Gregor Simonis, Veli-Pekka Harjola, Hannes Reuter, Johan Lassus, Horng-Ruey Chua, Jindrich Spinar, Rinaldo Bellomo, Serafina Valente, Jiri Parenica, Faiez Zannad, GAUDARD, Philippe, Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anesthésie et Soins Intensifs [HEGP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), University Hospital Brno, Masaryk University [Brno] (MUNI), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Helsinki University Eye Hospital, Heart and Lung Center [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki-Helsinki University Eye Hospital, Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion], Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Azienda Ospedaliero-Universitaria Careggi [Firenze] (AOUC), Hôpital de la Tour, Austin Hospital [Melbourne], Austin Health, Australian and New Zealand Intensive Care Research Centre (ANZIC RC ), School of Public Health and Preventive Medicine [Monash University-Melbourne], Monash University [Melbourne]-Monash University [Melbourne], School of Medicine [University of Melbourne], University of Melbourne, The Royal Melbourne Hospital, University Medicine Cluster (UMC), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), AMC Heart Center, Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA)-University of Amsterdam [Amsterdam] (UvA), Technische Universität Dresden = Dresden University of Technology (TU Dresden), Praxisklinik Herz und Gefaesse, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Soins Intensifs [CHRU Nancy], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Henry Ford Hospital, University medical centre Maribor (UKC Maribor), Universität zu Köln = University of Cologne, Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Service d’Accueil des urgences [CHRU Nancy], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biomarqueurs CArdioNeuroVASCulaires ( BioCANVAS ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Masaryk University, University of Helsinki [Helsinki], University of Helsinki [Helsinki]-Helsinki University Eye Hospital, Centre hospitalier Felix Guyon (Saint-Denis), Centre d'investigation clinique plurithématique Pierre Drouin ( CIC-P ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), Azienda Ospedaliero-Universitaria Careggi ( AOU Careggi ), Austin Hospital, Australian and New Zealand Intensive Care Research Centre ( ANZIC RC ), University Medicine Cluster ( UMC ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Academic Medical Center [Amsterdam] ( AMC ), University of Amsterdam [Amsterdam] ( UvA ) -University of Amsterdam [Amsterdam] ( UvA ), Technische Universität Dresden ( TUD ), Défaillance Cardiovasculaire Aiguë et Chronique ( DCAC ), Université de Lorraine ( UL ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), University medical centre Maribor, Universität zu Köln, Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] ( INI-CRCT ), University of Helsinki, University of Helsinki-Helsinki University Eye Hospital, Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Azienda Ospedaliero-Universitaria Careggi (AOU Careggi), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Clinicum, HUS Heart and Lung Center, Department of Diagnostics and Therapeutics, Department of Medicine, Kardiologian yksikkö, and HUS Emergency Medicine and Services
Subjects: Male, CONTEMPORARY MANAGEMENT, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 0302 clinical medicine, CARDIAC-ARREST, Vasoconstrictor Agents, Myocardial infarction, PREDICTORS, 10. No inequality, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Cardiogenic shock, Mortality rate, Incidence (epidemiology), INTRAAORTIC BALLOON PUMP, MECHANICAL CIRCULATORY SUPPORT, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Middle Aged, Prognosis, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Epinephrine, Shock (circulatory), Cohort, TRIAL, REVASCULARIZATION, Female, medicine.symptom, medicine.drug, Adult, ACUTE MYOCARDIAL-INFARCTION, medicine.medical_specialty, Shock, Cardiogenic, 03 medical and health sciences, Percutaneous Coronary Intervention, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, Propensity Score, Aged, business.industry, 030208 emergency & critical care medicine, medicine.disease, Meta-analysis, CARDIOPULMONARY-RESUSCITATION, REGISTRY, 3121 General medicine, internal medicine and other clinical medicine, Propensity score matching, business
Abstract: Correction Volume: 44 Issue: 11 Pages: 2022-2023 DOI: 10.1007/s00134-018-5372-9 Catecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients. We performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors. The primary outcome was short-term mortality. Fourteen published cohorts and two unpublished data sets were included. We studied 2583 patients. Across all cohorts of patients, the incidence of epinephrine use was 37% (17-76%) and short-term mortality rate was 49% (21-69%). A positive correlation was found between percentages of epinephrine use and short-term mortality in the CS cohort. The risk of death was higher in epinephrine-treated CS patients (OR [CI] = 3.3 [2.8-3.9]) compared to patients treated with other drug regimens. Adjusted mortality risk remained striking in epinephrine-treated patients (n = 1227) (adjusted OR = 4.7 [3.4-6.4]). After propensity score matching, two sets of 338 matched patients were identified and epinephrine use remained associated with a strong detrimental impact on short-term mortality (OR = 4.2 [3.0-6.0]). In this very large cohort, epinephrine use for hemodynamic management of CS patients is associated with a threefold increase of risk of death.
Published: 2018
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44. Higher post-resuscitation hemoglobin, lower pO2 and lower lactate are associated with survival after cardiac arrest

Author: Ana Keršič, Doroteja Meško, Andrej Markota, Sandra Burja, and Jernej Mori
Subjects: business.industry, Anesthesia, Emergency Medicine, Post resuscitation, Medicine, Hemoglobin, Emergency Nursing, Cardiology and Cardiovascular Medicine, business
Published: 2019
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45. Difference Between Bladder and Esophageal Temperatures in Mild Induced Hypothermia

Author: Andraž Stožer, Miroslav Palfy, Andreja Sinkovič, and Andrej Markota
Subjects: Male, Mild hypothermia, Time Factors, Saline infusion, Urinary Bladder, Induction Phase, Sodium Chloride, Body Temperature, Esophagus, Hypothermia, Induced, medicine, Humans, Prospective Studies, Coma, Prospective cohort study, Aged, Aged, 80 and over, Urinary bladder, business.industry, Middle Aged, Hypothermia, Heart Arrest, Cold Temperature, medicine.anatomical_structure, Fluid infusion, Anesthesia, Emergency Medicine, Female, medicine.symptom, business
Abstract: Mild induced hypothermia is an established treatment strategy for comatose survivors of cardiac arrest. The goal of the induction phase of mild induced hypothermia is to cool the patient's core body temperature to 32°-34°C.The main goal of this study was to compare temperature changes measured in the esophagus and urinary bladder in survivors of cardiac arrest undergoing mild induced hypothermia using cold saline infusion.We performed a prospective study in a 12-bed adult medical intensive care unit at a tertiary level hospital in comatose adult survivors of nontraumatic cardiac arrest admitted from January to April 2012. Paired temperature readings from bladder and esophageal probes were recorded every 5 min for 95 min (20 readings). Cold fluid infusion was terminated when the measured temperature from either of the probes reached 33.9°C. Factorial repeated-measures analysis of variance was used to determine the effect of time and site of measurement on temperature readings.Measurements were performed in 8 patients. Target temperature was achieved in 33 ± 15 min in the esophagus and in 63 ± 15 min in the bladder (p = 0.006). We discovered a significant interaction effect (p0.001) between time and site of measurement, indicating that temperature changes differently depending on the site of measurement, with esophageal temperatures decreasing faster than temperatures measured in urinary bladder.Our results indicate that esophageal temperature measurements show a faster response rate compared to temperature measured in the bladder when cold saline infusion is used to induce mild hypothermia.
Published: 2015
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46. Gender-related differences in patients with ST-elevation myocardial infarction

Author: Andrej Markota, Andreja Sinkovič, Matevž Privšek, and Nejc Piko
Subjects: Male, medicine.medical_specialty, Prasugrel, medicine.medical_treatment, Slovenia, Population, Myocardial Infarction, Percutaneous Coronary Intervention, Postoperative Complications, Risk Factors, Internal medicine, medicine, Humans, Bivalirudin, Hospital Mortality, cardiovascular diseases, Myocardial infarction, Sex Distribution, education, Retrospective Studies, education.field_of_study, business.industry, Incidence (epidemiology), Percutaneous coronary intervention, General Medicine, Length of Stay, Middle Aged, medicine.disease, Clopidogrel, Survival Rate, Treatment Outcome, Cardiology, Female, business, Ticagrelor, medicine.drug
Abstract: A decade ago women with ST-elevation myocardial infarction (STEMI) were significantly older than men, with more comorbidities, less likely treated by primary percutaneous coronary intervention (PPCI) and their prognosis was worse. The progress in treatment led to increased survival after STEMI. Our aim was to evaluate the possible current differences between the genders in treatments, mortality and the changes in women over time in STEMI population. We retrospectively evaluated 307 STEMI patients (224 men, 83 women), admitted between October 1, 2011 and December 31, 2012 and a historic group of 523 STEMI patients from 2008 to 2009 (361 men, 162 women). Reperfusion strategy was PPCI, combined with aspirin and clopidogrel or prasugrel or ticagrelor and a heparin with glycoprotein receptor IIb/IIIa antagonist or bivalirudin. Between the genders and in women over time we compared clinical data, the use and time to PPCI, in-hospital complications, 30-day and 6-month mortality. STEMI patients in recent years were treated by PPCI in 94.5 %. Their 30-day mortality was 10.4 % and 6-month mortality 14.7 %. Between the genders we observed mostly nonsignificant differences (age, comorbidities, treatments, in-hospital complications, 30-day and 6-month mortality). Over the last years in women mean age significantly decreased, the use of PPCI significantly increased, the incidence of heart failure and bleedings decreased significantly, but mortalities nonsignificantly. Women still account for 1/4 of STEMI population, but the gap between the genders in presentation, treatments and outcome in STEMI population is decreasing.
Published: 2015
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47. Intra-arrest percutaneous coronary intervention: a case series

Author: Andreja Sinkovič, Matej Bernhardt, Darinka Purg, Andrej Markota, Igor Balevski, Matej Strnad, and Vojko Kanic
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Slovenia, Population, Comorbidity, Return of spontaneous circulation, Percutaneous Coronary Intervention, Postoperative Complications, Refractory, Risk Factors, Internal medicine, medicine, Humans, Cardiopulmonary resuscitation, education, Retrospective Studies, education.field_of_study, business.industry, Percutaneous coronary intervention, General Medicine, Middle Aged, medicine.disease, Heart Arrest, Causality, Survival Rate, Treatment Outcome, Coronary Occlusion, Coronary occlusion, Life support, Ventricular fibrillation, Cardiology, Female, business
Abstract: In patients with refractory cardiac arrest presumably from acute coronary occlusion, primary percutaneous coronary intervention (PPCI) may provide an opportunity for revascularisation and, subsequently, return of spontaneous circulation. We present our experience from a 24/7 primary percutaneous coronary intervention centre serving a population of approximately 800,000 individuals. A retrospective analysis was performed in patients with cardiac arrest treated from July 2011 to January 2014. Inclusion criteria were cardiac arrest and emergency coronary angiography performed during on-going external cardiopulmonary resuscitation (CPR). Course of treatment was analysed to outline the reasons for poor survival. Eight patients met the inclusion criteria; six (75 %) were male, and the mean age was 63 ± 16 years. Revascularisation under continuous cardiopulmonary resuscitation was achieved in all eight patients. Sustained return of spontaneous circulation was achieved in two patients (25 %). Both patients had poor neurological outcome (cerebral performance category 4), and both died within 3 months. We identified total duration of cardiopulmonary resuscitation (90.5 ± 33.3 min), lack of prehospital mechanical cardiopulmonary resuscitation devices and lack of extra-corporeal life support devices as the most likely reasons contributing to poor survival.
Published: 2015
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48. Efficacy of a bundle approach in preventing the incidence of ventilator associated pneumonia (VAP)

Author: Jernej Mori, Andreja Sinkovič, Andrej Markota, Nika Bizjak, Tina Belec, and Sandra Burja
Subjects: Male, medicine.medical_treatment, primary prevention, 030501 epidemiology, law.invention, 0302 clinical medicine, law, Epidemiology, Intubation, primarna preventiva, Hospital Mortality, Aged, 80 and over, lcsh:R5-920, Incidence, Incidence (epidemiology), Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, General Medicine, Middle Aged, Combined Modality Therapy, Intensive care unit, ventilatorska pljučnica, Anesthesia, Female, epidemiology, lcsh:Medicine (General), 0305 other medical science, medicine.medical_specialty, Critical Care, Short Communication, epidemiologija, medicinski pripomočki, medical devices, 03 medical and health sciences, ventilator-associated pneumonia, Intubation, Intratracheal, medicine, Humans, Aged, Retrospective Studies, Mechanical ventilation, business.industry, 030208 emergency & critical care medicine, Retrospective cohort study, Length of Stay, udc:616.24-002, intratrahealna intubacija, medicine.disease, bacterial infections and mycoses, Respiration, Artificial, intratracheal intubation, respiratory tract diseases, Pneumonia, VAP, business, bundle
Abstract: Ventilator-associated pneumonia (VAP) is a potentially preventable iatrogenic illness that may develop following mechanical ventilation. A bundle for the prevention of VAP consists of different measures which may vary between institutions, and may include: elevation of the head of the bed, oral care with chlorhexidine, subglottic suctioning, daily assessment for extubation and the need for proton-pump inhibitors, use of closed suction systems, and maintaining endotracheal cuff pressure at 25 cmH2O. Our aim was to determine the efficacy of a VAP prevention bundle, consisting of the above-mentioned measures, by evaluating the incidence of VAP before (no-VAP-B group) and after (VAP-B group) the introduction of the bundle. We retrospectively evaluated the data for patients who were mechanically ventilated with an endotracheal tube, in the period between 1 September and 31 December 2014 (no-VAP-B group, n = 55, 54.5% males, mean age 67.8 ± 14.5 years) and between 1 January to 30 April 2015 (VAP-B group, n = 74, 62.1% males, mean age 64.8 ± 13.7 years). There were no statistically significant differences between no-VAP-B and VAP-B groups in demographic data, intensive care unit (ICU) mortality, hospital mortality, duration of ICU treatment, and duration of mechanical ventilation. No significant differences in the rates of VAP and early VAP (onset ≤7 days after intubation) were found between no-VAP-B and VAP-B groups (41.8% versus 25.7%, p = 0.06 and 10.9% versus 12.2%, p > 0.99, respectively). However, a significant decrease in the late VAP (onset >8 days after intubation) was found in VAP-B group compared to no-VAP-B group (13.5% versus 30.9%, p = 0.027). Overall, our results support the use of VAP prevention bundle in clinical practice.
Published: 2017

49. Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Author: Maria Gray, Neeraj Badjatia, Andrej Markota, Joseph Haymore, Melissa Naiman, Ahmed F. Hegazy, and Erik Kulstad
Subjects: Hyperthermia, Adult, Male, medicine.medical_specialty, Burn injury, medicine.medical_treatment, General Chemical Engineering, cardiac arrest, 030204 cardiovascular system & hematology, Targeted temperature management, General Biochemistry, Genetics and Molecular Biology, Body Temperature, 03 medical and health sciences, 0302 clinical medicine, Esophagus, Hypothermia, Induced, medicine, Humans, Meningitis, Stroke, neurogenic fever, normothermia, fever, Temperature control, General Immunology and Microbiology, business.industry, General Neuroscience, 030208 emergency & critical care medicine, Perioperative, Hypothermia, Middle Aged, medicine.disease, Surgery, Heart Arrest, Anesthesia, Shivering, Medicine, Issue 129, Female, medicine.symptom, business, hypothermia, Burns, burn injury
Abstract: Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time. There are many reported approaches for temperature management, including improvised methods that repurpose standard supplies (e.g., ice, chilled saline, fans, blankets) but more sophisticated technologies designed for temperature management are typically more successful in delivering an optimized protocol. Over the last decade, advanced technologies have developed around two heat transfer methods: surface devices (water blankets, forced-air warmers) or intravascular devices (sterile catheters requiring vascular placement). Recently, a novel device became available that is placed in the esophagus, analogous to a standard orogastric tube, that provides efficient heat transfer through the patient's core. The device connects to existing heat exchange units to allow automatic patient temperature management via a servo mechanism, using patient temperature from standard temperature sensors (rectal, Foley, or other core temperature sensors) as the input variable. This approach eliminates vascular placement complications (deep venous thrombosis, central line associated bloodstream infection), reduces obstruction to patient access, and causes less shivering when compared to surface approaches. Published data have also shown a high degree of accuracy and maintenance of target temperature using the esophageal approach to temperature management. Therefore, the purpose of this method is to provide a low-risk alternative method for controlling patient temperature in critical care settings.
Published: 2017

50. Rewarming After Severe Accidental Hypothermia Using the Esophageal Heat Transfer Device: A Case Report

Author: Andreja Sinkovič, Franci Svenšek, Katarina Katja Primožič, and Andrej Markota
Subjects: Male, medicine.medical_specialty, Fatal outcome, Accidental hypothermia, medicine.medical_treatment, Vascular access, macromolecular substances, Hypothermia, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Fatal Outcome, medicine, Humans, Renal replacement therapy, Esophagus, Rewarming, business.industry, 030208 emergency & critical care medicine, Middle Aged, Surgery, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Anesthesia, Accidental, medicine.symptom, business
Abstract: Patients with severe accidental hypothermia require active rewarming. External rewarming may not be successful in severe hypothermia, and use of invasive techniques is limited to regional centers and is associated with vascular access site and other complications. We present a patient with severe accidental hypothermia who was successfuly rewarmed using a novel esophageal heat transfer device. A 55-year-old male (175 cm, 71 kg) was admitted with the first recorded temperature 23.3°C. Rewarming using renal replacement therapy circuit was unsuccessful because of severe hypotension. We inserted the esophageal heat transfer device and rewarmed him successfully to target temperature 35–36°C. After rewarming, we maintained his body temperature in the range 35–36°C until accidental removal of the device. We observed no major adverse effects. To conclude, rewarming from severe accidental hypothermia was possible using the esophageal heat transfer device.
Published: 2017

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