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274 results on '"Lichtenstern C"'

5. Bacterial sepsis: Diagnostics and calculated antibiotic therapy

Author

Richter, D. C., Heininger, A., Brenner, T., Hochreiter, M., Bernhard, M., Briegel, J., Dubler, S., Grabein, B., Hecker, A., Kruger, W. A., Mayer, K., Pletz, M. W., Storzinger, D., Pinder, N., Hoppe-Tichy, T., Weiterer, S., Zimmermann, S., Brinkmann, A., Weigand, M. A., and Lichtenstern, C.

Published
2019
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6. Pathophysiologie

Author

Uhle, F., Lichtenstern, C., Weigand, M.A., Werdan, Karl, editor, Müller-Werdan, Ursula, editor, Schuster, Hans-Peter, editor, and Brunkhorst, Frank M., editor

Published
2016
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14. ZVD – ein Sicherheitsparameter

Author

Siegler, B.H., Bernhard, M., Brenner, T., Gerlach, H., Henrich, M., Hofer, S., John, S., Kilger, E., Krüger, W.A., Lichtenstern, C., Mayer, K., Müller, M., Niemann, B., Oppert, M., Rex, S., Rossaint, R., Weiterer, S., and Weigand, M.A.

Published
2015
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35. Initial experience with intrauterine MMC repair

Author

Bächli, H, Elsässer, M, Fluhr, H, Rom, J, Pöschl, J, Beedgen, B, Ronellenfitsch, S, Lichtenstern, C, Schreckenberger, R, El Damaty, A, Sohn, C, Unterberg, AW, Bächli, H, Elsässer, M, Fluhr, H, Rom, J, Pöschl, J, Beedgen, B, Ronellenfitsch, S, Lichtenstern, C, Schreckenberger, R, El Damaty, A, Sohn, C, and Unterberg, AW

Published
2018

37. Bacterial sepsis

Author

Richter, D. C., primary, Heininger, A., additional, Brenner, T., additional, Hochreiter, M., additional, Bernhard, M., additional, Briegel, J., additional, Dubler, S., additional, Grabein, B., additional, Hecker, A., additional, Kruger, W. A., additional, Mayer, K., additional, Pletz, M. W., additional, Storzinger, D., additional, Pinder, N., additional, Hoppe-Tichy, T., additional, Weiterer, S., additional, Zimmermann, S., additional, Brinkmann, A., additional, Weigand, M. A., additional, and Lichtenstern, C., additional

Published
2018
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40. The impact of early surgical intervention in free intestinal perforation: a time-to-intervention pilot study

Author

Hecker, Andreas, Schneck, Emmanuel, Röhrig, Rainer, Roller, F., Hecker, B., Holler, J., Koch, C., Hecker, M., Reichert, M., Lichtenstern, C., Krombach, G., Padberg, Winfried, Weigand, M. A., and Justus Liebig University Giessen

Subjects
sepsis, time-to-intervention, ddc:610, free intestinal perforation
Abstract

PURPOSES: An abdominal inflammatory focus is the second most often source of sepsis with a high risk of death in surgical intensive care units. By establishing evidence-based bundled strategies the surviving sepsis campaign provided an optimized rapid and continuous treatment of these emergency patients. Hereby the hospital mortality decreased from 35 to 30%. Sepsis treatment is based on three major therapeutic elements: surgical treatment (source control), antiinfective treatment, and supportive care. The international guidelines of the surviving sepsis campaign were updated recently and recommend rapid diagnosis of the infection and source control within the first 12h after the diagnosis (grade 1c). Interestingly this recommendation is mainly based on studies on soft tissue infections. METHODS: In this retrospective analysis 76 septic patients with an intraabdominal inflammatory focus were included. All patients underwent surgery at different time-points after diagnosis. RESULTS: With 80% patients of the early intervention group had an improved overall survival (vs. 73% in the late intervention group). CONCLUSIONS: Literature on the time dependency of early source control is rare and in part contradicting. Results of this pilot study reveal that immediate surgical intervention might be of advantage for septic emergency patients. Further multi-center approaches will be necessary to evaluate, whether the TTI has any impact on the outcome of septic patients with intestinal perforation.

Published
2015
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41. Bakterielle Sepsis : Diagnostik und kalkulierte Antibiotikatherapie.

Author

Richter, D. C., Heininger, A., Brenner, T., Hochreiter, M., Bernhard, M., Briegel, J., Dubler, S., Grabein, B., Hecker, A., Kruger, W. A., Mayer, K., Pletz, M. W., Storzinger, D., Pinder, N., Hoppe-Tichy, T., Weiterer, S., Zimmermann, S., Brinkmann, A., Weigand, M. A., and Lichtenstern, C.

Subjects
SEPTICEMIA treatment, SEPSIS, ANTIBIOTICS, PHARMACOKINETICS, BACTERIAL diseases, ANTI-infective agents
Abstract

The mortality of patients with sepsis and septic shock is still unacceptably high. An effective calculated antibiotic treatment within 1 h of recognition of sepsis is an important target of sepsis treatment. Delays lead to an increase in mortality; therefore, structured treatment concepts form a rational foundation, taking relevant diagnostic and treatment steps into consideration. In addition to the assumed infection and individual risks of each patient, local resistance patterns and specific problem pathogens must be taken into account during the selection of anti-infective treatment. Many pathophysiologic alterations influence the pharmacokinetics (PK) of antibiotics during sepsis. The principle of standard dosing should be abandoned and replaced by an individual treatment approach with stronger weighting of the pharmacokinetics/pharmacodynamics (PK/PD) index of the substance groups. Although this is not yet the clinical standard, prolonged (or continuous) infusion of β‑lactam antibiotics and therapeutic drug monitoring (TDM) can help to achieve defined PK targets. Prolonged infusion is sufficient without TDM, but for continuous infusion, TDM is generally necessary. A further argument for individual PK/PD-oriented antibiotic approaches is the increasing number of infections due to multidrug-resistant (MDR) pathogens in the intensive care unit. For effective treatment, antibiotic stewardship teams (ABS teams) are becoming more established. Interdisciplinary cooperation of the ABS team with infectious disease (ID) specialists, microbiologists, and clinical pharmacists leads not only to rational administration of antibiotics, but also has a positive influence on treatment outcome. The gold standards for pathogen identification are still culture-based detection and microbiologic resistance testing for the various antibiotic groups. Despite the rapid investigation time, novel polymerase chain reaction(PCR)-based procedures for pathogen identification and resistance determination are currently only an adjunct to routine sepsis diagnostics, due to the limited number of studies, high costs, and limited availability. In complicated septic courses with multiple anti-infective therapies or recurrent sepsis, PCR-based procedures can be used in addition to treatment monitoring and diagnostics. Novel antibiotics represent potent alternatives in the treatment of MDR infections. Due to the often defined spectrum of pathogens and the practically (still) absent resistance, they are suitable for targeted treatment of severe MDR infections (therapy escalation). (Contribution available free of charge by "Free Access" [ https://link.springer.com/article/10.1007/s00101-017-0396-z ].). [ABSTRACT FROM AUTHOR]

Published
2019
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50. Update: intensivmedizinische Studien

Author

Knapp, J., primary, Marx, G., additional, Weismüller, K., additional, Steinebach, S., additional, Lichtenstern, C., additional, Popp, E., additional, Mayer, K., additional, Brunkhorst, F.M., additional, Weigand, M.A., additional, and Bernhard, M., additional

Published
2011
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