Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Cardiac biomarkers in intensive care medicine are an excellent complement to existing clinical and diagnostic information in specific diseases. Due to their lack of specificity, the diagnostic properties of common cardiac biomarkers, such as natriuretic peptides and cardiac troponins, remain ambiguous, while their prognostic value has already been proven. In addition, there are several promising new biomarkers that might contribute to a "multimarker strategy" in the critically ill patient in the future, but further evaluation is still required.
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Med Klin Intensivmed Notfmed · Feb 2012
Comparative StudyMicrobial diagnostics in patients with presumed severe infection in the emergency department.
Sepsis in the early stage is a common disease in emergency medicine, and rapid diagnosis is essential. Our aim was to compare pathogen diagnosis using blood cultures (BC) and the multiplex polymerase chain reaction (PCR) test.Methods. At total of 211 patients admitted to the multidisciplinary emergency department of our university hospital between 2006 and 2009 with suspected severe infection from any origin were studied. Blood samples for BC (aerobic and anaerobic) and multiplex PCR were taken for identification of infectious microorganisms immediately after hospital admission. Results of the BC and PCR correlated with procalcitonin concentration (PCT) and clinical diagnosis of sepsis (≥2 positive SIRS criteria) as well as with severity of disease at admission and with clinical outcome measures. ⋯ In patients admitted with suspected severe infection, a high percentage of positive BC and PCR were observed. Positive findings in the PCR correlate with elevated levels of PCT and high APACHE II scores.
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Med Klin Intensivmed Notfmed · Nov 2011
Review[Blood, blood components and plasma derivatives. Guideline-based implementation].
The transfusion act authorized the German Medical Association to provide "guidelines for therapy with blood components and plasma derivatives" by a working party for the critical use of blood products to help to protect patients from avoidable risks. Responsible and carefully considered use of blood products is mandatory, particularly because obtaining them requires the willingness of numerous volunteers to donate blood. The individual recommendations were evaluated by evidence-based criteria and for many medical interventions so that they will serve to provide comprehensive operational procedures for transfusion personnel in clinics.