@article{MengerLeeNotzetal.2022,
  author    = {Menger, Johannes and Lee, Zheng-Yii and Notz, Quirin and Wallqvist, Julia and Hasan, M. Shahnaz and Elke, Gunnar and Dworschak, Martin and Meybohm, Patrick and Heyland, Daren K. and Stoppe, Christian},
  title     = {Administration of vitamin D and its metabolites in critically ill adult patients: an updated systematic review with meta-analysis of randomized controlled trials},
  series = {Critical Care},
  volume    = {26},
  journal   = {Critical Care},
  number    = {1},
  doi       = {10.1186/s13054-022-04139-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299700},
  year      = {2022},
  abstract  = {Background The clinical significance of vitamin D administration in critically ill patients remains inconclusive. The purpose of this systematic review with meta-analysis was to investigate the effect of vitamin D and its metabolites on major clinical outcomes in critically ill patients, including a subgroup analysis based on vitamin D status and route of vitamin D administration. Methods Major databases were searched through February 9, 2022. Randomized controlled trials of adult critically ill patients with an intervention group receiving vitamin D or its metabolites were included. Random-effect meta-analyses were performed to estimate the pooled risk ratio (dichotomized outcomes) or mean difference (continuous outcomes). Risk of bias assessment included the Cochrane tool for assessing risk of bias in randomized trials. Results Sixteen randomized clinical trials with 2449 patients were included. Vitamin D administration was associated with lower overall mortality (16 studies: risk ratio 0.78, 95\% confidence interval 0.62-0.97, p = 0.03; I2 = 30\%), reduced intensive care unit length of stay (12 studies: mean difference - 3.13 days, 95\% CI - 5.36 to - 0.89, n = 1250, p = 0.006; I2 = 70\%), and shorter duration of mechanical ventilation (9 studies: mean difference - 5.07 days, 95\% CI - 7.42 to - 2.73, n = 572, p < 0.0001; I2 = 54\%). Parenteral administration was associated with a greater effect on overall mortality than enteral administration (test of subgroup differences, p = 0.04), whereas studies of parenteral subgroups had lower quality. There were no subgroup differences based on baseline vitamin D levels. Conclusions Vitamin D supplementation in critically ill patients may reduce mortality. Parenteral administration might be associated with a greater impact on mortality. Heterogeneity and assessed certainty among the studies limits the generalizability of the results.},
  language  = {en}
}
@article{HelmerHottenrottSteinischetal.2022,
  author    = {Helmer, Philipp and Hottenrott, Sebastian and Steinisch, Andreas and R{\"o}der, Daniel and Schubert, J{\"o}rg and Steigerwald, Udo and Choorapoikayil, Suma and Meybohm, Patrick},
  title     = {Avoidable blood loss in critical care and patient blood management: scoping review of diagnostic blood loss},
  series = {Journal of Clinical Medicine},
  volume    = {11},
  journal   = {Journal of Clinical Medicine},
  number    = {2},
  issn      = {2077-0383},
  doi       = {10.3390/jcm11020320},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-255145},
  year      = {2022},
  abstract  = {Background: Anemia remains one of the most common comorbidities in intensive care patients worldwide. The cause of anemia is often multifactorial and triggered by underlying disease, comorbidities, and iatrogenic factors, such as diagnostic phlebotomies. As anemia is associated with a worse outcome, especially in intensive care patients, unnecessary iatrogenic blood loss must be avoided. Therefore, this scoping review addresses the amount of blood loss during routine phlebotomies in adult (>17 years) intensive care patients and whether there are factors that need to be improved in terms of patient blood management (PBM). Methods: A systematic search of the Medline Database via PubMed was conducted according to PRISMA guidelines. The reported daily blood volume for diagnostics and other relevant information from eligible studies were charted. Results: A total of 2167 studies were identified in our search, of which 38 studies met the inclusion criteria (9 interventional studies and 29 observational studies). The majority of the studies were conducted in the US (37\%) and Canada (13\%). An increasing interest to reduce iatrogenic blood loss has been observed since 2015. Phlebotomized blood volume per patient per day was up to 377 mL. All interventional trials showed that the use of pediatric-sized blood collection tubes can significantly reduce the daily amount of blood drawn. Conclusion: Iatrogenic blood loss for diagnostic purposes contributes significantly to the development and exacerbation of hospital-acquired anemia. Therefore, a comprehensive PBM in intensive care is urgently needed to reduce avoidable blood loss, including blood-sparing techniques, regular advanced training, and small-volume blood collection tubes.},
  language  = {en}
}
@article{NassWeissbrichHuberetal.2012,
  author    = {Nass, Maximilian and Weissbrich, Benedikt and Huber, Moritz and Schneider, Elisabeth Marion and Weiss, Manfred},
  title     = {BK viremia in critically ill surgical patients with hemorrhagic or septic shock},
  series = {BMC Research Notes},
  volume    = {5},
  journal   = {BMC Research Notes},
  number    = {100},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124136},
  year      = {2012},
  abstract  = {Background Infections with polyomavirus BK virus (BKV) are a common cause of renal dysfunction after renal transplantation and may also be harmful in surgical patients with shock. The aim of the present study was to determine the frequency of BKV viremia in critically ill surgical patients with septic or hemorrhagic shock, and, if viremia is detectable, whether viremia may be associated with renal dysfunction. Findings A total of 125 plasma samples from 44 critically ill surgical patients with septic or hemorrhagic shock were tested by real-time polymerase chain reaction (PCR) for BKV DNA during their stay on the intensive care unit (ICU). BKV viremia occurred in four patients, i.e. in three of the septic and in one of the hemorrhagic shock group. There was no association between viremia and renal dysfunction. All positive samples contained a low viral load (< 500 copies/ml). Conclusions Since BK viremia was rarely found and with low viral load only in critically ill surgical patients with shock, it is very unlikely that BK viremia results in BK nephropathy later on.},
  language  = {en}
}