@article{WernerPoppFichtneretal.2022,
  author    = {Werner, Anne and Popp, Maria and Fichtner, Falk and Holzmann-Littig, Christopher and Kranke, Peter and Steckelberg, Anke and L{\"u}hnen, Julia and Redlich, Lisa Marie and Dickel, Steffen and Grimm, Clemens and Moerer, Onnen and Nothacker, Monika and Seeber, Christian},
  title     = {COVID-19 intensive care — Evaluation of public information sources and current standards of care in German intensive care units: a cross sectional online survey on intensive care staff in Germany},
  series = {Healthcare},
  volume    = {10},
  journal   = {Healthcare},
  number    = {7},
  issn      = {2227-9032},
  doi       = {10.3390/healthcare10071315},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-281865},
  year      = {2022},
  abstract  = {Backround: In February 2021, the first formal evidence and consensus-based (S3) guidelines for the inpatient treatment of patients with COVID-19 were published in Germany and have been updated twice during 2021. The aim of the present study is to re-evaluate the dissemination pathways and strategies for ICU staff (first evaluation in December 2020 when previous versions of consensus-based guidelines (S2k) were published) and question selected aspects of guideline adherence of standard care for patients with COVID-19 in the ICU. Methods: We conducted an anonymous online survey among German intensive care staff from 11 October 2021 to 11 November 2021. We distributed the survey via e-mail in intensive care facilities and requested redirection to additional intensive care staff (snowball sampling). Results: There was a difference between the professional groups in the number, selection and qualitative assessment of information sources about COVID-19. Standard operating procedures were most frequently used by all occupational groups and received a high quality rating. Physicians preferred sources for active information search (e.g., medical journals), while nurses predominantly used passive consumable sources (e.g., every-day media). Despite differences in usage behaviour, the sources were rated similarly in terms of the quality of the information on COVID-19. The trusted organizations have not changed over time. The use of guidelines was frequently stated and highly recommended. The majority of the participants reported guideline-compliant treatment. Nevertheless, there were certain variations in the use of medication as well as the criteria chosen for discontinuing non-invasive ventilation (NIV) compared to guideline recommendations. Conclusions: An adequate external source of information for nursing staff is lacking, the usual sources of physicians are only appropriate for the minority of nursing staff. The self-reported use of guidelines is high.},
  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{StrengPrifertWeissbrichetal.2015,
  author    = {Streng, Andrea and Prifert, Christiane and Weissbrich, Benedikt and Liese, Johannes G.},
  title     = {Continued high incidence of children with severe influenza A(H1N1)pdm09 admitted to paediatric intensive care units in Germany during the first three post-pandemic influenza seasons, 2010/11-2012/13},
  series = {BMC Infectious Diseases},
  volume    = {15},
  journal   = {BMC Infectious Diseases},
  number    = {573},
  organization    = {Bavarian PICU Study Group on Influenza and Other Viral ARI},
  doi       = {10.1186/s12879-015-1293-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125280},
  year      = {2015},
  abstract  = {Background Previous influenza surveillance at paediatric intensive care units (PICUs) in Germany indicated increased incidence of PICU admissions for the pandemic influenza subtype A(H1N1)pdm09. We investigated incidence and clinical characteristics of influenza in children admitted to PICUs during the first three post-pandemic influenza seasons, using active screening. Methods We conducted a prospective surveillance study in 24 PICUs in Bavaria (Germany) from October 2010 to September 2013. Influenza cases among children between 1 month and 16 years of age admitted to these PICUs with acute respiratory infection were confirmed by PCR analysis of respiratory secretions. Results A total of 24/7/20 influenza-associated PICU admissions were recorded in the post-pandemic seasons 1/2/3; incidence estimates per 100,000 children were 1.72/0.76/1.80, respectively. Of all 51 patients, 80 \% had influenza A, including 65 \% with A(H1N1)pdm09. Influenza A(H1N1)pdm09 was almost absent in season 2 (incidence 0.11), but dominated PICU admissions in seasons 1 (incidence 1.35) and 3 (incidence 1.17). Clinical data was available for 47 influenza patients; median age was 4.8 years (IQR 1.6-11.0). The most frequent diagnoses were influenza-associated pneumonia (62 \%), bronchitis/bronchiolitis (32 \%), secondary bacterial pneumonia (26 \%), and ARDS (21 \%). Thirty-six patients (77 \%) had underlying medical conditions. Median duration of PICU stay was 3 days (IQR 1-11). Forty-seven per cent of patients received mechanical ventilation, and one patient (2 \%) extracorporeal membrane oxygenation; 19 \% were treated with oseltamivir. Five children (11 \%) had pulmonary sequelae. Five children (11 \%) died; all had underlying chronic conditions and were infected with A(H1N1)pdm09. In season 3, patients with A(H1N1)pdm09 were younger than in season 1 (p = 0.020), were diagnosed more often with bronchitis/bronchiolitis (p = 0.004), and were admitted to a PICU later after the onset of influenza symptoms (p = 0.041). Conclusions Active screening showed a continued high incidence of A(H1N1)pdm09-associated PICU admissions in the post-pandemic seasons 1 and 3, and indicated possible underestimation of incidence in previous German studies. The age shift of severe A(H1N1)pdm09 towards younger children may be explained by increasing immunity in the older paediatric population. The high proportion of patients with underlying chronic conditions indicates the importance of consistent implementation of the current influenza vaccination recommendations for risk groups in Germany.},
  language  = {en}
}