@phdthesis{Roeder2009,
  author    = {R{\"o}der, Daniel},
  title     = {Tumorzelladh{\"a}sion an monofilen und polyfilen Nahtmaterialien: Empfehlungen f{\"u}r die onkologische Chirurgie},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-38824},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2009},
  abstract  = {In der vorliegenden Arbeit wurde in einem in-vivo-Tiermodell das Ausmaß der Tumorzelladh{\"a}sion an chirurgischen Nahtmaterialien untersucht. In zwei Nacktm{\"a}usen wurde durch orthotope Implantation ein humanes Magenkarzinom induziert. Nach Laparotomie wurde das Magenkarzinom freigelegt und folgende acht kommerziell verf{\"u}gbare Fadensorten in der St{\"a}rke 4/0 (USP) in vivo durch vitales Tumorgewebe gezogen: Prolene®, Monoplus®, Monosyn®, PDS II® und Maxon® (jeweils monofil), Polysorb®, Safil® und Vicryl® (jeweils polyfil). Anschließend wurde die Fadenoberfl{\"a}che direkt hinter der Nadel sowie zehn Zentimeter hinter der Nadel raster-elektronenmikroskopisch dargestellt und immunzytochemisch sowie molekular-biologisch auf die Adh{\"a}sion humaner Tumorzellen hin untersucht. Als qualitatives Nachweisverfahren dienten die EPIMET®-F{\"a}rbung, bei der das humane epitheliale Stukturprotein Zytokeratin CK-20 im Zytoplasma farblich markiert wird, sowie eine nested-reverse-Transkriptase-Polymerasekettenreaktion (PCR) mit human-CK-20-spezifischen Primerpaaren. Die Rasterelektronenmikroskopie zeigte bei jeder Fadensorte auf mindestens einer Probe Zellbel{\"a}ge. Der immunzytologische Nachweis erwies sich als wenig sensitiv und gelang nur f{\"u}r Proben von Monoplus®, Maxon® und Safil®. Die PCR identifizierte CK-20-positive Zellen auf allen polyfilen F{\"a}den (Polysorb®, Safil® und Vicryl®) sowie den monofilen Sorten Monosyn®, Monoplus® und Maxon®. Alle PCR-Proben von Prolene® oder PDS II® waren negativ. Damit fiel die Tumorzelladh{\"a}sion auf monofilen Proben in der PCR signifikant geringer aus als auf polyfilen Proben (p < 0.017). Dies kann im wesentlichen mit der ausgepr{\"a}gten Traumatisierung des Gewebes durch den S{\"a}geeffekt polyfiler F{\"a}den begr{\"u}ndet werden. Unterschiede in der Zelladh{\"a}sion zwischen den einzelnen monofilen Fadensorten lassen sich m{\"o}glicherweise auf ihre unterschiedliche chemische Struktur (polare Gruppen, Wasserstoffbr{\"u}ckenbindungen) und deren Interaktion mit der Tumorzelloberfl{\"a}che zur{\"u}ckf{\"u}hren. F{\"u}r die gastrointestinale Tumorchirurgie wird empfohlen, weiterhin eine konsequente No-Touch-Technik einzuhalten, um eine Exfoliation viabler Tumorzellen, deren Adh{\"a}sion an Nahtmaterial und damit das Risiko eines Anastomosenrezidivs durch Implantation der am Faden adh{\"a}renten Tumorzellen zu reduzieren. Zusammenfassend kann gesagt werden, dass die monofilen F{\"a}den aus PDS II® und Prolene® in der Gesamtschau der Ergebnisse die geringste Tendenz zur Tumorzelladh{\"a}sion aufweisen und somit im Vergleich zu den anderen untersuchten F{\"a}den bei onkologischen Eingriffen bevorzugt werden sollten; die mehrfache Verwendung eines Fadens sollte wegen der verl{\"a}ngerten Kontaktzeit zwischen Faden und Anastomose vermieden und f{\"u}r jeden Durchstich ein neuer Faden verwendet werden. Geflochtene Nahtmaterialien sollten dagegen wegen des erh{\"o}hten Risikos f{\"u}r Tumorzelladh{\"a}sion und -implantation in der onkologischen Anastomosentechnik keine Anwendung finden. Es bedarf weiterer Studien zum Verst{\"a}ndnis der unterschiedlich stark ausgepr{\"a}gten Tumorzelladh{\"a}sion unter den verschiedenen monofilen F{\"a}den. Als Ursachen denkbar w{\"a}ren Oberfl{\"a}cheneigenschaften wie z. B. elektrische Ladung, Hydrophilie/-phobie oder chemische Eigenschaften. Ein weiterer Ansatz w{\"a}re die Beschichtung von monofilen Nahtmaterialien mit Zytostatika zur Inhibition der Tumorzellvermehrung auf der Oberfl{\"a}che der Anastomosennaht.},
  subject      = {Rezidiv},
  language  = {de}
}
@article{SitterFroehlichKrankeetal.2023,
  author    = {Sitter, Magdalena and Fr{\"o}hlich, Corinna and Kranke, Peter and Markus, Christian and W{\"o}ckel, Achim and Rehn, Monika and Bartmann, Catharina and Frieauff, Eric and Meybohm, Patrick and Pecks, Ulrich and R{\"o}der, Daniel},
  title     = {ECMO-Therapie bei COVID-19-ARDS in der Schwangerschaft erm{\"o}glicht den Erhalt einer Schwangerschaft mit termingerechter Entbindung},
  series = {Die Anaesthesiologie},
  volume    = {72},
  journal   = {Die Anaesthesiologie},
  number    = {3},
  doi       = {10.1007/s00101-022-01232-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-346762},
  pages     = {166-170},
  year      = {2023},
  abstract  = {No abstract available.},
  language  = {de}
}
@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{ZeinerSchroederMetzneretal.2023,
  author    = {Zeiner, Carsten and Schr{\"o}der, Malte and Metzner, Selina and Herrmann, Johannes and Notz, Quirin and Hottenrott, Sebastian and R{\"o}der, Daniel and Meybohm, Patrick and Lepper, Philipp M. and Lotz, Christopher},
  title     = {High-dose methylprednisolone pulse therapy during refractory COVID-19 acute respiratory distress syndrome: a retrospective observational study},
  series = {BMC Pulmonary Medicine},
  volume    = {23},
  journal   = {BMC Pulmonary Medicine},
  doi       = {10.1186/s12890-023-02664-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357231},
  year      = {2023},
  abstract  = {Background Current COVID-19 guidelines recommend the early use of systemic corticoids for COVID-19 acute respiratory distress syndrome (ARDS). It remains unknown if high-dose methylprednisolone pulse therapy (MPT) ameliorates refractory COVID-19 ARDS after many days of mechanical ventilation or rapid deterioration with or without extracorporeal membrane oxygenation (ECMO). Methods This is a retrospective observational study. Consecutive patients with COVID-19 ARDS treated with a parenteral high-dose methylprednisolone pulse therapy at the intensive care units (ICU) of two University Hospitals between January 1st 2021 and November 30st 2022 were included. Clinical data collection was at ICU admission, start of MPT, 3-, 10- and 14-days post MPT. Results Thirty-seven patients (mean age 55 ± 12 years) were included in the study. MPT started at a mean of 17 ± 12 days after mechanical ventilation. Nineteen patients (54\%) received ECMO support when commencing MPT. Mean paO2/FiO2 significantly improved 3- (p = 0.034) and 10 days (p = 0.0313) post MPT. The same applied to the necessary FiO2 10 days after MPT (p = 0.0240). There were no serious infectious complications. Twenty-four patients (65\%) survived to ICU discharge, including 13 out of 20 (65\%) needing ECMO support. Conclusions Late administration of high-dose MPT in a critical subset of refractory COVID-19 ARDS patients improved respiratory function and was associated with a higher-than-expected survival of 65\%. These data suggest that high-dose MPT may be a viable salvage therapy in refractory COVID-19 ARDS.},
  language  = {en}
}
@article{DoehlerRoederSchlesingeretal.2023,
  author    = {D{\"o}hler, Ida and R{\"o}der, Daniel and Schlesinger, Tobias and Nassen, Christian Alexander and Germer, Christoph-Thomas and Wiegering, Armin and Lock, Johan Friso},
  title     = {Risk-adjusted perioperative bridging anticoagulation reduces bleeding complications without increasing thromboembolic events in general and visceral surgery},
  series = {BMC Anesthesiology},
  volume    = {23},
  journal   = {BMC Anesthesiology},
  doi       = {10.1186/s12871-023-02017-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357305},
  year      = {2023},
  abstract  = {Background Perioperative bridging of oral anticoagulation increases the risk of bleeding complications after elective general and visceral surgery. The aim of this study was to explore, whether an individual risk-adjusted bridging regimen can reduce bleeding events, while still protecting against thromboembolic events. Methods We performed a quality improvement study comparing bridging parameters and postoperative outcomes before (period 1) and after implementation (period 2) of a new risk-adjusted bridging regimen. The primary endpoint of the study was overall incidence of postoperative bleeding complications during 30 days postoperatively. Secondary endpoints were major postoperative bleeding, minor bleeding, thromboembolic events, postoperative red blood cell transfusion, perioperative length-of-stay (LOS) and in-hospital mortality. Results A total of 263 patients during period 1 and 271 patients during period 2 were compared. The included elective operations covered the entire field of general and visceral surgery. The overall incidence of bleeding complications declined from 22.1\% during period 1 to 10.3\% in period 2 (p < 0.001). This reduction affected both major as well as minor bleeding events (8.4\% vs. 4.1\%; p = 0.039; 13.7\% vs. 6.3\%; p = 0.004). The incidence of thromboembolic events remained low (0.8\% vs. 1.1\%). No changes in mortality or length-of-stay were observed. Conclusion It is important to balance the individual thromboembolic and bleeding risks in perioperative bridging management. The risk adjusted bridging regimen reduces bleeding events in general and visceral surgery while the risk of thromboembolism remains comparably low.},
  language  = {en}
}