@article{HillHeylandRossaintetal.2020,
  author    = {Hill, Aileen and Heyland, Daren K. and Rossaint, Rolf and Arora, Rakesh C. and Engelman, Daniel T. and Day, Andrew G. and Stoppe, Christian},
  title     = {Longitudinal outcomes in octogenarian critically ill patients with a focus on frailty and cardiac surgery},
  series = {Journal of Clinical Medicine},
  volume    = {10},
  journal   = {Journal of Clinical Medicine},
  number    = {1},
  issn      = {2077-0383},
  doi       = {10.3390/jcm10010012},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-220064},
  year      = {2020},
  abstract  = {Cardiac surgery (CSX) can be lifesaving in elderly patients (age ≥ 80 years) but may still be associated with complications and functional decline. Frailty represents a determinant to outcomes in critically ill patients, but little is known about its influence on elderly CSX-patients. This is a secondary exploratory analysis of a multi-center, prospective observational cohort study of 610 elderly patients admitted to the ICU and followed for one year to document long-term outcomes. CSX-ICU-patients (n = 49) were compared to surgical ICU patients (n = 184) with regard to demographics, frailty, and outcomes. Of all surgical patients, 102 (43\%) were considered vulnerable or frail. The subdistribution hazard ratio (SHR) of time to discharge home (TTDH) for vulnerable/frail vs. fit/well patients was 0.54 (95\% confidence interval (CI), 0.34, 0.86, p = 0.007). The p-value for effect modification between surgery group (CSX vs. surgical ICU patients) and Clinical Frailty Scale (CFS) group was not significant (p = 0.37) suggesting that the observed difference in the CFS effect between the CSX and surgical ICU patients is consistent with random error. A further subgroup analysis shows that among surgical ICU patients, the SHR of time to discharge home (TTDH) for vulnerable/frail vs. fit/well patients was 0.49 (95\% CI, 0.29, 0.83) while the corresponding SHR for CSX patients was 0.77 (0.32-1.88). In conclusion, preoperative frailty reduced the rate of discharge to home in both surgical and CSX patients, but a larger sample of CSX patients is needed to adequately address this question in this patient group.},
  language  = {en}
}
@article{HillDossowHeylandetal.2022,
  author    = {Hill, Aileen and Dossow, Vera von and Heyland, Daren K. and Rossaint, Rolf and Meybohm, Patrick and Fox, Henrik and Morshuis, Michiel and Elke, Gunnar and Panholzer, Bernd and Haneya, Assad and B{\"o}ning, Andreas and Niemann, Bernd and Zayat, Rashad and Moza, Ajay and Stoppe, Christian},
  title     = {Preoperative nutritional optimization and physical exercise for patients scheduled for elective implantation for a left-ventricular assist device — The PROPER-LVAD study},
  series = {Surgeries},
  volume    = {3},
  journal   = {Surgeries},
  number    = {4},
  issn      = {2673-4095},
  doi       = {10.3390/surgeries3040031},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-288317},
  pages     = {284 -- 296},
  year      = {2022},
  abstract  = {Background: Prehabilitation is gaining increasing interest and shows promising effects on short- and long-term outcomes among patients undergoing major surgery. The effect of multimodal, interdisciplinary prehabilitation has not yet been studied in patients with severe heart failure scheduled for the implantation of a left-ventricular assist device (LVAD). Methods: This randomized controlled multi-center study evaluates the effect of preoperative combined optimization of nutritional and functional status. Patients in the intervention group are prescribed daily in-bed cycling and oral nutrition supplements (ONS) from study inclusion until the day before LVAD-implantation. Patients in the control group receive standard of care treatment. The primary outcomes for the pilot study that involves 48 patients are safety (occurrence of adverse events), efficacy (group separation regarding the intake of macronutrients), feasibility of the trial protocol (compliance (percentage of received interventions) and confirmation of recruitment rates. Secondary outcomes include longitudinal measurements of muscle mass, muscle strength, physical function and quality of life, next to traditional clinical outcomes (30-day mortality, hospital and ICU length of stay, duration of mechanical ventilation and number of complications and infections). If the pilot study is successful, a larger confirmatory, international multicenter study is warranted.},
  language  = {en}
}
@article{NotzLeeMengeretal.2022,
  author    = {Notz, Quirin and Lee, Zheng-Yii and Menger, Johannes and Elke, Gunnar and Hill, Aileen and Kranke, Peter and Roeder, Daniel and Lotz, Christopher and Meybohm, Patrick and Heyland, Daren K. and Stoppe, Christian},
  title     = {Omega-6 sparing effects of parenteral lipid emulsions-an updated systematic review and meta-analysis on clinical outcomes in critically ill patients},
  series = {Critical Care},
  volume    = {26},
  journal   = {Critical Care},
  number    = {1},
  doi       = {10.1186/s13054-022-03896-3},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299710},
  year      = {2022},
  abstract  = {Background Parenteral lipid emulsions in critical care are traditionally based on soybean oil (SO) and rich in pro-inflammatory omega-6 fatty acids (FAs). Parenteral nutrition (PN) strategies with the aim of reducing omega-6 FAs may potentially decrease the morbidity and mortality in critically ill patients. Methods A systematic search of MEDLINE, EMBASE, CINAHL and CENTRAL was conducted to identify all randomized controlled trials in critically ill patients published from inception to June 2021, which investigated clinical omega-6 sparing effects. Two independent reviewers extracted bias risk, treatment details, patient characteristics and clinical outcomes. Random effect meta-analysis was performed. Results 1054 studies were identified in our electronic search, 136 trials were assessed for eligibility and 26 trials with 1733 critically ill patients were included. The median methodologic score was 9 out of 14 points (95\% confidence interval [CI] 7, 10). Omega-6 FA sparing PN in comparison with traditional lipid emulsions did not decrease overall mortality (20 studies; risk ratio [RR] 0.91; 95\% CI 0.76, 1.10; p = 0.34) but hospital length of stay was substantially reduced (6 studies; weighted mean difference [WMD] - 6.88; 95\% CI - 11.27, - 2.49; p = 0.002). Among the different lipid emulsions, fish oil (FO) containing PN reduced the length of intensive care (8 studies; WMD - 3.53; 95\% CI - 6.16, - 0.90; p = 0.009) and rate of infectious complications (4 studies; RR 0.65; 95\% CI 0.44, 0.95; p = 0.03). When FO was administered as a stand-alone medication outside PN, potential mortality benefits were observed compared to standard care. Conclusion Overall, these findings highlight distinctive omega-6 sparing effects attributed to PN. Among the different lipid emulsions, FO in combination with PN or as a stand-alone treatment may have the greatest clinical impact.},
  language  = {en}
}