TY - JOUR A1 - Werner, Anne A1 - Popp, Maria A1 - Fichtner, Falk A1 - Holzmann-Littig, Christopher A1 - Kranke, Peter A1 - Steckelberg, Anke A1 - Lühnen, Julia A1 - Redlich, Lisa Marie A1 - Dickel, Steffen A1 - Grimm, Clemens A1 - Moerer, Onnen A1 - Nothacker, Monika A1 - Seeber, Christian T1 - 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 JF - Healthcare N2 - 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. KW - COVID-19 KW - implementation KW - guideline usage KW - guideline adherence KW - intensive care KW - Germany KW - ICU staff Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-281865 SN - 2227-9032 VL - 10 IS - 7 ER - TY - JOUR A1 - Sitter, Magdalena A1 - Pecks, Ulrich A1 - Rüdiger, Mario A1 - Friedrich, Sabine A1 - Fill Malfertheiner, Sara A1 - Hein, Alexander A1 - Königbauer, Josefine T. A1 - Becke-Jakob, Karin A1 - Zöllkau, Janine A1 - Ramsauer, Babett A1 - Rathberger, Katharina A1 - Pontones, Constanza A. A1 - Kraft, Katrina A1 - Meybohm, Patrick A1 - Härtel, Christoph A1 - Kranke, Peter T1 - Pregnant and postpartum women requiring intensive care treatment for COVID-19 — first data from the CRONOS-registry JF - Journal of Clinical Medicine N2 - (1) Background: Data on coronavirus 2 infection during pregnancy vary. We aimed to describe maternal characteristics and clinical presentation of SARS-CoV-2 positive women requiring intensive care treatment for COVID-19 during pregnancy and postpartum period based on data of a comprehensive German surveillance system in obstetric patients. (2) Methods: Data from COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), a prospective multicenter registry for SARS-CoV-2 positive pregnant women, was analyzed with respect to ICU treatment. All women requiring intensive care treatment for COVID-19 were included and compared regarding maternal characteristics, course of disease, as well as maternal and neonatal outcomes. (3) Results: Of 2650 cases in CRONOS, 101 women (4%) had a documented ICU stay. Median maternal age was 33 (IQR, 30–36) years. COVID-19 was diagnosed at a median gestational age of 33 (IQR, 28–35) weeks. As the most invasive form of COVID-19 treatment interventions, patients received either continuous monitoring of vital signs without further treatment requirement (n = 6), insufflation of oxygen (n = 30), non-invasive ventilation (n = 22), invasive ventilation (n = 28), or escalation to extracorporeal membrane oxygenation (n = 15). No significant clinical differences were identified between patients receiving different forms of ventilatory support for COVID-19. Prevalence of preterm delivery was significantly higher in women receiving invasive respiratory treatments. Four women died of COVID-19 and six fetuses were stillborn. (4) Conclusions: Our cohort shows that progression of COVID-19 is rare in pregnant and postpartum women treated in the ICU. Preterm birth rate is high and COVID-19 requiring respiratory support increases the risk of poor maternal and neonatal outcome. KW - maternal critical care KW - COVID-19 KW - ARDS KW - SARS-CoV-2 KW - pregnancy KW - obstetrics Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-255257 SN - 2077-0383 VL - 11 IS - 3 ER - TY - JOUR A1 - Schmid, Benedikt A1 - Griesel, Mirko A1 - Fischer, Anna-Lena A1 - Romero, Carolina S. A1 - Metzendorf, Maria-Inti A1 - Weibel, Stephanie A1 - Fichtner, Falk T1 - Awake prone positioning, high-flow nasal oxygen and non-invasive ventilation as non-invasive respiratory strategies in COVID-19 acute respiratory failure: a systematic review and meta-analysis JF - Journal of Clinical Medicine N2 - Background: Acute respiratory failure is the most important organ dysfunction of COVID-19 patients. While non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC) oxygen are frequently used, efficacy and safety remain uncertain. Benefits and harms of awake prone positioning (APP) in COVID-19 patients are unknown. Methods: We searched for randomized controlled trials (RCTs) comparing HFNC vs. NIV and APP vs. standard care. We meta-analyzed data for mortality, intubation rate, and safety. Results: Five RCTs (2182 patients) were identified. While it remains uncertain whether HFNC compared to NIV alters mortality (RR: 0.92, 95% CI 0.65–1.33), HFNC may increase rate of intubation or death (composite endpoint; RR 1.22, 1.03–1.45). We do not know if HFNC alters risk for harm. APP compared to standard care probably decreases intubation rate (RR 0.83, 0.71–0.96) but may have little or no effect on mortality (RR: 1.08, 0.51–2.31). Conclusions: Certainty of evidence is moderate to very low. There is no compelling evidence for either HFNC or NIV, but both carry substantial risk for harm. The use of APP probably has benefits although mortality appears unaffected. KW - respiratory failure KW - non-invasive ventilation KW - high-flow nasal cannula KW - awake prone positioning KW - COVID-19 KW - systematic review Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-255225 SN - 2077-0383 VL - 11 IS - 2 ER - TY - JOUR A1 - Lambertini, Alessandro A1 - Hartrampf, Philipp E. A1 - Higuchi, Takahiro A1 - Serfling, Sebastian E. A1 - Meybohm, Patrick A1 - Schirbel, Andreas A1 - Buck, Andreas K. A1 - Werner, Rudolf A. T1 - CXCR4-targeted molecular imaging after severe SARS-Cov-2 infection JF - European Journal of Nuclear Medicine and Molecular Imaging N2 - No abstract available. KW - CXCR4-targeting KW - SARS-CoV-2 KW - COVID-19 KW - molecular imaging Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324619 VL - 50 IS - 1 ER - TY - JOUR A1 - Holzmann-Littig, Christopher A1 - Frank, Tamara A1 - Schmaderer, Christoph A1 - Braunisch, Matthias C. A1 - Renders, Lutz A1 - Kranke, Peter A1 - Popp, Maria A1 - Seeber, Christian A1 - Fichtner, Falk A1 - Littig, Bianca A1 - Carbajo-Lozoya, Javier A1 - Meerpohl, Joerg J. A1 - Haller, Bernhard A1 - Allwang, Christine T1 - COVID-19 Vaccines: Fear of side effects among German health care workers JF - Vaccines N2 - (1) Background: Health care workers (HCWs) play a key role in increasing anti-COVID vaccination rates. Fear of potential side effects is one of the main reasons for vaccine hesitancy. We investigated which side effects are of concern to HCWs and how these are associated with vaccine hesitancy. (2) Methods: Data were collected in an online survey in February 2021 among HCWs from across Germany with 4500 included participants. Free-text comments on previously experienced vaccination side effects, and fear of short- and long-term side effects of the COVID-19 vaccination were categorized and analyzed. (3) Results: Most feared short-term side effects were vaccination reactions, allergic reactions, and limitations in daily life. Most feared long-term side effects were (auto-) immune reactions, neurological side effects, and currently unknown long-term consequences. Concerns about serious vaccination side effects were associated with vaccination refusal. There was a clear association between refusal of COVID-19 vaccination in one's personal environment and fear of side effects. (4) Conclusions: Transparent information about vaccine side effects is needed, especially for HCW. Especially when the participants' acquaintances advised against vaccination, they were significantly more likely to fear side effects. Thus, further education of HCW is necessary to achieve good information transfer in clusters as well. KW - COVID-19 KW - vaccine hesitancy KW - health care workers KW - side-effects KW - fears Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-270561 SN - 2076-393X VL - 10 IS - 5 ER -