TY  - JOUR
A1  - Hoppe, K.
A1  - Khan, E.
A1  - Meybohm, P.
A1  - Riese, T.
T1  - Mechanical power of ventilation and driving pressure: two undervalued parameters for pre extracorporeal membrane oxygenation ventilation and during daily management?
JF  - Critical Care
N2  - The current ARDS guidelines highly recommend lung protective ventilation which include plateau pressure (Pplat < 30 cm H\(_2\)O), positive end expiratory pressure (PEEP > 5 cm H2O) and tidal volume (Vt of 6 ml/kg) of predicted body weight. In contrast, the ELSO guidelines suggest the evaluation of an indication of veno-venous extracorporeal membrane oxygenation (ECMO) due to hypoxemic or hypercapnic respiratory failure or as bridge to lung transplantation. Finally, these recommendations remain a wide range of scope of interpretation. However, particularly patients with moderate-severe to severe ARDS might benefit from strict adherence to lung protective ventilation strategies. Subsequently, we discuss whether extended physiological ventilation parameter analysis might be relevant for indication of ECMO support and can be implemented during the daily routine evaluation of ARDS patients. Particularly, this viewpoint focus on driving pressure and mechanical power.
KW  - ARDS
KW  - ventilation
KW  - ECMO indication
KW  - mechanical power
KW  - driving pressure
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357181
VL  - 27
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  -