TY  - JOUR
A1  - Herrmann, David P.
A1  - Müller-Graff, Franz-Tassilo
A1  - Kaulitz, Stefan
A1  - Cebulla, Mario
A1  - Kurz, Anja
A1  - Hagen, Rudolf
A1  - Neun, Tilmann
A1  - Rak, Kristen
T1  - Application of intentional facial nerve stimulation during cochlear implantation as an electrophysiological tool to estimate the intracochlear electrode position
JF  - Scientific Reports
N2  - This proof of concept describes the use of evoked electromyographic (EMG) activation of the facial nerve for intraoperative monitoring of the electrode insertion during cochlear implantation (CI). Intraoperative EMG measurements from the facial nerve were conducted in nine patients undergoing CI implantation. Electric current pulses were emitted from contacts on the CI array during and immediately after electrode insertion. For control, the results of EMG measurements were compared to postoperative flat panel volume computed tomography scans with secondary reconstruction (fpVCT\(_{SECO}\)). During insertion, the EMG response evoked by the electrical stimulation from the CI was growing with the stimulating contact approaching the facial nerve and declined with increasing distance. After full insertion, contacts on the apical half of the CI array stimulated higher EMG responses compared with those on the basal half. Comparison with postoperative imaging demonstrated that electrode contacts stimulating high EMG responses had the shortest distances to the facial nerve. It could be demonstrated that electrically evoked EMG activation of the facial nerve can be used to monitor the progress during CI electrode insertion and to control the intracochlear electrode position after full insertion.
KW  - facial nerve
KW  - electromyographic
KW  - cochlear implantation
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300197
VL  - 12
IS  - 1
ER  - 
TY  - JOUR
A1  - Fiedler, Mascha O.
A1  - Muellenbach, Ralf M.
A1  - Rolfes, Caroline
A1  - Lotz, Christopher
A1  - Nickel, Felix
A1  - Müller-Stich, Beat P.
A1  - Supady, Alexander
A1  - Lepper, Philipp M.
A1  - Weigand, Markus A.
A1  - Meybohm, Patrick
A1  - Kalenka, Armin
A1  - Reyher, Christian
T1  - Pumpless extracorporeal hemadsorption technique (pEHAT): a proof-of-concept animal study
JF  - Journal of Clinical Medicine
N2  - Background: Extracorporeal hemadsorption eliminates proinflammatory mediators in critically ill patients with hyperinflammation. The use of a pumpless extracorporeal hemadsorption technique allows its early usage prior to organ failure and the need for an additional medical device. In our animal model, we investigated the feasibility of pumpless extracorporeal hemadsorption over a wide range of mean arterial pressures (MAP). Methods: An arteriovenous shunt between the femoral artery and femoral vein was established in eight pigs. The hemadsorption devices were inserted into the shunt circulation; four pigs received CytoSorb\(^®\) and four Oxiris\(^®\) hemadsorbers. Extracorporeal blood flow was measured in a range between mean arterial pressures of 45–85 mmHg. Mean arterial pressures were preset using intravenous infusions of noradrenaline, urapidil, or increased sedatives. Results: Extracorporeal blood flows remained well above the minimum flows recommended by the manufacturers throughout all MAP steps for both devices. Linear regression resulted in CytoSorb\(^®\) blood flow [mL/min] = 4.226 × MAP [mmHg] − 3.496 (R-square 0.8133) and Oxiris\(^®\) blood flow [mL/min] = 3.267 × MAP [mmHg] + 57.63 (R-square 0.8708), respectively. Conclusion: Arteriovenous pumpless extracorporeal hemadsorption resulted in sufficient blood flows through both the CytoSorb\(^®\) and Oxiris\(^®\) devices over a wide range of mean arterial blood pressures and is likely an intriguing therapeutic option in the early phase of septic shock or hyperinflammatory syndromes.
KW  - blood purification
KW  - extracorporeal hemadsorption
KW  - cytokines
KW  - adsorption
KW  - animal model
KW  - immunosorbents
KW  - septic shock
KW  - endotoxin
KW  - extracorporeal techniques in hemadsorption therapy
KW  - arteriovenous extracorporeal hemadsorption technique
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-297347
SN  - 2077-0383
VL  - 11
IS  - 22
ER  -