TY  - JOUR
A1  - Schmitt, Elke
A1  - Meybohm, Patrick
A1  - Neef, Vanessa
A1  - Baumgarten, Peter
A1  - Bayer, Alexandra
A1  - Choorapoikayil, Suma
A1  - Friederich, Patrick
A1  - Friedrich, Jens
A1  - Geisen, Christof
A1  - Güresir, Erdem
A1  - Grünewald, Matthias
A1  - Gutjahr, Martin
A1  - Helmer, Philipp
A1  - Herrmann, Eva
A1  - Müller, Markus
A1  - Narita, Diana
A1  - Raadts, Ansgar
A1  - Schwendner, Klaus
A1  - Seifried, Erhard
A1  - Stark, Patrick
A1  - Steinbicker, Andrea U.
A1  - Thoma, Josef
A1  - Velten, Markus
A1  - Weigt, Henry
A1  - Wiesenack, Christoph
A1  - Wittmann, Maria
A1  - Zacharowski, Kai
A1  - Piekarski, Florian
T1  - Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage - a multicentre subanalysis of the German PBM Network Registry
JF  - Acta Neurochirurgica
N2  - Purpose
Anaemia is common in patients presenting with aneurysmal subarachnoid (aSAH) and intracerebral haemorrhage (ICH). In surgical patients, anaemia was identified as an idenpendent risk factor for postoperative mortality, prolonged hospital length of stay (LOS) and increased risk of red blood cell (RBC) transfusion. This multicentre cohort observation study describes the incidence and effects of preoperative anaemia in this critical patient collective for a 10-year period.

Methods
This multicentre observational study included adult in-hospital surgical patients diagnosed with aSAH or ICH of 21 German hospitals (discharged from 1 January 2010 to 30 September 2020). Descriptive, univariate and multivariate analyses were performed to investigate the incidence and association of preoperative anaemia with RBC transfusion, in-hospital mortality and postoperative complications in patients with aSAH and ICH.

Results
A total of n = 9081 patients were analysed (aSAH n = 5008; ICH n = 4073). Preoperative anaemia was present at 28.3% in aSAH and 40.9% in ICH. RBC transfusion rates were 29.9% in aSAH and 29.3% in ICH. Multivariate analysis revealed that preoperative anaemia is associated with a higher risk for RBC transfusion (OR = 3.25 in aSAH, OR = 4.16 in ICH, p < 0.001), for in-hospital mortality (OR = 1.48 in aSAH, OR = 1.53 in ICH, p < 0.001) and for several postoperative complications.

Conclusions
Preoperative anaemia is associated with increased RBC transfusion rates, in-hospital mortality and postoperative complications in patients with aSAH and ICH.
KW  - aneurysmal subarachnoid haemorrhage
KW  - intracerebral haemorrhage
KW  - anaemia
KW  - red blood cell transfusion
KW  - patient blood management
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-346754
VL  - 164
ER  - 
TY  - JOUR
A1  - Notz, Quirin
A1  - Heyland, Daren K.
A1  - Lee, Zheng-Yii
A1  - Menger, Johannes
A1  - Herrmann, Johannes
A1  - Chillon, Thilo S.
A1  - Fremes, Stephen
A1  - Mohammadi, Siamak
A1  - Elke, Gunnar
A1  - Mazer, C. David
A1  - Hill, Aileen
A1  - Velten, Markus
A1  - Ott, Sascha
A1  - Kleine-Brueggeney, Maren
A1  - Meybohm, Patrick
A1  - Schomburg, Lutz
A1  - Stoppe, Christian
T1  - Identifying a target group for selenium supplementation in high-risk cardiac surgery: a secondary analysis of the SUSTAIN CSX trial
JF  - Intensive Care Medicine Experimental
N2  - Background
Recent data from the randomized SUSTAIN CSX trial could not confirm clinical benefits from perioperative selenium treatment in high-risk cardiac surgery patients. Underlying reasons may involve inadequate biosynthesis of glutathione peroxidase (GPx3), which is a key mediator of selenium's antioxidant effects. This secondary analysis aimed to identify patients with an increase in GPx3 activity following selenium treatment. We hypothesize that these responders might benefit from perioperative selenium treatment.

Methods
Patients were selected based on the availability of selenium biomarker information. Four subgroups were defined according to the patient's baseline status, including those with normal kidney function, reduced kidney function, selenium deficiency, and submaximal GPx3 activity.

Results
Two hundred and forty-four patients were included in this analysis. Overall, higher serum concentrations of selenium, selenoprotein P (SELENOP) and GPx3 were correlated with less organ injury. GPx3 activity at baseline was predictive of 6-month survival (AUC 0.73; p = 0.03). While selenium treatment elevated serum selenium and SELENOP concentrations but not GPx3 activity in the full patient cohort, subgroup analyses revealed that GPx3 activity increased in patients with reduced kidney function, selenium deficiency and low to moderate GPx3 activity. Clinical outcomes did not vary between selenium treatment and placebo in any of these subgroups, though the study was not powered to conclusively detect differences in outcomes.

Conclusions
The identification of GPx3 responders encourages further refined investigations into the treatment effects of selenium in high-risk cardiac surgery patients.
KW  - selenium
KW  - glutathione peroxidase
KW  - cardiac surgery
KW  - critical care
KW  - oxidative stress
KW  - SUSTAIN CSX
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357196
VL  - 11
ER  -