Praxisleitfaden Organspende

Der Praxisleitfaden Organspende orientiert sich am Aufbau und dem Inhalt der Richtlinie Spendererkennung der Bundesärztekammer. Kernelement der Richtlinie ist, dass die intensivmedizinisch tätige Ärzteschaft im Krankenhaus eine Organspende bei potenziellen Organspendern ermöglichen muss, wenn ein prinzipieller Wunsch zur Organspende besteht. Der Praxisleitfaden vermittelt das relevante Wissen zur Erkennung von potentiellen Organspendern und das Vorgehen bei diesem im komplexen klinischen Alltag eher seltenen Ereignisses. Auch der Spendeprozess wird im Hinblick auf die Spendererkennung grundlegend erörtert. Das Buch wendet sich an Ärztinnen und Ärzte auf den Intensivstationen, an die Transplantationsbeauftragten sowie an alle Health Professionals, die bei potenziellen Organspendern konfrontiert werden können

Praxisleitfaden Organspende

The Organ Donation Practice Guide is based on the structure and content of the donor identification guidelines of the German Medical Association. The core element of the guideline is that doctors working in intensive care medicine in hospitals must enable organ donation from potential organ donors if there is a fundamental wish to donate organs. The practical guide provides the relevant knowledge for recognizing potential organ donors and the procedure for this event, which is rather rare in complex everyday clinical practice. The donation process is also fundamentally discussed with regard to donor identification. The book is aimed at doctors in intensive care units, transplant officers and all health professionals who may be confronted with potential organ donors

Praxisleitfaden Organspende

Der Praxisleitfaden Organspende orientiert sich am Aufbau und dem Inhalt der Richtlinie Spendererkennung der Bundesärztekammer. Kernelement der Richtlinie ist, dass die intensivmedizinisch tätige Ärzteschaft im Krankenhaus eine Organspende bei potenziellen Organspendern ermöglichen muss, wenn ein prinzipieller Wunsch zur Organspende besteht. Der Praxisleitfaden vermittelt das relevante Wissen zur Erkennung von potentiellen Organspendern und das Vorgehen bei diesem im komplexen klinischen Alltag eher seltenen Ereignisses. Auch der Spendeprozess wird im Hinblick auf die Spendererkennung grundlegend erörtert. Das Buch wendet sich an Ärztinnen und Ärzte auf den Intensivstationen, an die Transplantationsbeauftragten sowie an alle Health Professionals, die bei potenziellen Organspendern konfrontiert werden können

Effects of COVID-19 on in-hospital cardiac arrest: incidence, causes, and outcome – a retrospective cohort study

Background!#!Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), an emerging virus, has caused a global pandemic. Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has led to high hospitalization rates worldwide. Little is known about the occurrence of in-hospital cardiac arrest (IHCA) and high mortality rates have been proposed. The aim of this study was to investigate the incidence, characteristics and outcome of IHCA during the pandemic in comparison to an earlier period.!##!Methods!#!This was a retrospective analysis of data prospectively recorded during 3-month-periods 2019 and 2020 at the University Medical Centre Hamburg-Eppendorf (Germany). All consecutive adult patients with IHCA were included. Clinical parameters, neurological outcomes and organ failure/support were assessed.!##!Results!#!During the study period hospital admissions declined from 18,262 (2019) to 13,994 (2020) (- 23%). The IHCA incidence increased from 4.6 (2019: 84 IHCA cases) to 6.6 (2020: 93 IHCA cases)/1000 hospital admissions. Median stay before IHCA was 4 (1-9) days. Demographic characteristics were comparable in both periods. IHCA location shifted towards the ICU (56% vs 37%, p < 0.01); shockable rhythm (VT/VF) (18% vs 29%, p = 0.05) and defibrillation were more frequent in the pandemic period (20% vs 35%, p < 0.05). Resuscitation times, rates of ROSC and post-CA characteristics were comparable in both periods. The severity of illness (SAPS II/SOFA), frequency of mechanical ventilation and frequency of vasopressor therapy after IHCA were higher during the 2020 period. Overall, 43 patients (12 with & 31 without COVID-19), presented with respiratory failure at the time of IHCA. The Horowitz index and resuscitation time were significantly lower in patients with COVID-19 (each p < 0.01). Favourable outcomes were observed in 42 and 10% of patients with and without COVID-19-related respiratory failure, respectively.!##!Conclusion!#!Hospital admissions declined during the pandemic, but a higher incidence of IHCA was observed. IHCA in patients with COVID-19 was a common finding. Compared to patients with non-COVID-19-related respiratory failure, the outcome was improved

Characteristics and Risk Factors for Intensive Care Unit Cardiac Arrest in Critically Ill Patients with COVID-19—A Retrospective Study

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19) led to an ongoing pandemic with a surge of critically ill patients. Very little is known about the occurrence and characteristic of cardiac arrest in critically ill patients with COVID-19 treated at the intensive care unit (ICU). The aim was to investigate the incidence and outcome of intensive care unit cardiac arrest (ICU-CA) in critically ill patients with COVID-19. This was a retrospective analysis of prospectively recorded data of all consecutive adult patients with COVID-19 admitted (27 February 2020–14 January 2021) at the University Medical Centre Hamburg-Eppendorf (Germany). Of 183 critically ill patients with COVID-19, 18% (n = 33) had ICU-CA. The median age of the study population was 63 (55–73) years and 66% (n = 120) were male. Demographic characteristics and comorbidities did not differ significantly between patients with and without ICU-CA. Simplified Acute Physiological Score II (SAPS II) (ICU-CA: median 44 points vs. no ICU-CA: 39 points) and Sequential Organ Failure Assessment (SOFA) score (median 12 points vs. 7 points) on admission were significantly higher in patients with ICU-CA. Acute respiratory distress syndrome (ARDS) was present in 91% (n = 30) with and in 63% (n = 94) without ICU-CA (p = 0.002). Mechanical ventilation was more common in patients with ICU-CA (97% vs. 67%). The median stay in ICU before CA was 6 (1–17) days. A total of 33% (n = 11) of ICU-CAs occurred during the first 24 h of ICU stay. The initial rhythm was non-shockable (pulseless electrical activity (PEA)/asystole) in 91% (n = 30); 94% (n = 31) had sustained return of spontaneous circulation (ROSC). The median time to ROSC was 3 (1–5) minutes. Patients with ICU-CA had significantly higher ICU mortality (61% vs. 37%). Multivariable logistic regression showed that the presence of ARDS (odds ratio (OR) 4.268, 95% confidence interval (CI) 1.211–15.036; p = 0.024) and high SAPS II (OR 1.031, 95% CI 0.997–1.065; p = 0.077) were independently associated with the occurrence of ICU-CA. A total of 18% of critically ill patients with COVID-19 suffered from a cardiac arrest within the intensive care unit. The occurrence of ICU-CA was associated with presence of ARDS and severity of illness