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Heppner HJ, Hag H. [The older patient in intensive care]. Dtsch Med Wochenschr 2025; 150:219-229. [PMID: 39938539 DOI: 10.1055/a-2286-6585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2025]
Abstract
Demographic trends mean that the proportion of older and very old patients in hospitals at all levels of care is increasing. This means that significantly more patients from these age groups can be expected in the future. These developments pose new challenges for both medical care and the management of geriatric intensive care patients, taking into account their multimorbidity and functional limitations due to acute illness. Although mortality increases with age, the outcome is highly dependent on the patient's functionality and comorbidity. The elderly patient also shows structural and functional organ changes, knowledge of which is important for the treatment of geriatric patients in intensive care medicine. This increasing need for geriatric treatment will have a decisive influence on the development of intensive care medicine in the coming years.
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Zhang S, Xiao B, Zhang Y, Zhou Z, Fu X, Zuo S. Retroperitoneal ganglioneuroblastoma with postoperative stress ulcer perforation in an adolescent: A case report and review of the literature. Oncol Lett 2022; 24:208. [PMID: 35720481 PMCID: PMC9178696 DOI: 10.3892/ol.2022.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Ganglioneuroblastoma (GNB) is a condition belonging to the neuroblastoma family. It is a transitional tumor consisting of a mixture of mature ganglioneuromas and malignant neuroblastomas. Its biological behavior is intermediate between benign and malignant, with a risk of recurrence and metastasis. It usually occurs in pediatric patients aged <10 years, particularly between the ages of 1 and 2 years, but may also occur in adolescents or adults. The present study reported on the clinical management of a case of postoperative stress ulcer with perforation in a 17-year-old female patient with retroperitoneal GNB and provided a review of the literature on retroperitoneal GNB in adolescents and adults.
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Affiliation(s)
- Shilong Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Benli Xiao
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Yewei Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Zihan Zhou
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Xiangyu Fu
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Shi Zuo
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
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Michels G, Sieber CC, Marx G, Roller-Wirnsberger R, Joannidis M, Müller-Werdan U, Müllges W, Gahn G, Pfister R, Thürmann PA, Wirth R, Fresenborg J, Kuntz L, Simon ST, Janssens U, Heppner HJ. [Geriatric intensive care : Consensus paper of DGIIN, DIVI, DGAI, DGGG, ÖGGG, ÖGIAIN, DGP, DGEM, DGD, DGNI, DGIM, DGKliPha and DGG]. Med Klin Intensivmed Notfmed 2020; 115:393-411. [PMID: 31278437 DOI: 10.1007/s00063-019-0590-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The proportion of elderly, frail, and multimorbid people has increased dramatically in recent decades resulting from demographic changes and will further increase, which will impact acute medical care. Prospective, randomized studies on geriatric intensive care are still lacking. There are also no international or national recommendations regarding the management of critically ill elderly patients. Based on an expert opinion, this consensus paper provides 16 statements that should be considered when dealing with geriatric critical care patients.
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Affiliation(s)
- Guido Michels
- Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - Cornel C Sieber
- Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland
| | - Gernot Marx
- Klinik für Operative Intensivmedizin und Intermediate Care, Medizinische Fakultät, RWTH Aachen, Aachen, Deutschland
| | | | - Michael Joannidis
- Gemeinsame Einrichtung für Internistische Intensiv- und Notfallmedizin, Department Innere Medizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Ursula Müller-Werdan
- Klinik für Geriatrie und Altersmedizin, Evangelisches Geriatriezentrum Berlin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Wolfgang Müllges
- Neurologische Klinik und Poliklinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Georg Gahn
- Neurologische Klinik, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Deutschland
| | - Roman Pfister
- Klinik III für Innere Medizin, Herzzentrum, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - Petra A Thürmann
- Lehrstuhl für Klinische Pharmakologie, Helios Universitätsklinkum Wuppertal, Universität Witten/Herdecke, Wuppertal, Deutschland
| | - Rainer Wirth
- Klinik für Altersmedizin und Frührehabilitation, Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Herne, Deutschland
| | - Jana Fresenborg
- Seminar für Allgemeine BWL und Management im Gesundheitswesen, Universität zu Köln, Köln, Deutschland
| | - Ludwig Kuntz
- Seminar für Allgemeine BWL und Management im Gesundheitswesen, Universität zu Köln, Köln, Deutschland
| | - Steffen T Simon
- Zentrum für Palliativmedizin, Uniklinik Köln, Köln, Deutschland
| | - Uwe Janssens
- Klinik für Innere Medizin und Internistische Intensivmedizin, St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland
| | - Hans Jürgen Heppner
- Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland
- Geriatrische Klinik und Tagesklinik, Lehrstuhl für Geriatrie, HELIOS Klinikum Schwelm, Universität Witten/Herdecke, Schwelm, Deutschland
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[Geriatric intensive care : Consensus paper of DGIIN, DIVI, DGAI, DGGG, ÖGGG, ÖGIAIN, DGP, DGEM, DGD, DGNI, DGIM, DGKliPha and DGG]. Z Gerontol Geriatr 2019; 52:440-456. [PMID: 31278486 DOI: 10.1007/s00391-019-01584-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The proportion of elderly, frail, and multimorbid people has increased dramatically in recent decades resulting from demographic changes and will further increase, which will impact acute medical care. Prospective, randomized studies on geriatric intensive care are still lacking. There are also no international or national recommendations regarding the management of critically ill elderly patients. Based on an expert opinion, this consensus paper provides 16 statements that should be considered when dealing with geriatric critical care patients.
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