1
|
Rottermann K, Dittrich S, Dewald O, Teske A, Kwapil N, Bleck S, Purbujo A, Münch F. Mobility and Freedom of Movement: A Novel Out-of-Hospital Treatment for Paediatric Patients with Terminal Cardiac Deficiency and Ventricular-Assist Device. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- K. Rottermann
- Unversitätsklinikum Erlangen, Kinderkardiologische Abteilung, Erlangen, Deutschland
| | | | - O. Dewald
- Department of Paediatric Surgery University Hospital Erlangen, Erlangen, Deutschland
| | - A. Teske
- Department of Paediatric Cardiac Surgery, Erlangen, Deutschland
| | - N. Kwapil
- Department of Paediatric Cardiac Surgery, Erlangen, Deutschland
| | - S. Bleck
- University of Erlangen-Nuremberg, Erlangen, Deutschland
| | - A. Purbujo
- Department of Pediatric Cardiac Surgery, University Hospital Erlangen, FAU-Erlangen-Nuernberg, Erlangen, Deutschland
| | - F. Münch
- Pediatric Cardiac Surgery of the University Hospital Erlangen, Erlangen, Deutschland
| |
Collapse
|
2
|
Münch F, Purbojo A, Wenzel F, Kohl M, Dittrich S, Rauh M, Zimmermann R, Kwapil N. [Improved quality of stored packed red blood cells by mechanical rinsing]. Anaesthesiologie 2022; 71:882-892. [PMID: 35969253 PMCID: PMC9636120 DOI: 10.1007/s00101-022-01189-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/03/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The transfusion of packed red blood cells (PRBC) is associated with various side effects, including storage damage to PRBCs. The cells change their structure, releasing potassium as well as lactate. Mechanical rinsing, available in many hospitals, is able to remove toxic substances and possibly minimizes the negative side effects of transfusion. OBJECTIVE The primary aim of our study was to improve the quality of PRBCs before transfusion. The effects of different washing solutions on PRBC quality were analyzed. MATERIAL AND METHODS This in vitro study compares 30 mechanically washed PRBCs. They were either processed with standard normal saline 0.9% (n = 15, N group) or a hemofiltration solution containing 4 mmol/l potassium (n = 15, HF group) by a mechanical rinsing device (Xtra, LivaNova, Munich, Germany). A subgroup analysis was performed based on the storage duration of the processed PRBCs (7, 14, 37 days). Samples were taken before washing (EKprä), immediately after washing (EKpost) and 10 h later (EKpost10h), after storage in the "wash medium" at room temperature. Concentrations of ATP (probability of survival in transfused erythrocytes), lactate, citrate and electrolytes (potassium, sodium, chloride, calcium) were tested. RESULTS AND CONCLUSION Mechanical rinsing improves pretransfusion quality of PRBC. Washing with a hemofiltration solution results in a more physiological electrolyte composition. Even 10 h after mechanical rinsing with a hemofiltration solution, the quality of 37-day-old PRBC is comparable to young PRBC that have been stored for 7 days and have not been washed. Washing stored PRBC increases the ATP content, which subsequently leads to an increased probability of survival of red cells after transfusion.
Collapse
Affiliation(s)
- F Münch
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland.
| | - A Purbojo
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
| | - F Wenzel
- Fakultät Medical and Life Science, Hochschule Furtwangen University Campus Villingen-Schwenningen, Jakob-Kienzle-Str. 17, 78054, Villingen-Schwenningen, Deutschland
| | - M Kohl
- Fakultät Medical and Life Science, Hochschule Furtwangen University Campus Villingen-Schwenningen, Jakob-Kienzle-Str. 17, 78054, Villingen-Schwenningen, Deutschland
| | - S Dittrich
- Kinderkardiologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
| | - M Rauh
- Klinisches Labor der Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
| | - R Zimmermann
- Transfusionsmedizinische und Hämostaseologische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - N Kwapil
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Loschgestraße 15, 91054, Erlangen, Deutschland
| |
Collapse
|
3
|
Cesnjevar R, Harig F, Purbujo A, Cuomo M, Blumauer R, Münch F, Alkassar M, Dittrich S. Tracheobronchial Compression by Congenital Vascular Anomalies – Surgical Procedures and Results. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
4
|
Münch F, David M, Ebert A. Subjektive Krankheitstheorien von Myompatientinnen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1622758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- F Münch
- Klinik für Gynäkologie, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin
| | - M David
- Klinik für Gynäkologie, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin
| | - A Ebert
- Praxis für Frauengesundheit, Gynäkologie & Geburtshilfe, Berlin
| |
Collapse
|
5
|
Purbojo A, Kläver N, Münch F, Blumauer R, Cesnjevar R, Rüffer A. Modified Pediatric Full Blood Cardioplegia Is Not Inferior to Classic Cold Crystalloid Cardioplegia in the Surgical Repair of Septal Defects. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Purbojo
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Erlangen, Germany
| | - N. Kläver
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Erlangen, Germany
| | - F. Münch
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Erlangen, Germany
| | - R. Blumauer
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Erlangen, Germany
| | - R. Cesnjevar
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Erlangen, Germany
| | - A. Rüffer
- Kinderherzchirurgische Abteilung, Universitätsklinikum Erlangen, Erlangen, Germany
| |
Collapse
|
6
|
Münch F, Callister Y, Beck A, David M. Machbarkeit der Therapieoption fokussierter Ultraschall bei Myompatientinnen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
7
|
Luksch H, Schlipfenbacher V, Köhler S, Münch F, Winkler S, Schulze F, Roesler J, Rösen-Wolff A. Expression of Caspase-1 variants induced ER stress. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597323 DOI: 10.1186/1546-0096-13-s1-p17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
8
|
Münch F, Kellermann S, Purbojo A, Janssen C, Cesnjevar R, Rüffer A. Neue Wege zur Optimierung der Kinderperfusion: Modifizierte Blutkardioplegie nach Calafiore. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1556032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
9
|
Münch F, Purbojo A, Kellermann S, Janssen C, Cesnjevar R, Rüffer A. Improved Contractility with Modified Tepid Full Blood Cardioplegia Compared to Cold Crystalloid Cardioplegia in a Piglet Model. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
10
|
Münch F, Sandrio S, Purbojo A, Rüffer A, Cesnjevar R. “UNIVAD”- vereinfachter Kreislaufsupport bei Single Ventrikel Anatomie mit aortopulmonalem Shunt und Low Output Syndrom. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1394060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
11
|
Rüffer A, Münch F, Purbojo A, Glöckler M, Toka O, Dittrich S, Cesnjevar R. Improving outcomes of pediatric postcardiotomy extracorporeal membrane oxygenation. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1393990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
12
|
Rüffer A, Janssen C, Kellermann S, Münch F, Cesnjevar R. Aortic arch repair in a piglet model: improved contractility with the beating-heart technique. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Suc J, Purbojo A, Rüffer A, Koch A, Eberle K, Münch F, Cesnjevar R. Neonatal myocardium is more sensitive to perioperative ischemic damage than myocardium of elder children. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
14
|
Rüffer A, Münch F, Purbojo A, Glöckler M, Toka O, Koch AM, Dittrich S, Cesnjevar R. Ventricular Assist Device for Myocarditis or Cardiomyopathy in Pediatric Patients: A Single-Center Series with no Mortality and the Longest Reported Duration of Support, So Far. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0033-1354473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
15
|
Münch F, Ihlenburg S, Rüffer A, Göen T, Müller J, Cesnjevar R. Verhindern Alternative „Weichmacher“ im medizinischen PVC Toxische Nebenwirkungen? Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0033-1354477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
16
|
Rüffer A, Münch F, Purbojo A, Toka O, Glöckler M, Koch AM, Dittrich S, Cesnjevar R. Single-Center Outcome of Pediatric Extracorporeal Membrane Oxygenation. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0033-1354475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
17
|
Rüffer A, Kellermann S, Janssen C, Münch F, Demuth M, Toka O, Cesnjevar RA. Evaluation of myocardial ischemia during beating-heart aortic arch repair in a piglet model. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
18
|
Münch F, Oehrlein S, Cesnjevar RA, Rüffer A. Improved flexibility of babies with a mobile VAD Ikus unit. An in hospital solution. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
19
|
Neetzel C, Münch F, Schachtsiek A, Ensinger W. Copper Nanowires, Nanotubes, and Hierarchical Nanopatterns: One-Dimensional Architectures using Ion Track Etched Templates. ACTA ACUST UNITED AC 2012. [DOI: 10.14723/tmrsj.37.213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- C. Neetzel
- Darmstadt University of Technology, Department of Materials Science
| | - F. Münch
- Darmstadt University of Technology, Department of Materials Science
| | - A. Schachtsiek
- Darmstadt University of Technology, Department of Materials Science
| | - W. Ensinger
- Darmstadt University of Technology, Department of Materials Science
| |
Collapse
|
20
|
Rüffer A, Klopsch C, Münch F, Gottschalk U, Mir T, Weil J, Reichenspurner H, Cesnjevar R. Aortic Arch Repair: Let It Beat! Thorac Cardiovasc Surg 2011; 60:189-94. [DOI: 10.1055/s-0030-1271042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A. Rüffer
- Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
| | - C. Klopsch
- Department of Cardiac Surgery, Medical Faculty, University of Rostock, Rostock, Germany
| | - F. Münch
- Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
| | - U. Gottschalk
- Department of Pediatric Cardiology, University-Heart-Center-Hamburg, Hamburg, Germany
| | - T. Mir
- Department of Pediatric Cardiology, University-Heart-Center-Hamburg, Hamburg, Germany
| | - J. Weil
- Department of Pediatric Cardiology, University-Heart-Center-Hamburg, Hamburg, Germany
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University-Heart-Center-Hamburg, Hamburg, Germany
| | - R. Cesnjevar
- Department of Pediatric Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany
| |
Collapse
|
21
|
Rüffer A, Münch F, Potapov S, Ihlenburg S, Purbojo A, Glöckler M, Dittrich S, Cesnjevar R. Troponin-I is a predictor of mortality in patients with postoperative Extra-Corporeal-Membrane-Oxygenation (ECMO) following congenital cardiac surgery. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
22
|
Rüffer A, Purbojo A, Münch F, Mahmoud N, Schmid J, Koch A, Cesnjevar RA. Continuous hypothermic low-flow-perfusion during aortic arch operations is neuroprotective and cardioprotective. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Harig F, Meier C, Hakami L, Strasser R, Bretzger J, Münch F, Vestweber-Wilmes E, Singer H, Weyand M, Cesnjevar R. Does the Additional Use of Heparin-Coated Extracorporeal Circuits (ECC) Optimize the Effect of Modified Ultrafiltration (MUF) in Pediatric Perfusion? Thorac Cardiovasc Surg 2006; 54:168-72. [PMID: 16639677 DOI: 10.1055/s-2005-872863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Modified ultrafiltration (MUF) has been shown to exert beneficial effects on the coagulation system and the capillary leak after pediatric cardiac surgery using extracorporeal circulation (ECC). The aim of this study was to investigate whether the additional use of heparin-coated circuits is a useful option for improving biocompatibility. METHODS We randomized 28 children, using heparin-coated ECC circuits in group A (n = 14) and an uncoated equivalent set in group B (n = 14). After congenital heart surgery, MUF was performed post ECC in a standardized fashion. Blood samples were analyzed preoperatively, 10 min, 30 min, 1 h, and 48 h after ECC by flow cytometric analysis (FACSort) using surface antigens CD62/CD41b (platelets) and CD45/CD14 (monocytes). RESULTS No significant difference was found with respect to mean age (20.6 months vs. 21.6 months), mean body weight (9.2 kg vs. 8.4 kg), mean ultrafiltration rate (9.1 ml/kg vs. 11.4 ml/kg), chest tube drainage, blood products, ICU stay, and 30-d survival. The percentage of CD62/CD41-positive platelets in group A (vs. B) increased up to 118 % at 60 min vs. 130 % ( P < 0.05) and declined to 98 % at 48 h postop. vs. 99 % (n. s.). The percentage of CD45/CD14-positive monocytes in group A (vs. B) increased up to 158 % at 60 min vs. 155 % (n. s.) and declined to 122 % (A) at 48 h postop. vs. 61 % (B) ( P > 0.05). CONCLUSIONS Heparin coating of ECC in addition to MUF leads to a lower platelet activation. Monocyte surface markers CD45 and CD14 indicated a marked activation during ECC in both groups but additional heparin coating showed a better postoperative regeneration of monocyte markers in the late course indicating a beneficial additive effect.
Collapse
Affiliation(s)
- F Harig
- Center of Cardiac Surgery, University Hospital Erlangen, Erlangen, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Harig F, Feyrer R, Reimann A, Hakami L, Strasser E, Münch F, Vestweber-Wilmes E, Bretzger J, Singer H, Weyand M, Cesnjevar R. Does the additional use of heparin-coated extracorporeal circuits (ECC) optimize the effect of Modified Ultrafiltration (MUF) in pediatric perfusion? Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-862047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
25
|
van Deyk K, Hempel V, Münch F, Kopp M, Graf H, Epple E. Influence of parenteral fat administration on the pulmonary vascular system in man. Intensive Care Med 1983; 9:73-7. [PMID: 6406580 DOI: 10.1007/bf01699260] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In 16 patients with multiple injuries the effect of parenteral administration of a fat emulsion on the pulmonary vascular system has been studied. Using the Hewlett Packard 5600 A Intensive Care System, which allows vital parameters to be sampled at a rate of two values per min, pulmonary artery pressure (PAP) was monitored before, during, and after the administration of Lipofundin S 20% (0.24 g/kg/h). In addition right ventricular stroke work index (RVSWI), alveolar-arterial oxygen difference (A-aDO2) and pulmonary shunt (Qs/Qt) were calculated. The results indicate that there are no changes of the PAP, the RVSWI, and the A-aDO2 during the period of observation.
Collapse
|
26
|
Voigt E, van Deyk K, Münch F. O2-CO2-diagram and iso-shunt-lines for assessment of pulmonary gas exchange during artificial respiration. Intensive Care Med 1982; 8:125-30. [PMID: 6806342 DOI: 10.1007/bf01693431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|