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  1. Article ; Online: Hypoxic, anemic and cardiac hypoxemia: When does tissue hypoxia begin?

    Köhler, Dieter / Voshaar, Thomas / Stais, Patrick / Haidl, Peter / Dellweg, Dominic

    Deutsche medizinische Wochenschrift (1946)

    2023  Volume 148, Issue 8, Page(s) 475–482

    Abstract: In case of hypoxemia, the oxygen content is often still in the lower normal range, so that there is no hypoxia in the tissue. If the hypoxia-threshold is reached in the tissue in hypoxic, anemic and also cardiac-related hypoxemia, identical ... ...

    Title translation Hypoxische, anämische und kardial bedingte  Hypoxämie: Wann beginnt die Hypoxie im Gewebe?
    Abstract In case of hypoxemia, the oxygen content is often still in the lower normal range, so that there is no hypoxia in the tissue. If the hypoxia-threshold is reached in the tissue in hypoxic, anemic and also cardiac-related hypoxemia, identical counterregulations occur in the cell metabolism, regardless of the cause of hypoxemia. In clinical practice, this pathophysiologic fact is sometimes ignored, although depending on the cause of hypoxemia, assessment and therapy vary widely. While restrictive and generally accepted rules are specified in the transfusion guidelines for anemic hypoxemia, in the case of hypoxic hypoxia, the indication for invasive ventilation is made very early. The clinical assessment and indication are limited to the parameters oxygen saturation, oxygen partial pressure and oxygenation index. During the corona pandemic, misinterpretations of pathophysiology have become evident and may have led to unnecessary intubations. However, there is no evidence for the treatment of hypoxic hypoxia with ventilation. This review addresses the pathophysiology of the different types of hypoxia focusing on the problems associated with intubation and ventilation in the intensive care unit.
    MeSH term(s) Humans ; Hypoxia/etiology ; Hypoxia/therapy ; Anemia/therapy ; Anemia/complications ; Lung ; Intensive Care Units ; Oxygen/therapeutic use
    Chemical Substances Oxygen (S88TT14065)
    Language German
    Publishing date 2023-03-29
    Publishing country Germany
    Document type Review ; Journal Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-2007-5450
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Conservative management of COVID-19 associated hypoxaemia.

    Voshaar, Thomas / Stais, Patrick / Köhler, Dieter / Dellweg, Dominic

    ERJ open research

    2021  Volume 7, Issue 1

    Abstract: Background: Invasive mechanical ventilation of hypoxaemic coronavirus disease 2019 (COVID-19) patients is associated with mortality rates of >50%. We evaluated clinical outcome data of two hospitals that agreed on a predefined protocol for restrictive ... ...

    Abstract Background: Invasive mechanical ventilation of hypoxaemic coronavirus disease 2019 (COVID-19) patients is associated with mortality rates of >50%. We evaluated clinical outcome data of two hospitals that agreed on a predefined protocol for restrictive use of invasive ventilation where the decision to intubate was based on the clinical presentation and oxygen content rather than on the degree of hypoxaemia.
    Method: Data analysis was carried out of patients with positive PCR-testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typical history, and symptoms and pulmonary infiltrates who exhibited oxygen saturation values of <93%.
    Results: We identified 78 patients who met the inclusion criteria. The oxygen saturation nadir was 84.4±6.5% for the whole group. 53 patients (68%) received nasal oxygen (group 1), 17 patients (22%) were treated with nasal high-flow continuous positive airway pressure (CPAP), noninvasive ventilation or a combination thereof (group 2), and eight patients (10%) were intubated (group 3). The Horovitz index was 216±8 for group 1, 157±13 for group 2 and 106±15 for group 3. Oxygen content was 14.5±2.5, 13.4±1.9 and 11.6±2.6 mL O
    Conclusion: Permissive hypoxaemia where decisions for the level of respiratory therapy were based on the clinical presentation and oxygen content resulted in low intubation rates, low overall mortality and a low number of patients who require oxygen after discharge.
    Language English
    Publishing date 2021-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00026-2021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Conservative management of COVID-19 associated hypoxaemia.

    Voshaar, Thomas / Stais, Patrick / Köhler, Dieter / Dellweg, Dominic

    ERJ open research

    2021  Volume 7, Issue 2

    Abstract: This correspondence argues that happy hypoxaemic patients should not be intubated as long as they remain ... ...

    Abstract This correspondence argues that happy hypoxaemic patients should not be intubated as long as they remain happy
    Language English
    Publishing date 2021-04-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00134-2021
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  4. Article: Conservative management of COVID-19 associated hypoxaemia.

    Voshaar, Thomas / Stais, Patrick / Köhler, Dieter / Dellweg, Dominic

    ERJ open research

    2021  Volume 7, Issue 2

    Abstract: Treat hypoxia, not ... ...

    Abstract Treat hypoxia, not hypoxaemia
    Language English
    Publishing date 2021-06-21
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00292-2021
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  5. Article ; Online: Expression of HLA-DR by mesenchymal stromal cells in the platelet lysate era: an obsolete release criterion for MSCs?

    Kuçi, Zyrafete / Piede, Natascha / Vogelsang, Kathrin / Pfeffermann, Lisa-Marie / Wehner, Sibylle / Salzmann-Manrique, Emilia / Stais, Miriam / Kreyenberg, Hermann / Bonig, Halvard / Bader, Peter / Kuçi, Selim

    Journal of translational medicine

    2024  Volume 22, Issue 1, Page(s) 39

    Abstract: Background: According to the definition of the International Society for Cell and Gene Therapy (ISCT), mesenchymal stromal cells (MSCs) do not express HLA-DR. This phenotypic marker as a release criterion for clinical use was established at a time when ... ...

    Abstract Background: According to the definition of the International Society for Cell and Gene Therapy (ISCT), mesenchymal stromal cells (MSCs) do not express HLA-DR. This phenotypic marker as a release criterion for clinical use was established at a time when MSCs were expanded in fetal bovine serum (FBS)-containing media. Replacement of FBS with platelet lysate (PLs) as a medium supplement induced a significantly higher fraction of MSCs to express MHC class II antigens.
    Methods: As this raised concerns that such MSCs may play the role of antigen-presenting cells for T cells, in the current study, we studied major factors that may induce HLA-DR on MSCs by means of flow cytometry and real-time polymerase chain reaction. The immunomodulatory potential of MSCs was assessed by a mixed lymphocyte reaction.
    Results: Our results demonstrated that a very low percentage of generated and expanded MSCs in FBS express HLA-DR (median: 1.1%, range: 0.3-22%) compared to MSCs generated and expanded in PLs (median: 28.4%, range: 3.3-73.7%). Analysis of the cytokine composition of ten PLs showed a significant positive correlation between the levels of IL-1β, IL-4, IL-10, IL-17, bFGF and expression of HLA-DR, in contrast to no correlation with the age of MSC donors and HLA-DR (r = 0.21). Both MSCs expressing low and high levels of HLA-DR expressed class II transactivator (CIITA), a master gene coding for these molecules. Our results demonstrate for the first time that MSCs with constitutively high levels of HLA-DR also express moderate levels of indoleamine 2,3-dioxygenase (IDO). Treatment of MSCs with multiple doses of TGF-β1 at passage 0 (P0) and passage 1 (P1) completely abrogated HLA-DR and IDO expression. In contrast, treatment of MSCs with a single dose of TGF-β1 after P0 only partially reduced the expression of HLA-DR and CIITA. Remarkably, increased expression of HLA-DR on MSCs that constitutively express high levels of this antigen after overnight incubation with IFN-γ was rather unaffected by incubation with TGF-β1. However, treatment of MSCs with TGF-β1 for 24 h completely abrogated constitutive expression of IDO.
    Conclusions: Irrespective of HLA-DR expression at the population level, all MSC preparations significantly inhibited the proliferation of stimulated peripheral blood mononuclear cells, indicating that HLA-DR represents an obsolete release marker for the clinical use of MSCs.
    MeSH term(s) Humans ; Transforming Growth Factor beta1 ; Leukocytes, Mononuclear ; HLA-DR Antigens ; Histocompatibility Antigens Class II ; Mesenchymal Stem Cells
    Chemical Substances Transforming Growth Factor beta1 ; HLA-DR Antigens ; Histocompatibility Antigens Class II
    Language English
    Publishing date 2024-01-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2118570-0
    ISSN 1479-5876 ; 1479-5876
    ISSN (online) 1479-5876
    ISSN 1479-5876
    DOI 10.1186/s12967-023-04684-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Conference proceedings: Therapiepause nach 2 Jahren Immuntherapie bei einer metabolischen Komplettremission beim NSCLC

    Kambartel, K / Yildirim, A / Stais, P / Liebisch, P / Mattonet, C / Ferdinandus, J / Fendler, W / Voshaar, T

    Pneumologie

    2023  Volume 77, Issue S 01

    Event/congress 63. Kongress der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e. V., Düsseldorf, 2023-03-29
    Language German
    Publishing date 2023-03-01
    Publisher Georg Thieme Verlag
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 607630-0
    ISSN 1438-8790 ; 0934-8387
    ISSN (online) 1438-8790
    ISSN 0934-8387
    DOI 10.1055/s-0043-1760977
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  7. Article ; Online: Praktische Anwendung digitaler Gesundheitsanwendungen (DiGA) in der Inneren Medizin.

    Mittermaier, Mirja / Sina, Christian / Richter, Jutta G / Raspe, Matthias / Stais, Patrick / Vehreschild, Jörg / Wolfrum, Sebastian / Anthes, Christina / Möckel, Martin

    Der Internist

    2022  Volume 63, Issue 3, Page(s) 245–254

    Abstract: Since 2020 physicians can prescribe digital health applications (DiGA), also colloquially known as apps on prescription, which are reimbursed by the statutory health insurance when they are approved by the Federal Institute for Drugs and Medical Devices ( ...

    Title translation Practical use of digital health applications (DiGA) in internal medicine.
    Abstract Since 2020 physicians can prescribe digital health applications (DiGA), also colloquially known as apps on prescription, which are reimbursed by the statutory health insurance when they are approved by the Federal Institute for Drugs and Medical Devices (BfArM) and are included in the DiGA Ordinance. Currently, there is one approved DiGA (indication obesity) for internal medicine. There are many questions on the practical use of the DiGA, ranging from the prescription, the effectiveness, the complexities and reimbursement as well as the liability risks. The DiGA are innovative new means, which maybe support internal medicine physicians in the diagnostics and treatment in the future. The benefits in this field of indications are limited by unclarified issues, especially on the prescription practice and the currently low number of DiGA available in internal medicine.
    MeSH term(s) Germany ; Humans ; Internal Medicine ; National Health Programs ; Physicians
    Language German
    Publishing date 2022-01-17
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2913-0
    ISSN 1432-1289 ; 0020-9554
    ISSN (online) 1432-1289
    ISSN 0020-9554
    DOI 10.1007/s00108-022-01264-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: 48-jähriger Triathlet mit schwerer COVID-19-Pneumonie: erfolgreiche und sichere Behandlung mit Sauerstoff und CPAP.

    Stais, P / Salloum, O / Kühle, D / Fisteag, S / Kambartel, K / Veelken, D / Ewig, S / Voshaar, T

    Pneumologie (Stuttgart, Germany)

    2020  Volume 74, Issue 7, Page(s) 417–422

    Abstract: We present the case of a 48-year old man, a triathlet, with severe COVID-19 and extensive bilateral pneumonia. On day 7 since onset of symptoms, the patient had fever, cough, rheumatic pain, dyspnea as well as severe hypoxemic respiratory failure ( ... ...

    Title translation 48-Year-Old Triathlete with Severe COVID-19 Pneumonia: Successful and Safe Treatment with Oxygen and CPAP.
    Abstract We present the case of a 48-year old man, a triathlet, with severe COVID-19 and extensive bilateral pneumonia. On day 7 since onset of symptoms, the patient had fever, cough, rheumatic pain, dyspnea as well as severe hypoxemic respiratory failure (PaO
    MeSH term(s) Betacoronavirus ; COVID-19 ; Continuous Positive Airway Pressure/methods ; Coronavirus Infections ; Humans ; Intubation, Intratracheal ; Male ; Masks ; Middle Aged ; Oxygen/blood ; Oxygen/therapeutic use ; Pandemics ; Pneumonia/complications ; Pneumonia, Viral/complications ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; SARS-CoV-2 ; Treatment Outcome
    Chemical Substances Oxygen (S88TT14065)
    Keywords covid19
    Language German
    Publishing date 2020-07-16
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 607630-0
    ISSN 1438-8790 ; 0934-8387
    ISSN (online) 1438-8790
    ISSN 0934-8387
    DOI 10.1055/a-1200-3336
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  9. Article ; Conference proceedings: Management von leichtgradigen Pneumonitiden unter Immuntherapie. Nutzen von BAL und CO-Diffusionsmessung

    Kambartel, K / Liebisch, P / Mattonet, C / Stark, R / Stais, P / Voshaar, T

    Pneumologie

    2020  Volume 74, Issue S 01

    Event/congress 61. Kongress der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e.V., Leipzig, 2020-03-25
    Language German
    Publishing date 2020-02-28
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 607630-0
    ISSN 1438-8790 ; 0934-8387
    ISSN (online) 1438-8790
    ISSN 0934-8387
    DOI 10.1055/s-0039-3403152
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  10. Article ; Online: Nachweis positiver Versorgungseffekte von digitalen Gesundheitsanwendungen – methodische Herausforderungen und Lösungsansätze.

    König, Inke R / Mittermaier, Mirja / Sina, Christian / Raspe, Matthias / Stais, Patrick / Gamstätter, Thomas / Stachwitz, Philipp / Wolfrum, Sebastian / Richter, Jutta G / Möckel, Martin

    Innere Medizin (Heidelberg, Germany)

    2022  Volume 63, Issue 12, Page(s) 1298–1306

    Abstract: Since 2020, digital health applications (DiGA) can be prescribed at the expense of the German statutory health insurance (SHI) system after undergoing an approval procedure by the Federal Institute for Drugs and Medical Devices (BfArM). DiGA can be ... ...

    Title translation Evidence of positive care effects by digital health apps-methodological challenges and approaches.
    Abstract Since 2020, digital health applications (DiGA) can be prescribed at the expense of the German statutory health insurance (SHI) system after undergoing an approval procedure by the Federal Institute for Drugs and Medical Devices (BfArM). DiGA can be approved provisionally for 1 year (with the option of extension) or permanently. The latter is dependent on scientific evidence of a positive effect on care, which can be a medical benefit or a patient-relevant structural and procedural improvement in care. However, it is apparent that the investigation of DiGA in scientific studies is challenging, as they are often complex interventions whose success also includes user and prescriber factors. In addition, health services research data underpinning the benefits of DiGA are lacking to date. In the current article, methodological considerations for DiGA research are presented, and a selection of internal medicine DiGAs is used to critically discuss current research practice.
    MeSH term(s) Humans ; Health Services Research ; National Health Programs ; Digital Technology
    Language German
    Publishing date 2022-10-24
    Publishing country Germany
    Document type English Abstract ; Journal Article ; Review
    ISSN 2731-7099
    ISSN (online) 2731-7099
    DOI 10.1007/s00108-022-01429-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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