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  1. Article ; Online: Beat-to-Beat Blood Pressure Estimation by Photoplethysmography and Its Interpretation.

    Fleischhauer, Vincent / Feldheiser, Aarne / Zaunseder, Sebastian

    Sensors (Basel, Switzerland)

    2022  Volume 22, Issue 18

    Abstract: Blood pressure (BP) is among the most important vital signals. Estimation of absolute BP solely using photoplethysmography (PPG) has gained immense attention over the last years. Available works differ in terms of used features as well as classifiers and ...

    Abstract Blood pressure (BP) is among the most important vital signals. Estimation of absolute BP solely using photoplethysmography (PPG) has gained immense attention over the last years. Available works differ in terms of used features as well as classifiers and bear large differences in their results. This work aims to provide a machine learning method for absolute BP estimation, its interpretation using computational methods and its critical appraisal in face of the current literature. We used data from three different sources including 273 subjects and 259,986 single beats. We extracted multiple features from PPG signals and its derivatives. BP was estimated by xgboost regression. For interpretation we used Shapley additive values (SHAP). Absolute systolic BP estimation using a strict separation of subjects yielded a mean absolute error of 9.456mmHg and correlation of 0.730. The results markedly improve if data separation is changed (MAE: 6.366mmHg,
    MeSH term(s) Algorithms ; Blood Pressure ; Blood Pressure Determination/methods ; Humans ; Photoplethysmography/methods ; Pulse Wave Analysis
    Language English
    Publishing date 2022-09-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2052857-7
    ISSN 1424-8220 ; 1424-8220
    ISSN (online) 1424-8220
    ISSN 1424-8220
    DOI 10.3390/s22187037
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Reply to: vasopressor effects on venous return in septic patients: a review.

    Feldheiser, Aarne / Gelman, Simon / Chew, Michelle S / Stopfkuchen-Evans, Matthias

    European journal of anaesthesiology

    2022  Volume 39, Issue 3, Page(s) 289–291

    Language English
    Publishing date 2022-02-10
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1097/EJA.0000000000001631
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1955: Show issues Location:
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  3. Article ; Online: Acute Kidney Injury Following Enhanced Recovery after Surgery in Patients Undergoing Radical Cystectomy. Letter.

    Stopfkuchen-Evans, Matthias / Preston, Mark / Feldheiser, Aarne

    The Journal of urology

    2021  Volume 206, Issue 3, Page(s) 782–783

    MeSH term(s) Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Cystectomy/adverse effects ; Enhanced Recovery After Surgery ; Humans ; Urinary Bladder
    Language English
    Publishing date 2021-05-14
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/JU.0000000000001888
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  4. Article ; Online: Primary perioperative haemodynamic effects of ß-receptor blockade in patients with catecholamine-secreting tumours.

    Groeben, Harald / Nottebaum, Bente J / Feldheiser, Aarne / Buch, Steffen / Alesina, Piero F / Walz, Martin K

    BJA open

    2023  Volume 8, Page(s) 100240

    Abstract: Introduction: Guidelines for the treatment of catecholamine-producing tumours strictly recommend starting ß-receptor blocking medication only after α-receptor blockade has been established. This recommendation is supported only by non-surgical case ... ...

    Abstract Introduction: Guidelines for the treatment of catecholamine-producing tumours strictly recommend starting ß-receptor blocking medication only after α-receptor blockade has been established. This recommendation is supported only by non-surgical case reports. However, in clinical practice ß-receptor blockade is often started before the diagnosis of a phaeochromocytoma is made. As we routinely treat patients with catecholamine-producing tumours without α-receptor blockade, our aim was to evaluate haemodynamic changes in such patients with and without ß-receptor blockade.
    Methods: Perioperative blood pressure was assessed prospectively for all patients. The primary outcome was the highest pre-, intra-, and postoperative systolic blood pressure in patients with or without a ß-receptor blockade. Secondary outcomes were the incidence of intraoperative systolic blood pressure peaks >250 mm Hg and hypotensive episodes. Subsequently, a propensity score matching (PSM) analysis was performed.
    Results: Out of 584 phaeochromocytoma and paraganglioma resections, 383 operations were performed without α-receptor blockade (including 84 with ß-receptor blockade). Before operation and intraoperatively, patients with ß-receptor blockade presented with higher systolic blood pressure (155 [25] and 207 [62] mm Hg) than patients without ß-receptor blockade (147 [24] and 183 [52] mm Hg;
    Conclusion: Overall, patients with isolated ß-receptor blockade developed higher blood pressure before operation and intraoperatively. After propensity score matching a difference could no longer be detected. Overall, ß-receptor blockade seems to be more a sign for severe disease than a risk factor for haemodynamic instability.
    Language English
    Publishing date 2023-12-06
    Publishing country England
    Document type Journal Article
    ISSN 2772-6096
    ISSN (online) 2772-6096
    DOI 10.1016/j.bjao.2023.100240
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Driving forces of venous return.

    Feldheiser, Aarne / Gelman, Simon / Chew, Michelle S / Stopfkuchen-Evans, Matthias

    European journal of anaesthesiology

    2021  Volume 39, Issue 4, Page(s) 393–394

    MeSH term(s) Blood Pressure ; Cardiac Output ; Humans
    Language English
    Publishing date 2021-10-18
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1097/EJA.0000000000001661
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1955: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  6. Article ; Online: Vasopressor effects on venous return in septic patients: a review.

    Feldheiser, Aarne / Gelman, Simon / Chew, Michelle / Stopfkuchen-Evans, Matthias

    European journal of anaesthesiology

    2021  Volume 38, Issue 6, Page(s) 659–663

    MeSH term(s) Humans ; Intensive Care Units ; Sepsis/diagnosis ; Sepsis/drug therapy ; Shock, Septic/diagnosis ; Shock, Septic/drug therapy ; Vasoconstrictor Agents/therapeutic use
    Chemical Substances Vasoconstrictor Agents
    Language English
    Publishing date 2021-04-29
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1097/EJA.0000000000001508
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  7. Article: Capillary leak and endothelial permeability in critically ill patients: a current overview.

    Saravi, Babak / Goebel, Ulrich / Hassenzahl, Lars O / Jung, Christian / David, Sascha / Feldheiser, Aarne / Stopfkuchen-Evans, Matthias / Wollborn, Jakob

    Intensive care medicine experimental

    2023  Volume 11, Issue 1, Page(s) 96

    Abstract: Capillary leak syndrome (CLS) represents a phenotype of increased fluid extravasation, resulting in intravascular hypovolemia, extravascular edema formation and ultimately hypoperfusion. While endothelial permeability is an evolutionary preserved ... ...

    Abstract Capillary leak syndrome (CLS) represents a phenotype of increased fluid extravasation, resulting in intravascular hypovolemia, extravascular edema formation and ultimately hypoperfusion. While endothelial permeability is an evolutionary preserved physiological process needed to sustain life, excessive fluid leak-often caused by systemic inflammation-can have detrimental effects on patients' outcomes. This article delves into the current understanding of CLS pathophysiology, diagnosis and potential treatments. Systemic inflammation leading to a compromise of endothelial cell interactions through various signaling cues (e.g., the angiopoietin-Tie2 pathway), and shedding of the glycocalyx collectively contribute to the manifestation of CLS. Capillary permeability subsequently leads to the seepage of protein-rich fluid into the interstitial space. Recent insights into the importance of the sub-glycocalyx space and preserving lymphatic flow are highlighted for an in-depth understanding. While no established diagnostic criteria exist and CLS is frequently diagnosed by clinical characteristics only, we highlight more objective serological and (non)-invasive measurements that hint towards a CLS phenotype. While currently available treatment options are limited, we further review understanding of fluid resuscitation and experimental approaches to target endothelial permeability. Despite the improved understanding of CLS pathophysiology, efforts are needed to develop uniform diagnostic criteria, associate clinical consequences to these criteria, and delineate treatment options.
    Language English
    Publishing date 2023-12-20
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2740385-3
    ISSN 2197-425X
    ISSN 2197-425X
    DOI 10.1186/s40635-023-00582-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: A comprehensive echocardiographic analysis during simulated hypovolaemia: An observational study.

    Feldheiser, Aarne / Juhl-Olsen, Peter / Nordine, Michael / Stetzuhn, Matthias / Wiegank, Ludwig / Knebel, Fabian / Treskatsch, Sascha / Berger, Christian

    European journal of anaesthesiology

    2023  Volume 40, Issue 8, Page(s) 578–586

    Abstract: Background: Peri-operative and critically ill patients often experience mild to moderate hypovolaemic shock with preserved mean arterial pressure (MAP), heart rate (HR) and decreased stroke volume index (SVI).: Objectives: The aim of this study was ... ...

    Abstract Background: Peri-operative and critically ill patients often experience mild to moderate hypovolaemic shock with preserved mean arterial pressure (MAP), heart rate (HR) and decreased stroke volume index (SVI).
    Objectives: The aim of this study was to evaluate echocardiographic parameters during simulated mild to moderate central hypovolaemia.
    Design: This was a prospective preclinical study.
    Setting: Laboratory trial performed in Charité-Universitätsmedizin Berlin, Germany.
    Patients and methods: Thirty healthy male volunteers underwent graded central hypovolaemia using a lower body negative pressure (LBNP) chamber with a stepwise decrease to simulate a mild (-15 mmHg), mild-to-moderate (-30 mmHg), and moderate state of hypovolaemic shock (-45 mmHg). During every stage, a transthoracic echocardiography examination (TTE) was performed by a certified examiner.
    Main outcome measures: Systolic and diastolic myocardial performance markers, as well as cardiac volumes were recorded during simulated hypovolaemia and compared to baseline values.
    Results: During simulated hypovolaemia via LBNP, SVI decreased progressively at all stages, whereas MAP and HR did not consistently change. Left ventricular (LV) ejection fraction decreased at -30 and -45 mmHg. Simultaneously with SVI decline, LV global longitudinal strain (LV GLS), tricuspid annular plain systolic excursion (TAPSE), and right ventricular RV S' and left-atrial end-systolic volume (LA ESV) decreased compared to baseline at all stages.
    Conclusions: In this study, simulated central hypovolaemia using LBNP did not induce consistent changes in MAP and HR. SVI decreased and was associated with deteriorated right- and left-ventricular function, observed with echocardiography. The decreased filling status was characterised by decreased LA ESV.
    Clinical trial number: ClinicalTrials.gov Identifier: NCT03481855.
    MeSH term(s) Humans ; Male ; Hypovolemia/diagnostic imaging ; Prospective Studies ; Echocardiography ; Ventricular Function, Left/physiology ; Stroke Volume/physiology ; Ventricular Function, Right/physiology
    Language English
    Publishing date 2023-06-01
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 605770-6
    ISSN 1365-2346 ; 0265-0215
    ISSN (online) 1365-2346
    ISSN 0265-0215
    DOI 10.1097/EJA.0000000000001863
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Meta-analysis of goal-directed fluid therapy using transoesophageal Doppler monitoring in patients undergoing elective colorectal surgery.

    Feldheiser, A / Casans Francés, R / Stopfkuchen-Evans, M

    BJS open

    2019  Volume 4, Issue 1, Page(s) 164–165

    MeSH term(s) Colorectal Surgery ; Echocardiography, Transesophageal ; Elective Surgical Procedures ; Fluid Therapy ; Goals ; Humans
    Language English
    Publishing date 2019-10-22
    Publishing country England
    Document type Journal Article ; Comment
    ISSN 2474-9842
    ISSN (online) 2474-9842
    DOI 10.1002/bjs5.50229
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Detection of a Stroke Volume Decrease by Machine-Learning Algorithms Based on Thoracic Bioimpedance in Experimental Hypovolaemia.

    Stetzuhn, Matthias / Tigges, Timo / Pielmus, Alexandru Gabriel / Spies, Claudia / Middel, Charlotte / Klum, Michael / Zaunseder, Sebastian / Orglmeister, Reinhold / Feldheiser, Aarne

    Sensors (Basel, Switzerland)

    2022  Volume 22, Issue 14

    Abstract: Compensated shock and hypovolaemia are frequent conditions that remain clinically undetected and can quickly cause deterioration of perioperative and critically ill patients. Automated, accurate and non-invasive detection methods are needed to avoid such ...

    Abstract Compensated shock and hypovolaemia are frequent conditions that remain clinically undetected and can quickly cause deterioration of perioperative and critically ill patients. Automated, accurate and non-invasive detection methods are needed to avoid such critical situations. In this experimental study, we aimed to create a prediction model for stroke volume index (SVI) decrease based on electrical cardiometry (EC) measurements. Transthoracic echo served as reference for SVI assessment (SVI-TTE). In 30 healthy male volunteers, central hypovolaemia was simulated using a lower body negative pressure (LBNP) chamber. A machine-learning algorithm based on variables of EC was designed. During LBNP, SVI-TTE declined consecutively, whereas the vital signs (arterial pressures and heart rate) remained within normal ranges. Compared to heart rate (AUC: 0.83 (95% CI: 0.73-0.87)) and systolic arterial pressure (AUC: 0.82 (95% CI: 0.74-0.85)), a model integrating EC variables (AUC: 0.91 (0.83-0.94)) showed a superior ability to predict a decrease in SVI-TTE ≥ 20% (
    MeSH term(s) Algorithms ; Humans ; Hypovolemia/diagnosis ; Lower Body Negative Pressure/adverse effects ; Machine Learning ; Male ; Stroke Volume/physiology
    Language English
    Publishing date 2022-07-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2052857-7
    ISSN 1424-8220 ; 1424-8220
    ISSN (online) 1424-8220
    ISSN 1424-8220
    DOI 10.3390/s22145066
    Database MEDical Literature Analysis and Retrieval System OnLINE

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