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Article ; Online: Transition from a circular to a linear stapling protocol in laparoscopic Roux-en-Y gastric bypass surgery and its impact on quality of life: a 5-year outcome study.

Teixeira, Hugo / Halvachizadeh, Sascha / Teuben, Michel P J / Probst, Pascal / Muller, Markus K

2022 Volume 407, Issue 8, Page(s) 3341–3348

Abstract: Purpose: Surgical technique in bariatric surgery has been refined over the past decades. This study analysed the effect of changing the stapling protocol on the quality of life (QoL) at a midterm follow-up.: Methods: The retrospective cohort study ... ...

Abstract	Purpose: Surgical technique in bariatric surgery has been refined over the past decades. This study analysed the effect of changing the stapling protocol on the quality of life (QoL) at a midterm follow-up. Methods: The retrospective cohort study included patients undergoing Roux-en-Y gastric bypass between June 2012 and March 2016. Patients were stratified into the circular stapling protocol (CSP, n = 117) or the linear stapling protocol (LSP, n = 118). QoL was quantified by the Moorehead score at 12, 24 and 60 months. Multivariate testing was used to identify confounders. Results: The age was 42.8 ± 11.5 years and the body mass index (BMI) was 43.8 ± 6.2 kg/m Conclusion: The CSP and LSP achieve a long-lasting increase in QoL, although the LSP is associated with fewer complications, persistent weight loss and improved Moorehead score. Therefore, the LSP might be considered the favourable protocol in Roux-en-Y gastric bypass.
Language	English
Publishing date	2022-08-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02635-0
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Article ; Online: Systemic acylcarnitine levels are affected in response to multiple injuries and hemorrhagic shock - an analysis of lipidomic changes in a standardized porcine model.

Kalbas, Yannik / Kumabe, Yohei / Klingebiel, Felix Karl Ludwig / Halvachizadeh, Sascha / Teuben, Michel Paul Johan / Weisskopf, Miriam / Cesarovic, Nikola / Hülsmeier, Andreas J / Märsmann, Sonja / Hierholzer, Christian / Hildebrand, Frank / Hornemann, Thorsten / Pfeifer, Roman / Cinelli, Paolo / Pape, Hans-Christoph

The journal of trauma and acute care surgery

2024

Abstract: ... correlations were calculated. A p-value of 0.05 was defined as threshold for statistical significance ... a highly significant (p < 0.001) two-fold increase after HS in Group PT that promptly normalized after ... resuscitation. This increase was associated with a significant decrease of the base excess (p = 0.005 ...

Abstract	Introduction: Along with recent advances in analytical technologies, TCA-cycle intermediates are increasingly identified as promising makers for cellular ischemia and mitochondrial dysfunction during hemorrhagic shock (HS). For traumatized patients, the knowledge of the role of lipid oxidation substrates is sparse. In this study, we aimed to analyze the dynamics of systemic acylcarnitine (AcCa) release in a standardized polytrauma model with HS. Methods: 52 male pigs (50 ± 5 kg) were randomized into two groups: Group IF (isolated fracture) was subject to a standardized femur shaft fracture. Group PT (polytrauma) was subject to a femur fracture, followed by blunt chest trauma, liver laceration and a pressure controlled hemorrhagic shock for 60 min. Resuscitation was performed with crystalloids. Fractures were stabilized by intramedullary nailing. Venous samples were collected at 6 timepoints (baseline, trauma, resuscitation, 2 h, 4 h and 6 h). Lipidomic analysis was performed via liquid chromatography coupled mass spectrometry. Measurements were collated with clinical markers and near-infrared spectrometry measurements (NIRS) of tissue perfusion. Longitudinal analyses were performed with linear mixed models and spearman's correlations were calculated. A p-value of 0.05 was defined as threshold for statistical significance. Results: From a total of 303 distinct lipids, we identified two species of long-chain AcCas. Both showed a highly significant (p < 0.001) two-fold increase after HS in Group PT that promptly normalized after resuscitation. This increase was associated with a significant decrease of the base excess (p = 0.005) but recovery after resuscitation was faster. For both AcCas, there were significant correlations with decreased muscle tissue oxygen delivery (p = 0.008, p = 0.003) and significant time-lagged correlations with the increase of creatine kinase (p < 0.001, p < 0.001). Conclusion: Our results point to plasma AcCas as a possible indicator for mitochondrial dysfunction and cellular ischemia in HS. The more rapid normalization after resuscitation in comparison to acid base changes may warrant further investigation. Study type: Experimental Animal Model. Level of evidence: N/A.
Language	English
Publishing date	2024-03-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000004328
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Article ; Online: Discrimination and calibration of a prediction model for mortality is decreased in secondary transferred patients: a validation in the TraumaRegister DGU.

Halvachizadeh, Sascha / Störmann, P J / Özkurtul, Orkun / Berk, Till / Teuben, Michel / Sprengel, Kai / Pape, Hans-Christoph / Lefering, Rolf / Jensen, Kai Oliver

BMJ open

2022 Volume 12, Issue 4, Page(s) e056381

Abstract: ... transferred out (group P). The RISC II score was calculated within each group at admission after secondary ... transfer (group Tr) and at primary admission (group P) and compared with the observed mortality rate ... The calibration and discrimination of prediction were analysed.: Results: Group P included 116 112 (91 ...

Abstract	Introduction: The Revised Injury Severity Classification II (RISC II) score represents a data-derived score that aims to predict mortality in severely injured patients. The aim of this study was to assess the discrimination and calibration of RISC II in secondary transferred polytrauma patients. Methods: This study was performed on the multicentre database of the TraumaRegister DGU. Inclusion criteria included Injury Severity Score (ISS)≥9 points and complete demographic data. Exclusion criteria included patients with 'do not resuscitate' orders or late transfers (>24 hours after initial trauma). Patients were stratified based on way of admission into patients transferred to a European trauma centre after initial treatment in another hospital (group Tr) and primary admitted patients who were not transferred out (group P). The RISC II score was calculated within each group at admission after secondary transfer (group Tr) and at primary admission (group P) and compared with the observed mortality rate. The calibration and discrimination of prediction were analysed. Results: Group P included 116 112 (91%) patients and group Tr included 11 604 (9%) patients. The study population was predominantly male (n=86 280, 70.1%), had a mean age of 53.2 years and a mean ISS of 20.7 points. Patients in group Tr were marginally older (54 years vs 52 years) and a had slightly higher ISS (21.5 points vs 20.1 points). Median time from accident site to hospital admission was 60 min in group P and 241 min (4 hours) in group Tr. Observed and predicted mortality based on RISC II were nearly identical in group P (10.9% and 11.0%, respectively) but predicted mortality was worse (13.4%) than observed mortality (11.1%) in group Tr. Conclusion: The way of admission alters the calibration of prediction models for mortality in polytrauma patients. Mortality prediction in secondary transferred polytrauma patients should be calculated separately from primary admitted polytrauma patients.
MeSH term(s)	Calibration ; Female ; Germany ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; Registries ; Trauma Centers
Language	English
Publishing date	2022-04-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-056381
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Article ; Online: Shift of Neutrophils From Blood to Bone Marrow Upon Extensive Experimental Trauma Surgery.

Teuben, Michel P J / Heeres, Marjolein / Blokhuis, Taco / Spijkerman, Roy / Knot, Eric / Vrisekoop, Nienke / Pfeifer, Roman / Pape, Hans-Christoph / Koenderman, Leo / Leenen, Luke P H

Frontiers in immunology

2022 Volume 13, Page(s) 883863

Abstract: Introduction: Extensive trauma surgery evokes an immediate cellular immune response including altered circulatory neutrophil numbers. The concurrent bone marrow (BM) response however is currently unclear. We hypothesize that these BM changes include (1) ...

Abstract	Introduction: Extensive trauma surgery evokes an immediate cellular immune response including altered circulatory neutrophil numbers. The concurrent bone marrow (BM) response however is currently unclear. We hypothesize that these BM changes include (1) a relative reduction of the bone marrow neutrophil fraction and (2) increasing heterogeneity of the bone marrow neutrophil pool due to (3) the appearance of aged/returning neutrophils from circulation into the BM-compartment. Materials and methods: Eight pigs were included in a standardized extensive trauma surgery model. Blood and bone marrow samples were collected at baseline and after 3 hours of ongoing trauma surgery. Leukocyte and subtype counts and cell surface receptor expression levels were studied by flow cytometry. Results: All animals survived the interventions. A significant drop in circulating neutrophil counts from 9.3 to 3.2x10 Conclusion: The current study shows a shift in composition of the BM neutrophil pool during extensive trauma surgery that was associated with a relatively circulatory neutropenia. More specifically, under these conditions BM neutrophils were more mature than under homeostatic conditions and a CXCR4
MeSH term(s)	Animals ; Bone Marrow ; Bone Marrow Cells ; Flow Cytometry ; Homeostasis ; Neutrophils ; Swine
Language	English
Publishing date	2022-05-17
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.883863
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Article ; Online: Discrimination and calibration of a prediction model for mortality is decreased in secondary transferred patients

Orkun Özkurtul / Rolf Lefering / Kai Sprengel / Hans-Christoph Pape / Sascha Halvachizadeh / P J Störmann / Till Berk / Michel Teuben / Kai Oliver Jensen

BMJ Open, Vol 12, Iss

a validation in the TraumaRegister DGU

2022 Volume 4

Keywords	Medicine ; R
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
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Article ; Online: Altered cell surface receptor dynamics and circulatory occurrence of neutrophils in a small animal fracture model.

Teuben, Michel P J / Hofman, Martijn / Greven, Johannes / Shehu, Alba / Teuber, Henrik / Pfeifer, Roman / Pape, Hans-Christoph / Hildebrand, Frank

Pathology, research and practice

2020 Volume 216, Issue 10, Page(s) 153108

Abstract: Introduction: Excessive activation of the immune response after femoral fractures and fracture fixation is potentially associated with the development of systemic and local complications, particularly in multiple trauma patients. A dysregulated function ...

Abstract	Introduction: Excessive activation of the immune response after femoral fractures and fracture fixation is potentially associated with the development of systemic and local complications, particularly in multiple trauma patients. A dysregulated function of neutrophils, the most prevailing immune cells in circulation, has been discussed as a central pathophysiological background for these unfavourable post-traumatic courses. Our aim was to investigate alterations in activity and functionality as expressed by the cell surface receptor dynamics of circulatory neutrophils after femoral fracture and intramedullary stabilization. Material and methods: After intramedullary stabilization, an isolated femur fracture was induced in 18 Sprague-Dawley rats. Animals were terminated at different time points, i.e. after 3 (n = 5, group 3d), 7 (n = 5, group 7d) and 14 (n = 5, Group 14d) days and grouped accordingly. Additionally, baseline measurements were performed in one control animal per study group (n = 3) after anaesthesia induction and termination, without prior intramedullary nailing and fracture induction. The numbers and cell surface expression of CD11b, CD11a, CD62 L, and CD49d of circulating neutrophils were compared between groups. Results: Neutrophil numbers were significantly reduced at 3 days compared with baseline measurements (1.2 × 10 Conclusions: This descriptive small animal fracture study is the first to show that an intramedullary stabilized femur fracture is associated with a temporary reduction in circulatory neutrophil count and concurrent changes in circulatory neutrophil function. Moreover, we demonstrated that the restoration to homeostatic neutrophil activation status occurs concomitantly with the appearance of a novel neutrophil subtype (CD11b
MeSH term(s)	Animals ; Disease Models, Animal ; Femoral Fractures/complications ; Femoral Fractures/immunology ; Femoral Fractures/surgery ; Fracture Fixation, Intramedullary ; Inflammation/immunology ; Inflammation/pathology ; Multiple Trauma/complications ; Multiple Trauma/pathology ; Neutrophils/immunology ; Rats, Sprague-Dawley
Language	English
Publishing date	2020-07-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	391889-0
ISSN	1618-0631 ; 0344-0338
ISSN (online)	1618-0631
ISSN	0344-0338
DOI	10.1016/j.prp.2020.153108
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Article: Lessons learned from the mechanisms of posttraumatic inflammation extrapolated to the inflammatory response in COVID-19: a review.

Teuben, Michel P J / Pfeifer, Roman / Teuber, Henrik / De Boer, Leonard L / Halvachizadeh, Sascha / Shehu, Alba / Pape, Hans-Christoph

Patient safety in surgery

2020 Volume 14, Page(s) 28

Abstract: Up to 20% of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients develop severe inflammatory complications with diffuse pulmonary inflammation, reflecting acute respiratory distress syndrome (ARDS). A similar clinical profile occurs in ... ...

Abstract	Up to 20% of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients develop severe inflammatory complications with diffuse pulmonary inflammation, reflecting acute respiratory distress syndrome (ARDS). A similar clinical profile occurs in severe trauma cases. This review compares pathophysiological and therapeutic principles of severely injured trauma patients and severe coronavirus disease 2019 (COVID-19). The development of sequential organ failure in trauma parallels deterioration seen in severe COVID-19. Based on established pathophysiological models in the field of trauma, two complementary pathways of disease progression into severe COVID-19 have been identified. Furthermore, the transition from local contained disease into systemic and remote inflammation has been addressed. More specifically, the traumatology concept of sequential insults ('hits') resulting in immune dysregulation, is applied to COVID-19 disease progression modelling. Finally, similarities in post-insult humoral and cellular immune responses to severe trauma and severe COVID-19 are described. To minimize additional 'hits' to COVID-19 patients, we suggest postponing all elective surgery in endemic areas. Based on traumatology experience, we propose that immunoprotective protocols including lung protective ventilation, optimal thrombosis prophylaxis, secondary infection prevention and calculated antibiotic therapy are likely also beneficial in the treatment of SARS-CoV-2 infections. Finally, rising SARS-CoV-2 infection and mortality rates mandate exploration of out-of-the box treatment concepts, including experimental therapies designed for trauma care.
Keywords	covid19
Language	English
Publishing date	2020-07-09
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2409244-7
ISSN	1754-9493
ISSN	1754-9493
DOI	10.1186/s13037-020-00253-7
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Article ; Online: Lessons learned from the mechanisms of posttraumatic inflammation extrapolated to the inflammatory response in COVID-19

Michel P. J. Teuben / Roman Pfeifer / Henrik Teuber / Leonard L. De Boer / Sascha Halvachizadeh / Alba Shehu / Hans-Christoph Pape

Patient Safety in Surgery, Vol 14, Iss 1, Pp 1-

a review

2020 Volume 10

Abstract: Abstract Up to 20% of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients develop severe inflammatory complications with diffuse pulmonary inflammation, reflecting acute respiratory distress syndrome (ARDS). A similar clinical profile ... ...

Abstract	Abstract Up to 20% of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients develop severe inflammatory complications with diffuse pulmonary inflammation, reflecting acute respiratory distress syndrome (ARDS). A similar clinical profile occurs in severe trauma cases. This review compares pathophysiological and therapeutic principles of severely injured trauma patients and severe coronavirus disease 2019 (COVID-19). The development of sequential organ failure in trauma parallels deterioration seen in severe COVID-19. Based on established pathophysiological models in the field of trauma, two complementary pathways of disease progression into severe COVID-19 have been identified. Furthermore, the transition from local contained disease into systemic and remote inflammation has been addressed. More specifically, the traumatology concept of sequential insults (‘hits’) resulting in immune dysregulation, is applied to COVID-19 disease progression modelling. Finally, similarities in post-insult humoral and cellular immune responses to severe trauma and severe COVID-19 are described. To minimize additional ‘hits’ to COVID-19 patients, we suggest postponing all elective surgery in endemic areas. Based on traumatology experience, we propose that immunoprotective protocols including lung protective ventilation, optimal thrombosis prophylaxis, secondary infection prevention and calculated antibiotic therapy are likely also beneficial in the treatment of SARS-CoV-2 infections. Finally, rising SARS-CoV-2 infection and mortality rates mandate exploration of out-of-the box treatment concepts, including experimental therapies designed for trauma care.
Keywords	Covid-19 ; SARS-CoV-2 ; Severe trauma ; critical care ; ARDS ; Inflammation ; Surgery ; RD1-811 ; covid19
Subject code	610
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Lessons learned from the mechanisms of posttraumatic inflammation extrapolated to the inflammatory response in COVID-19

Teuben, Michel P. J. / Pfeifer, Roman / Teuber, Henrik / De Boer, Leonard L. / Halvachizadeh, Sascha / Shehu, Alba / Pape, Hans-Christoph

Patient Safety in Surgery

a review

2020 Volume 14, Issue 1

Keywords	Anesthesiology and Pain Medicine ; Surgery ; Orthopedics and Sports Medicine ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	2409244-7
ISSN	1754-9493
ISSN	1754-9493
DOI	10.1186/s13037-020-00253-7
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Lessons learned from the mechanisms of posttraumatic inflammation extrapolated to the inflammatory response in COVID-19

Teuben, Michel P J / Pfeifer, Roman / Teuber, Henrik / De Boer, Leonard L / Halvachizadeh, Sascha / Shehu, Alba / Pape, Hans-Christoph

Teuben, Michel P J; Pfeifer, Roman; Teuber, Henrik; De Boer, Leonard L; Halvachizadeh, Sascha; Shehu, Alba; Pape, Hans-Christoph (2020). Lessons learned from the mechanisms of posttraumatic inflammation extrapolated to the inflammatory response in COVID-19: a review. Patient Safety in Surgery, 14:28.

a review

2020

Abstract	Up to 20% of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients develop severe inflammatory complications with diffuse pulmonary inflammation, reflecting acute respiratory distress syndrome (ARDS). A similar clinical profile occurs in severe trauma cases. This review compares pathophysiological and therapeutic principles of severely injured trauma patients and severe coronavirus disease 2019 (COVID-19). The development of sequential organ failure in trauma parallels deterioration seen in severe COVID-19. Based on established pathophysiological models in the field of trauma, two complementary pathways of disease progression into severe COVID-19 have been identified. Furthermore, the transition from local contained disease into systemic and remote inflammation has been addressed. More specifically, the traumatology concept of sequential insults ('hits') resulting in immune dysregulation, is applied to COVID-19 disease progression modelling. Finally, similarities in post-insult humoral and cellular immune responses to severe trauma and severe COVID-19 are described. To minimize additional 'hits' to COVID-19 patients, we suggest postponing all elective surgery in endemic areas. Based on traumatology experience, we propose that immunoprotective protocols including lung protective ventilation, optimal thrombosis prophylaxis, secondary infection prevention and calculated antibiotic therapy are likely also beneficial in the treatment of SARS-CoV-2 infections. Finally, rising SARS-CoV-2 infection and mortality rates mandate exploration of out-of-the box treatment concepts, including experimental therapies designed for trauma care.
Keywords	Department of Trauma Surgery ; 610 Medicine & health ; covid19
Subject code	610
Language	English
Publisher	BioMed Central
Publishing country	ch
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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