Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Feb 2012
Review[Monitoring of organ functions. Dysfunction of kidneys, liver, gastrointestinal tract, and coagulation].
Monitoring of organ function is one of the core tasks of intensive care medicine. Although various monitoring devices and parameters have already been established for some organs, there are no or only few conditionally useful parameters or scores available for the kidneys, liver, gastrointestinal tract, and blood coagulation. Therefore, specific biomarkers and scores as well as combinations of both are currently investigated for better monitoring of these organs. This article gives a critical overview of currently used as well as investigational biomarkers, tests and scores in general, and shows some examples of the implications for common diseases, clinical situations and constellations in the intensive care unit.
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Cardiac biomarkers in intensive care medicine are an excellent complement to existing clinical and diagnostic information in specific diseases. Due to their lack of specificity, the diagnostic properties of common cardiac biomarkers, such as natriuretic peptides and cardiac troponins, remain ambiguous, while their prognostic value has already been proven. In addition, there are several promising new biomarkers that might contribute to a "multimarker strategy" in the critically ill patient in the future, but further evaluation is still required.
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Med Klin Intensivmed Notfmed · Nov 2011
Review[Blood, blood components and plasma derivatives. Guideline-based implementation].
The transfusion act authorized the German Medical Association to provide "guidelines for therapy with blood components and plasma derivatives" by a working party for the critical use of blood products to help to protect patients from avoidable risks. Responsible and carefully considered use of blood products is mandatory, particularly because obtaining them requires the willingness of numerous volunteers to donate blood. The individual recommendations were evaluated by evidence-based criteria and for many medical interventions so that they will serve to provide comprehensive operational procedures for transfusion personnel in clinics.