Ingo Voigt - Academia.edu (original) (raw)

Papers by Ingo Voigt

Research paper thumbnail of Efficacy and safety of ECG‐synchronized pulsatile extracorporeal membrane oxygenation in the clinical setting: The SynCor Trial

Artificial Organs, 2021

INTRODUCTION Mechanical circulatory support (MCS) devices are increasingly used as a treatment op... more INTRODUCTION Mechanical circulatory support (MCS) devices are increasingly used as a treatment option in resuscitation or in patients with cardiogenic shock (CS). Prophylactic implantation in high-risk percutaneous coronary interventions (HRPCI) is another upcoming indication. The i-cor ECG-synchronized cardiac assist device combines the hemodynamic support of a veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with the ability to generate a pulsatile flow and thus decreasing adverse effects of VA-ECMO on myocardial function. Aim of this study was to obtain data concerning feasibility, safety and outcomes in both indications. METHODS A total of 47 patients (34 HRPCI, 13 CS) were included in nine German centers and participated in this study. Demographic and clinical parameters, procedural as well as follow-up data were prospectively recorded and analyzed. RESULTS Device implantation and initiation of ECG-synchronized cardiac assist was technical successful in all cases and no failures of the consoles or disposable parts were observed. Furthermore, intended percutaneous coronary interventions and successful weaning from cardiac assist was achieved in 97.1% of HRPCI patients. We observed a 30d-survival of 94.1% in the HRPCI group and 69.2% in the CS group. Main complications in both groups were bleeding events (14.7% HRPCI, 23.1% CS) and critical limb ischemia (2.9% HRPCI, 38.5% CS). CONCLUSION The i-cor ECG-synchronized cardiac assist device appears safe and feasible showing clinical outcomes comparable to existing data in the setting of high-risk percutaneous coronary interventions and acute cardiogenic shock. Further prospective trials are warranted to identify optimal patient and interventional characteristics that will benefit most of this novel kind of mechanical circulatory support.

Research paper thumbnail of Kausale und symptomatische Therapie

Pflegewissen Kardiologie, 2017

Die therapeutischen Moglichkeiten im Bereich der Kardiologie sind mannigfaltig. Anhand der vorlie... more Die therapeutischen Moglichkeiten im Bereich der Kardiologie sind mannigfaltig. Anhand der vorliegenden Diagnose erfolgt die Therapie in der Regel anhand von Leitlinienempfehlungen der Fachgesellschaften. Die pharmakologischen Therapieoptionen verschiedener Krankheitsbilder, ihre Wirkweise und moglichen Nebenwirkungen sollen einen Einblick in die medikamentose Behandlung geben. Des Weiteren erfolgt die detaillierte Beschreibung interventioneller kardiologischer Therapieverfahren (PTCA, Ablation, Schrittmacherimplantation) die typischerweise im Herzkatheterlabor/EPU-Labor oder Schrittmacher-OP durchgefuhrt werden. Auch neue therapeutische Optionen wie TAVI, MitraClip, CRT oder LVAD werden dargestellt und geben damit eine Ubersicht der aktuellen invasiven Moglichkeiten einer Schwerpunktabteilung fur Kardiologie. Typische Verfahrensanweisungen und Praxistipps im peri-interventionellen Umgang mit den Patienten ermoglichen eine zielgerichtete pflegerische Versorgung im Stationsalltag.

Research paper thumbnail of Interprofessionelle und interdisziplinäre Arbeit

Pflegewissen Kardiologie, 2017

Die stationare kardiologische Versorgung umfasst nicht nur die aufwandige und oft lebensrettenden... more Die stationare kardiologische Versorgung umfasst nicht nur die aufwandige und oft lebensrettenden High-Tech-Medizin, sondern die langfristige Betreuung und Versorgung herzkranker Menschen. Die komplexe und ganzheitliche Versorgung durch ein multiprofessionelles Team stellt die beste Masnahme zur weitgehenden Wiederherstellung korperlicher, geistiger und/oder seelischer Funktionen dar, um individuell die grostmogliche Selbststandigkeit fur einen Patienten zu erreichen. Neben der Evaluation typischer kardialer Risikofaktoren und deren Behandlung durch Spezialisten wie Ernahrungsexperten oder Diabetologen spielt die Physiotherapie im Anschluss an ein Akutereignis aber auch im weiteren Verlauf in Form von »Herzsport« eine wichtige Rolle. Einige kardiologische Erkrankungen bedurfen spezieller Versorgungen in ausgewiesenen Zentren wie Chest Pain Unit, Heart Failure Unit oder Cardiac Arrest Centers. Abschliesend werden aktuelle Weiterbildungsmoglichkeiten, wie z. B. der kardiologische Fachassistent«(KFA), Pflegexperte Chest Pain Unit oder Herzinsuffizienzpfleger, vorgestellt.

Research paper thumbnail of Pflegewissen Kardiologie

Pflegewissen Kardiologie, 2017

Research paper thumbnail of Fatal Overdose due to Confusion of an Transdermal Fentanyl Delivery System

Case reports in critical care, 2013

Background. The use of transdermal fentanyl systems has increased over recent years, especially i... more Background. The use of transdermal fentanyl systems has increased over recent years, especially in patients with chronic pain. Large misuse potential and fatal outcomes have been described. Case Presentation. A 58-year-old patient presenting with clinical signs of opioid poisoning (hypoventilation, bradycardia, hypotension, and miosis) was admitted to our ICU. The first body check revealed a 75 mcg per hour fentanyl patch at the patient's right scapula. Some months ago, patient's aunt died after suffering from an oncological disease. During breaking up of her household, the patches were saved by the patient. Not knowing the risk of this drug, he mistook it as a heat plaster. Investigations. Laboratory test showed an impaired renal function and metabolic acidosis. Urine drug test was negative at admittance and 12 h later. CCT scan presented a global hypoxic brain disease. Treatment and Outcome. The patient was discharged 30 days after admittance in a hemodynamic stable condit...

Research paper thumbnail of Bleeding complications of percutaneous dilatation tracheostomy (PDT) in a group of ICU patients with dual antiplatelet therapy

criticalcareshock.org

Objective: Percutaneous dilatational tracheostomy (PDT) is one of the most commonly performed int... more Objective: Percutaneous dilatational tracheostomy (PDT) is one of the most commonly performed intervention in patients requiring long-term mechanical ventilation in ICUs. The ease of performance and the availability of bronchoscopic control contributed to its safety in the hands of experienced operators and to its widespread acceptance. The bleeding complications of PDT in a group of ICU patients with dual antiplatelet therapy with acetylsalicylic acid (ASS) and clopidogrel were studied. Design: Retrospective analysis of 56 percutaneous tracheostomies during the study period (July 2008-July 2010) were performed. Patients: Patients were divided into two groups whereas patients receiving dual platelet inhibition (n=15) were defined as Group 1 and all other patients were classified as Group 2 (n=41). Results: There was no evidence of major bleeding in the study-group. We found 3 patients in Group 1 and 5 patients in Group 2 who were in need of interventions (prolonged pressure dressing/local endobronchial application of epinephrine) due to prolonged bleeding. The PDT was aborted for one patient in Group 2 because of failed tracheal punction. One patient in Group 2 died during the procedure after perforation of the posterior tracheal wall with consecutive bilateral pneumothoraxes and myocardial depression. Conclusions: Our data suggest the incidence of bleeding is low in patients with dual platelet inhibition. However, occult bleedings leading to atelectasis due to obstruction of bronchial system, should beware of.

Research paper thumbnail of Efficacy and safety of ECG‐synchronized pulsatile extracorporeal membrane oxygenation in the clinical setting: The SynCor Trial

Artificial Organs, 2021

INTRODUCTION Mechanical circulatory support (MCS) devices are increasingly used as a treatment op... more INTRODUCTION Mechanical circulatory support (MCS) devices are increasingly used as a treatment option in resuscitation or in patients with cardiogenic shock (CS). Prophylactic implantation in high-risk percutaneous coronary interventions (HRPCI) is another upcoming indication. The i-cor ECG-synchronized cardiac assist device combines the hemodynamic support of a veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with the ability to generate a pulsatile flow and thus decreasing adverse effects of VA-ECMO on myocardial function. Aim of this study was to obtain data concerning feasibility, safety and outcomes in both indications. METHODS A total of 47 patients (34 HRPCI, 13 CS) were included in nine German centers and participated in this study. Demographic and clinical parameters, procedural as well as follow-up data were prospectively recorded and analyzed. RESULTS Device implantation and initiation of ECG-synchronized cardiac assist was technical successful in all cases and no failures of the consoles or disposable parts were observed. Furthermore, intended percutaneous coronary interventions and successful weaning from cardiac assist was achieved in 97.1% of HRPCI patients. We observed a 30d-survival of 94.1% in the HRPCI group and 69.2% in the CS group. Main complications in both groups were bleeding events (14.7% HRPCI, 23.1% CS) and critical limb ischemia (2.9% HRPCI, 38.5% CS). CONCLUSION The i-cor ECG-synchronized cardiac assist device appears safe and feasible showing clinical outcomes comparable to existing data in the setting of high-risk percutaneous coronary interventions and acute cardiogenic shock. Further prospective trials are warranted to identify optimal patient and interventional characteristics that will benefit most of this novel kind of mechanical circulatory support.

Research paper thumbnail of Kausale und symptomatische Therapie

Pflegewissen Kardiologie, 2017

Die therapeutischen Moglichkeiten im Bereich der Kardiologie sind mannigfaltig. Anhand der vorlie... more Die therapeutischen Moglichkeiten im Bereich der Kardiologie sind mannigfaltig. Anhand der vorliegenden Diagnose erfolgt die Therapie in der Regel anhand von Leitlinienempfehlungen der Fachgesellschaften. Die pharmakologischen Therapieoptionen verschiedener Krankheitsbilder, ihre Wirkweise und moglichen Nebenwirkungen sollen einen Einblick in die medikamentose Behandlung geben. Des Weiteren erfolgt die detaillierte Beschreibung interventioneller kardiologischer Therapieverfahren (PTCA, Ablation, Schrittmacherimplantation) die typischerweise im Herzkatheterlabor/EPU-Labor oder Schrittmacher-OP durchgefuhrt werden. Auch neue therapeutische Optionen wie TAVI, MitraClip, CRT oder LVAD werden dargestellt und geben damit eine Ubersicht der aktuellen invasiven Moglichkeiten einer Schwerpunktabteilung fur Kardiologie. Typische Verfahrensanweisungen und Praxistipps im peri-interventionellen Umgang mit den Patienten ermoglichen eine zielgerichtete pflegerische Versorgung im Stationsalltag.

Research paper thumbnail of Interprofessionelle und interdisziplinäre Arbeit

Pflegewissen Kardiologie, 2017

Die stationare kardiologische Versorgung umfasst nicht nur die aufwandige und oft lebensrettenden... more Die stationare kardiologische Versorgung umfasst nicht nur die aufwandige und oft lebensrettenden High-Tech-Medizin, sondern die langfristige Betreuung und Versorgung herzkranker Menschen. Die komplexe und ganzheitliche Versorgung durch ein multiprofessionelles Team stellt die beste Masnahme zur weitgehenden Wiederherstellung korperlicher, geistiger und/oder seelischer Funktionen dar, um individuell die grostmogliche Selbststandigkeit fur einen Patienten zu erreichen. Neben der Evaluation typischer kardialer Risikofaktoren und deren Behandlung durch Spezialisten wie Ernahrungsexperten oder Diabetologen spielt die Physiotherapie im Anschluss an ein Akutereignis aber auch im weiteren Verlauf in Form von »Herzsport« eine wichtige Rolle. Einige kardiologische Erkrankungen bedurfen spezieller Versorgungen in ausgewiesenen Zentren wie Chest Pain Unit, Heart Failure Unit oder Cardiac Arrest Centers. Abschliesend werden aktuelle Weiterbildungsmoglichkeiten, wie z. B. der kardiologische Fachassistent«(KFA), Pflegexperte Chest Pain Unit oder Herzinsuffizienzpfleger, vorgestellt.

Research paper thumbnail of Pflegewissen Kardiologie

Pflegewissen Kardiologie, 2017

Research paper thumbnail of Fatal Overdose due to Confusion of an Transdermal Fentanyl Delivery System

Case reports in critical care, 2013

Background. The use of transdermal fentanyl systems has increased over recent years, especially i... more Background. The use of transdermal fentanyl systems has increased over recent years, especially in patients with chronic pain. Large misuse potential and fatal outcomes have been described. Case Presentation. A 58-year-old patient presenting with clinical signs of opioid poisoning (hypoventilation, bradycardia, hypotension, and miosis) was admitted to our ICU. The first body check revealed a 75 mcg per hour fentanyl patch at the patient's right scapula. Some months ago, patient's aunt died after suffering from an oncological disease. During breaking up of her household, the patches were saved by the patient. Not knowing the risk of this drug, he mistook it as a heat plaster. Investigations. Laboratory test showed an impaired renal function and metabolic acidosis. Urine drug test was negative at admittance and 12 h later. CCT scan presented a global hypoxic brain disease. Treatment and Outcome. The patient was discharged 30 days after admittance in a hemodynamic stable condit...

Research paper thumbnail of Bleeding complications of percutaneous dilatation tracheostomy (PDT) in a group of ICU patients with dual antiplatelet therapy

criticalcareshock.org

Objective: Percutaneous dilatational tracheostomy (PDT) is one of the most commonly performed int... more Objective: Percutaneous dilatational tracheostomy (PDT) is one of the most commonly performed intervention in patients requiring long-term mechanical ventilation in ICUs. The ease of performance and the availability of bronchoscopic control contributed to its safety in the hands of experienced operators and to its widespread acceptance. The bleeding complications of PDT in a group of ICU patients with dual antiplatelet therapy with acetylsalicylic acid (ASS) and clopidogrel were studied. Design: Retrospective analysis of 56 percutaneous tracheostomies during the study period (July 2008-July 2010) were performed. Patients: Patients were divided into two groups whereas patients receiving dual platelet inhibition (n=15) were defined as Group 1 and all other patients were classified as Group 2 (n=41). Results: There was no evidence of major bleeding in the study-group. We found 3 patients in Group 1 and 5 patients in Group 2 who were in need of interventions (prolonged pressure dressing/local endobronchial application of epinephrine) due to prolonged bleeding. The PDT was aborted for one patient in Group 2 because of failed tracheal punction. One patient in Group 2 died during the procedure after perforation of the posterior tracheal wall with consecutive bilateral pneumothoraxes and myocardial depression. Conclusions: Our data suggest the incidence of bleeding is low in patients with dual platelet inhibition. However, occult bleedings leading to atelectasis due to obstruction of bronchial system, should beware of.