Reto Stocker - Academia.edu (original) (raw)
Papers by Reto Stocker
Antimicrobial Resistance and Infection Control, Feb 5, 2022
Background: There is insufficient evidence regarding the role of respirators in the prevention of... more Background: There is insufficient evidence regarding the role of respirators in the prevention of SARS-CoV-2 infection. We analysed the impact of filtering facepiece class 2 (FFP2) versus surgical masks on the risk of SARS-CoV-2 acquisition among Swiss healthcare workers (HCW). Methods: Our prospective multicentre cohort enrolled HCW from June to August 2020. Participants were asked about COVID-19 risk exposures/behaviours, including preferentially worn mask type when caring for COVID-19 patients outside of aerosol-generating procedures. The impact of FFP2 on (1) self-reported SARS-CoV-2-positive nasopharyngeal PCR/rapid antigen tests captured during weekly surveys, and (2) SARS-CoV-2 seroconversion between baseline and January/February 2021 was assessed. We enrolled 3259 participants from nine healthcare institutions, whereof 716 (22%) preferentially used FFP2. Among these, 81/716 (11%) reported a SARS-CoV-2-positive swab, compared to 352/2543 (14%) surgical mask users; seroconversion was documented in 85/656 (13%) FFP2 and 426/2255 (19%) surgical mask users. Adjusted for baseline characteristics, COVID-19 exposure, and risk behaviour, FFP2 use was non-significantly associated with decreased risk for SARS-CoV-2-positive swab (adjusted hazard ratio [aHR] 0.8, 95% CI 0.6-1.0) and seroconversion (adjusted odds ratio [aOR] 0.7, 95% CI 0.5-1.0); household exposure was the strongest risk factor (aHR 10.1, 95% CI 7.5-13.5; aOR 5.0, 95% CI 3.9-6.5). In subgroup analysis, FFP2 use was clearly protective among those with frequent (> 20 patients) COVID-19 exposure (aHR 0.7 for positive swab, 95% CI 0.5-0.8; aOR 0.6 for seroconversion, 95% CI 0.4-1.0). Respirators compared to surgical masks may convey additional protection from SARS-CoV-2 for HCW with frequent exposure to COVID-19 patients.
medRxiv (Cold Spring Harbor Laboratory), Jun 12, 2021
Anaesthesist, Mar 1, 2001
E. Martin, Heidelberg zeugende Weise gezeigt, dass ATC die Atemarbeit reduziert und den subjektiv... more E. Martin, Heidelberg zeugende Weise gezeigt, dass ATC die Atemarbeit reduziert und den subjektiven Atemkomfort erhöht.Zusätzlich konnte der Extubationserfolg unter ATC bei schwierig zu entwöhnenden Patienten besser vorhergesagt werden als auf der Basis anderer Modi.Es gibt keine detaillierten Einstellregeln für die klinische Anwendung von ATC.Um jedoch ein "overassist" zu vermeiden, sollte das Unterstützungsniveau des in Kombination mit ATC gewählten Modus reduziert werden.
Clinical Microbiology and Infection, Sep 1, 2021
Yearbook of intensive care and emergency medicine, 1999
Nutrition in the surgical intensive care patient is an important part of general treatment. Howev... more Nutrition in the surgical intensive care patient is an important part of general treatment. However the timing, route and composition of feeding is still subject to controversy. Whereas some investigators have found beneficial effects of early enteral feeding on gastrointestinal (GI) function and integrity, others still believe that postoperative feeding is not necessary at all. This chapter tries to address some issues of current controversy about GI function in the critically ill, based on physiological and pathophysiological aspects and the available literature.
Critical Care Medicine, Jul 1, 2009
Kim et al recently reported assessment of left ventricular function in patients with high-voltage... more Kim et al recently reported assessment of left ventricular function in patients with high-voltage electrical injury (1). Using transthoracic echocardiography they found no differences with control subjects in terms of left ventricular function using classic tools of evaluation of left ventricular function. The main interest of the work is the use of speckle tracking and analysis of strain and strain rate in such patients. As explained by the authors, this technique allows investigation of the different myocardial segments and analysis of strain and contraction. However, the authors chose to average values of the different segments in their final analysis. Regarding the mechanism of the possible myocardial injury and the hypothesis that an increase of catecholamines secretion may be suspected in their patients, local analysis of myocardial function may be of interest. Catecholamine-induced myocardial dysfunction may concern only some segments of the left ventricle. Tako-Tsubo or stress myocardiopathy was described as a transient left ventricular apical ballooning. A typical akinesia of the left ventricular apex or the midportions of the left ventricle as well as a hypercontractile base are consistently found with echocardiography (2). Pathophysiology of the syndrome may be partially explained by an increased sympathic activity, similar to the hypothesis of the authors. Increased serum concentrations of catecholamines have been shown to generate direct myocyte injury. Patients with high-voltage injury may theoretically present such complication. It would be of interest to know if some patients in the study experienced apical kinetic disorders or strain rate abnormalities in these segments, or if there was a difference between basal and apical left ventricular segments. Additionally, the authors argue that serum troponin is not useful for detecting left ventricular dysfunction in such patients. Considering the small increase of serum troponin reported and the fact that no pa-tient experienced left ventricular dysfunction, the study data do not support such a conclusion. The author has not disclosed any potential conflicts of interest. Je ´ro ˆme Fichet, MD, Service de Re ´animation Me ´dicale, CHU Cochin,
Springer eBooks, 1995
Head injury is still one of the leading causes of mortality and disability in young persons. Afte... more Head injury is still one of the leading causes of mortality and disability in young persons. After a period of dissatisfaction and frustration in treating these patients, the past few years have brought new insights in the pathophysiology of head trauma. These developments have provided new impulses for monitoring and treatment modalities.
PubMed, Jun 14, 1997
The main goal of intensive care of potential organ donors includes the maintenance of the organs'... more The main goal of intensive care of potential organ donors includes the maintenance of the organs' function with respect to their integrity after transplantation. Profound disturbances of cardiovascular, respiratory and endocrinological function may lead to early organ loss. Therefore, comprehensive therapy is required from the onset of brain death. The major dysfunctions and therapeutic goals in organ donors are summarized on the basis of current literature and our own findings.
Anaesthesist, Oct 19, 2000
Dem Zentralnervensystem kommt eine Schlüsselstellung für die adäquate Funktion von Organen und Or... more Dem Zentralnervensystem kommt eine Schlüsselstellung für die adäquate Funktion von Organen und Organsystemen im menschlichen Körper zu, insbesorders die Regulation von Atmung, Kreislauf sowie humoraler und immunologischer Systeme. Hirnverletzungen beeinträchtigen daher nicht nur das Zentralnervensystem, sondern den gesamten Organismus. Sie müssen in einer umfassenden Art und Weise behandelt werden, um optimale Bedingung für die Vermeidung von Sekundärläsionen am Gehirn und anderen Organen zu schaffen und die Erholung nicht irreversibel geschädigter Abschnitte des Gehirns zu ermöglichen.
Springer eBooks, 1997
Das schwere Schadelhirntrauma (SHT) stellt die haufigste Todesursache nach Trauma dar [1]. Obwohl... more Das schwere Schadelhirntrauma (SHT) stellt die haufigste Todesursache nach Trauma dar [1]. Obwohl die mechanische Krafteinwirkung fur das primare Ausmas der Hirnzellschadigung von Bedeutung ist, spielen das Hirnodem und die sekundare Hirnschadigung fur den Verlauf und die Prognose eine zentrale Rolle. Fur die Schadigung von Endothelzellen und von neuronalen Zellen werden immunologische Reaktionen verantwortlich gemacht [2]. Fas Antigen und Fas Ligand (FasL), die durch ihre Interaktion den programmierten Zelltod (Apoptose) von Zellen hervorrufen [3, 4], spielen fur die zellulare Homoostase eine wichtige Rolle [5]. Da in murinem Hirngewebe FasL nachgewiesen wurde [6], konnte die Aktivierung des Fas-FasL-Systems fur die sekundare Hirnschadigung von Bedeutung sein.
Schweizerische Ärztezeitung =, Oct 10, 2018
Interactive Cardiovascular and Thoracic Surgery, May 1, 2011
Extracorporeal membrane oxygenation (ECMO) is increasingly applied as rescue-therapy for patients... more Extracorporeal membrane oxygenation (ECMO) is increasingly applied as rescue-therapy for patients with severe acute respiratory distress syndrome (ARDS). Here, we evaluate the effect of different configuration strategies (venovenous vs. venoarterial vs. veno-venoarterial) on the outcome. From 2006 to 2008, 30 patients received ECMO for severe ARDS. Patients were divided into three groups according to the configuration: veno-venous (vv; ns11), venoarterial (va; ns8) or veno-venoarterial (vva; ns11). Data were prospectively collected and endpoint was 30-day mortality. To identify independent risk factors, univariate analysis was performed for clinical parameters, such as age, body mass index, gender, configuration, low-pH, oxygenation index (pO yFiO ) and underlying disease. Thirty-day mortality was 53% (ns16) for all comers: 63% (ns7) died in the vv-group, 75% (ns6) in the va-group and 27% (ns3) in the vva-group. Although univariate analysis could not rule out a significant predictor for the outcome, there was a trend visible to decreased mortality in the vva-group when compared to vv-and va-groups (27% vs. 63% vs. 75%; Ps0.057). ECMO provides a survival benefit in patients when considering a predicted mortality rate of 80% in ARDS. The configuration mode appears to impact the outcome as the veno-venoarterial appears to further improve the survival in this subset of patients.
Swiss medical forum =, Jan 28, 2020
Journal of Cardiothoracic and Vascular Anesthesia, Jun 1, 1994
medRxiv (Cold Spring Harbor Laboratory), Oct 22, 2021
Clinical Infectious Diseases, Jan 28, 2022
Bulletin des médecins suisses, Jun 30, 2020
Mikrozirkulation in Forschung und Klinik, Apr 20, 2015
Springer eBooks, 1994
Das schwere Trauma fuhrt zu einer erhohten Synthese und Freisetzung von proinflammatorischen Zyto... more Das schwere Trauma fuhrt zu einer erhohten Synthese und Freisetzung von proinflammatorischen Zytokinen wie TNF-α, IL-6 und IL-8 [1]. Neben TNF-α fallt IL-1β eine Schlusselrolle bei der Entstehung der systemischen Inflammation zu. IL-1β kann Fieber, eine katabole Stoffwechsellage, eine Depression des Myokards, Hypotonie und einen Schockzustand auslosen, der uber die systemische Inflammation (SIRS) und Gewebeschadigungen zum Multiorgan-Dysfunktionssyndrom (MODS) fuhren kann [2].
Antimicrobial Resistance and Infection Control, Feb 5, 2022
Background: There is insufficient evidence regarding the role of respirators in the prevention of... more Background: There is insufficient evidence regarding the role of respirators in the prevention of SARS-CoV-2 infection. We analysed the impact of filtering facepiece class 2 (FFP2) versus surgical masks on the risk of SARS-CoV-2 acquisition among Swiss healthcare workers (HCW). Methods: Our prospective multicentre cohort enrolled HCW from June to August 2020. Participants were asked about COVID-19 risk exposures/behaviours, including preferentially worn mask type when caring for COVID-19 patients outside of aerosol-generating procedures. The impact of FFP2 on (1) self-reported SARS-CoV-2-positive nasopharyngeal PCR/rapid antigen tests captured during weekly surveys, and (2) SARS-CoV-2 seroconversion between baseline and January/February 2021 was assessed. We enrolled 3259 participants from nine healthcare institutions, whereof 716 (22%) preferentially used FFP2. Among these, 81/716 (11%) reported a SARS-CoV-2-positive swab, compared to 352/2543 (14%) surgical mask users; seroconversion was documented in 85/656 (13%) FFP2 and 426/2255 (19%) surgical mask users. Adjusted for baseline characteristics, COVID-19 exposure, and risk behaviour, FFP2 use was non-significantly associated with decreased risk for SARS-CoV-2-positive swab (adjusted hazard ratio [aHR] 0.8, 95% CI 0.6-1.0) and seroconversion (adjusted odds ratio [aOR] 0.7, 95% CI 0.5-1.0); household exposure was the strongest risk factor (aHR 10.1, 95% CI 7.5-13.5; aOR 5.0, 95% CI 3.9-6.5). In subgroup analysis, FFP2 use was clearly protective among those with frequent (> 20 patients) COVID-19 exposure (aHR 0.7 for positive swab, 95% CI 0.5-0.8; aOR 0.6 for seroconversion, 95% CI 0.4-1.0). Respirators compared to surgical masks may convey additional protection from SARS-CoV-2 for HCW with frequent exposure to COVID-19 patients.
medRxiv (Cold Spring Harbor Laboratory), Jun 12, 2021
Anaesthesist, Mar 1, 2001
E. Martin, Heidelberg zeugende Weise gezeigt, dass ATC die Atemarbeit reduziert und den subjektiv... more E. Martin, Heidelberg zeugende Weise gezeigt, dass ATC die Atemarbeit reduziert und den subjektiven Atemkomfort erhöht.Zusätzlich konnte der Extubationserfolg unter ATC bei schwierig zu entwöhnenden Patienten besser vorhergesagt werden als auf der Basis anderer Modi.Es gibt keine detaillierten Einstellregeln für die klinische Anwendung von ATC.Um jedoch ein "overassist" zu vermeiden, sollte das Unterstützungsniveau des in Kombination mit ATC gewählten Modus reduziert werden.
Clinical Microbiology and Infection, Sep 1, 2021
Yearbook of intensive care and emergency medicine, 1999
Nutrition in the surgical intensive care patient is an important part of general treatment. Howev... more Nutrition in the surgical intensive care patient is an important part of general treatment. However the timing, route and composition of feeding is still subject to controversy. Whereas some investigators have found beneficial effects of early enteral feeding on gastrointestinal (GI) function and integrity, others still believe that postoperative feeding is not necessary at all. This chapter tries to address some issues of current controversy about GI function in the critically ill, based on physiological and pathophysiological aspects and the available literature.
Critical Care Medicine, Jul 1, 2009
Kim et al recently reported assessment of left ventricular function in patients with high-voltage... more Kim et al recently reported assessment of left ventricular function in patients with high-voltage electrical injury (1). Using transthoracic echocardiography they found no differences with control subjects in terms of left ventricular function using classic tools of evaluation of left ventricular function. The main interest of the work is the use of speckle tracking and analysis of strain and strain rate in such patients. As explained by the authors, this technique allows investigation of the different myocardial segments and analysis of strain and contraction. However, the authors chose to average values of the different segments in their final analysis. Regarding the mechanism of the possible myocardial injury and the hypothesis that an increase of catecholamines secretion may be suspected in their patients, local analysis of myocardial function may be of interest. Catecholamine-induced myocardial dysfunction may concern only some segments of the left ventricle. Tako-Tsubo or stress myocardiopathy was described as a transient left ventricular apical ballooning. A typical akinesia of the left ventricular apex or the midportions of the left ventricle as well as a hypercontractile base are consistently found with echocardiography (2). Pathophysiology of the syndrome may be partially explained by an increased sympathic activity, similar to the hypothesis of the authors. Increased serum concentrations of catecholamines have been shown to generate direct myocyte injury. Patients with high-voltage injury may theoretically present such complication. It would be of interest to know if some patients in the study experienced apical kinetic disorders or strain rate abnormalities in these segments, or if there was a difference between basal and apical left ventricular segments. Additionally, the authors argue that serum troponin is not useful for detecting left ventricular dysfunction in such patients. Considering the small increase of serum troponin reported and the fact that no pa-tient experienced left ventricular dysfunction, the study data do not support such a conclusion. The author has not disclosed any potential conflicts of interest. Je ´ro ˆme Fichet, MD, Service de Re ´animation Me ´dicale, CHU Cochin,
Springer eBooks, 1995
Head injury is still one of the leading causes of mortality and disability in young persons. Afte... more Head injury is still one of the leading causes of mortality and disability in young persons. After a period of dissatisfaction and frustration in treating these patients, the past few years have brought new insights in the pathophysiology of head trauma. These developments have provided new impulses for monitoring and treatment modalities.
PubMed, Jun 14, 1997
The main goal of intensive care of potential organ donors includes the maintenance of the organs'... more The main goal of intensive care of potential organ donors includes the maintenance of the organs' function with respect to their integrity after transplantation. Profound disturbances of cardiovascular, respiratory and endocrinological function may lead to early organ loss. Therefore, comprehensive therapy is required from the onset of brain death. The major dysfunctions and therapeutic goals in organ donors are summarized on the basis of current literature and our own findings.
Anaesthesist, Oct 19, 2000
Dem Zentralnervensystem kommt eine Schlüsselstellung für die adäquate Funktion von Organen und Or... more Dem Zentralnervensystem kommt eine Schlüsselstellung für die adäquate Funktion von Organen und Organsystemen im menschlichen Körper zu, insbesorders die Regulation von Atmung, Kreislauf sowie humoraler und immunologischer Systeme. Hirnverletzungen beeinträchtigen daher nicht nur das Zentralnervensystem, sondern den gesamten Organismus. Sie müssen in einer umfassenden Art und Weise behandelt werden, um optimale Bedingung für die Vermeidung von Sekundärläsionen am Gehirn und anderen Organen zu schaffen und die Erholung nicht irreversibel geschädigter Abschnitte des Gehirns zu ermöglichen.
Springer eBooks, 1997
Das schwere Schadelhirntrauma (SHT) stellt die haufigste Todesursache nach Trauma dar [1]. Obwohl... more Das schwere Schadelhirntrauma (SHT) stellt die haufigste Todesursache nach Trauma dar [1]. Obwohl die mechanische Krafteinwirkung fur das primare Ausmas der Hirnzellschadigung von Bedeutung ist, spielen das Hirnodem und die sekundare Hirnschadigung fur den Verlauf und die Prognose eine zentrale Rolle. Fur die Schadigung von Endothelzellen und von neuronalen Zellen werden immunologische Reaktionen verantwortlich gemacht [2]. Fas Antigen und Fas Ligand (FasL), die durch ihre Interaktion den programmierten Zelltod (Apoptose) von Zellen hervorrufen [3, 4], spielen fur die zellulare Homoostase eine wichtige Rolle [5]. Da in murinem Hirngewebe FasL nachgewiesen wurde [6], konnte die Aktivierung des Fas-FasL-Systems fur die sekundare Hirnschadigung von Bedeutung sein.
Schweizerische Ärztezeitung =, Oct 10, 2018
Interactive Cardiovascular and Thoracic Surgery, May 1, 2011
Extracorporeal membrane oxygenation (ECMO) is increasingly applied as rescue-therapy for patients... more Extracorporeal membrane oxygenation (ECMO) is increasingly applied as rescue-therapy for patients with severe acute respiratory distress syndrome (ARDS). Here, we evaluate the effect of different configuration strategies (venovenous vs. venoarterial vs. veno-venoarterial) on the outcome. From 2006 to 2008, 30 patients received ECMO for severe ARDS. Patients were divided into three groups according to the configuration: veno-venous (vv; ns11), venoarterial (va; ns8) or veno-venoarterial (vva; ns11). Data were prospectively collected and endpoint was 30-day mortality. To identify independent risk factors, univariate analysis was performed for clinical parameters, such as age, body mass index, gender, configuration, low-pH, oxygenation index (pO yFiO ) and underlying disease. Thirty-day mortality was 53% (ns16) for all comers: 63% (ns7) died in the vv-group, 75% (ns6) in the va-group and 27% (ns3) in the vva-group. Although univariate analysis could not rule out a significant predictor for the outcome, there was a trend visible to decreased mortality in the vva-group when compared to vv-and va-groups (27% vs. 63% vs. 75%; Ps0.057). ECMO provides a survival benefit in patients when considering a predicted mortality rate of 80% in ARDS. The configuration mode appears to impact the outcome as the veno-venoarterial appears to further improve the survival in this subset of patients.
Swiss medical forum =, Jan 28, 2020
Journal of Cardiothoracic and Vascular Anesthesia, Jun 1, 1994
medRxiv (Cold Spring Harbor Laboratory), Oct 22, 2021
Clinical Infectious Diseases, Jan 28, 2022
Bulletin des médecins suisses, Jun 30, 2020
Mikrozirkulation in Forschung und Klinik, Apr 20, 2015
Springer eBooks, 1994
Das schwere Trauma fuhrt zu einer erhohten Synthese und Freisetzung von proinflammatorischen Zyto... more Das schwere Trauma fuhrt zu einer erhohten Synthese und Freisetzung von proinflammatorischen Zytokinen wie TNF-α, IL-6 und IL-8 [1]. Neben TNF-α fallt IL-1β eine Schlusselrolle bei der Entstehung der systemischen Inflammation zu. IL-1β kann Fieber, eine katabole Stoffwechsellage, eine Depression des Myokards, Hypotonie und einen Schockzustand auslosen, der uber die systemische Inflammation (SIRS) und Gewebeschadigungen zum Multiorgan-Dysfunktionssyndrom (MODS) fuhren kann [2].