Tobias Bingold - Academia.edu (original) (raw)
Papers by Tobias Bingold
Trauma und Berufskrankheit, 2007
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, 2015
Die Intensivmedizin stellt den Bereich im Krankenhaus dar, in dem Patienten mit dem höchsten Risi... more Die Intensivmedizin stellt den Bereich im Krankenhaus dar, in dem Patienten mit dem höchsten Risiko für Komplikationen und dem höchsten Risiko zu versterben behandelt werden.
Praxis der Intensivmedizin, 2011
Die Intensivmedizin, 2014
Der Anaesthesist
Acute renal failure is a common complication in intensive care medicine. While the incidence of a... more Acute renal failure is a common complication in intensive care medicine. While the incidence of acute renal failure increases, mortality still remains at a high level. In Europe continuous renal replacement therapy (CRRT) has become the standard treatment for acute renal failure. Continuous renal replacement therapy has the advantage of achieving a more stable haemodynamic situation and an easier volume management compared to intermittent haemodialysis (IHD). Until now there has been no evidence to suggest that either classical IHD or CRRT is superior in reducing mortality. Using CRRT in patients with acute renal failure, an ultrafiltration rate adjusted to the patient's bodyweight at 35 ml/kg x h is recommended. A new approach in renal replacement therapy is the slow extended daily dialysis (SLEDD), which combines the advantages of CRRT and IHD. First results are promising, but further investigations are needed to show whether outcome can be improved. A final evidence-based rec...
Zeitschrift für Herz-, Thorax- und Gefäßchirurgie, 1997
... Ph. A. Schnabel R. Lange K. Amann TM Bingold H. Jakob M. Kampmann A. Koch B. Koch A. Magener ... more ... Ph. A. Schnabel R. Lange K. Amann TM Bingold H. Jakob M. Kampmann A. Koch B. Koch A. Magener H. Mehmanesh Z. Niemir EU. ... R. Lange ' H. Jakob • H. Mehmanesh EU. Sack - S. Hagl Abteilung Herzchirurgie, Chirurgische Universit/itsklinik, Heidelberg ...
European Journal of Cardio-Thoracic Surgery, 2001
Objective: The development of accelerated graft arteriosclerosis is a major cause of late death a... more Objective: The development of accelerated graft arteriosclerosis is a major cause of late death after orthotopic heart transplantation. The influence and the extent of peritransplant injury, especially of cardiomyocyte or capillary endothelial cell edema is discussed. Methods: A morphometric ultrastructural analysis of myocardial biopsies from 29 donor hearts (21 male, age 34^11 years) was performed. Right ventricular biopsies were obtained before cardioplegia (A), immediately following cardioplegia (B) (Custodiol w , Dr. F. Köhler Chemie GmbH, Alsbach-Hähnlein, Germany), before implantation (C), after 30 (D) or 60 (E) min of reperfusion and 1 week after transplantation (F). Mean ischemic time was 185^68 min. Quantitative electron microscopy was carried out in five samples per heart and time point and in 30 test fields per sample by 'random systematic sampling' and 'point and intersection counting'. As parameters for cell edema the volume density of myofibrils in cardiomyocytes and the mean barrier thickness of capillary endothelia were analyzed. P-values of less than 0.05 were regarded as significant. Significant differences in contrast to the previous values are marked by *. Results: The volume density of myofibrils (vol.%) was as follows: (B) 63.6^3.2, (C) 61.8^3.2, (D) 62.9^3.2, (E) 63.6^4.5. The mean barrier thickness (nm) was as follows: (A) 353^21, (B) 376^59, (C) 416^71*, (D) 473^45*; (E) 453^50*, (F) 379^39.
Zusammenfassung Die wesentlichen Fragen nach Herztransplantation (HTx) beinhalten Transplantatve... more Zusammenfassung Die wesentlichen Fragen nach Herztransplantation (HTx) beinhalten Transplantatversagen, akute Abstoßung, Infektionen und die chronische Rejektion. Im Rahmen der HTx wurden rechtsventrikuläre Myokardbiopsien zu folgenden Zeitpunkten entnommen: a) vor Kardioplegie, b) sofort nach Kardioplegie mit Custodiol® und Explantation, c) vor Implantation, d) nach 30 und/oder 60 min Reperfusion, e) im ersten postoperativen Monat wöchentlich und danach in größeren Intervallen. Nach Formalinfixierung
Der Chirurg
Streptococcus agalactiae, known as a pathogen that causes meningitis and septicemia in neonates, ... more Streptococcus agalactiae, known as a pathogen that causes meningitis and septicemia in neonates, emerges as an invasive organism in nonpregnant adults. This case report describes the fulminant course of a necrotizing fasciitis (NF) with streptococcal toxic shock-like syndrome (STSS) in a 76-year-old diabetic patient caused by S. agalactiae, serotype V. Chronic diseases and immunodeficiency are considered to be risk factors for the acquisition of group B streptococcal disease. Since early surgical treatment in conjunction with antimicrobial and intensive care therapy is critical for the outcome of patients with NF and/or STSS, clinicians should be aware of invasive S. agalactiae infections in adults with subcutaneous emphysema.
PLOS ONE, 2015
Organ dysfunction or failure after the first days of ICU treatment and subsequent mortality with ... more Organ dysfunction or failure after the first days of ICU treatment and subsequent mortality with respect to the type of intensive care unit (ICU) admission is poorly elucidated. Therefore we analyzed the association of ICU mortality and admission for medical (M), scheduled surgery (ScS) or unscheduled surgery (US) patients mirrored by the occurrence of organ dysfunction/failure (OD/OF) after the first 72h of ICU stay. For this retrospective cohort study (23,795 patients; DIVI registry; German Interdisciplinary Association for Intensive Care Medicine (DIVI)) organ dysfunction or failure were derived from the Sequential Organ Failure Assessment (SOFA) score (excluding the Glasgow Coma Scale). SOFA scores were collected on admission to ICU and 72h later. For patients with a length of stay of at least five days, a multivariate analysis was performed for individual OD/OF on day three. M patients had the lowest prevalence of cardiovascular failure (M 31%; ScS 35%; US 38%), and the highest prevalence of respiratory (M 24%; ScS 13%; US 17%) and renal failure (M 10%; ScS 6%; US 7%). Risk of death was highest for M- and ScS-patients in those with respiratory failure (OR; M 2.4; ScS 2.4; US 1.4) and for surgical patients with renal failure (OR; M 1.7; ScS 2.7; US 2.4). The dynamic evolution of OD/OF within 72h after ICU admission and mortality differed between patients depending on their types of admission. This has to be considered to exclude a systematic bias during multi-center trials.
Der Anaesthesist
The wide variability of clinical symptoms and the ongoing difficulties concerning the rapid and s... more The wide variability of clinical symptoms and the ongoing difficulties concerning the rapid and specific laboratory diagnosis of sepsis, contribute to the fact that sepsis primarily remains a clinical diagnosis. To contribute to a more tailored antibiotic coverage of the patient early on in the course of the disease, modern diagnostic concepts favour the qualitative and quantitative molecular biological detection of blood stream pathogens directly from whole blood. This offers a very attractive alternative to the currently applied less sensitive and much more time-consuming blood culture-based laboratory methods. Moreover, recent study results suggest an increasing impact of molecular detection methods with short turn-around times for more effective treatment and better outcomes of patients with sepsis and septic shock. In the short term, such tests will not substitute conventional blood culture despite their superior rapidity and sensitivity, mainly because of higher cost. The amaz...
Journal of intensive care, 2015
In critically ill patients, Candida spp. can often be identified in pulmonary samples. The impact... more In critically ill patients, Candida spp. can often be identified in pulmonary samples. The impact of prompt antifungal therapy in these patients is unknown. In this retrospective study, 500 adult patients with pulmonary Candida spp. colonization admitted to the intensive care unit (ICU) between 2010 and 2012 were included. The patients were analyzed according to whether or not they received antifungal therapy, which was administered at the discretion of the attending physician. Logistic regression analysis was performed to investigate the impact of antifungal therapy on hospital mortality and new onset of ventilator-associated pneumonia. In a stepwise backward elimination, the impact of age, cancer as an underlying disease, Simplified Acute Physiology Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) score were considered. After excluding 178 patients with multifocal Candida spp., isolated pulmonary Candida spp. colonization was found in 322 patients (cohort 1). Pre-ex...
Die Intensivmedizin, 2014
Surgical infections, 2015
Intestinal fatty acid binding protein (iFABP) is elevated in plasma by intestinal injury. We inve... more Intestinal fatty acid binding protein (iFABP) is elevated in plasma by intestinal injury. We investigated the influence of surgical trauma and severe sepsis caused by abdominal and pulmonary infection on plasma iFABP concentrations. Seventy-nine patients were included in this prospective observational study: 31 patients before elective major abdominal surgery (EMS), 33 patients with severe sepsis on admission to the intensive care unit (ICU), and 15 healthy volunteers who served as controls. Blood samples were taken before and after surgery for a period up to 5 d. Prior to surgery, EMS patients had increased iFABP concentrations in those patients with intestinal cancer compared with patients without intestinal cancer (217 pg/mL, interquartile range [IQR] I-III 100-369 pg/mL versus 79 pg/mL, IQR I-III: 0-182 pg/mL; p<0.01) and with controls (114 pg/mL, IQR I-III: 103-124 pg/mL; p<0.01). Surgical trauma increased iFABP levels in patients without intestinal cancer (240 pg/mL, IQR...
Der Anaesthesist, 2014
In the year 2000 a working group of the German Interdisciplinary Association for Intensive Care M... more In the year 2000 a working group of the German Interdisciplinary Association for Intensive Care Medicine (DIVI) defined a core data set on quality assurance for the first time. In the following years the participating intensive care units sent data to the registry on a voluntary basis and received an annual report on benchmarking data. Alterations in the quality in the field of intensive care medicine have so far only been published to a very low extent. This study analyzed the core date set of the DIVI between 2000 and 2010 in respect to changes in disease severity using the simplified acute physiology score (SAPS II), the sequential organ failure assessment (SOFA), the need for therapeutic interventions with the therapeutic intervention scoring system (TISS 28) and intensive care unit (ICU) mortality. Inclusion criteria were participation in the registry for at least 4 years, SAPS II, SOFA, TISS28 scores available and data on ICU discharge. A standardized mortality rate (SMR) was ...
Anaesthesia and intensive care, 2007
Intensive care unit patients are at particular risk of respiratory failure after major abdominal ... more Intensive care unit patients are at particular risk of respiratory failure after major abdominal surgery. Non-invasive ventilation or application of continuous positive airway pressure through a face mask may stabilise respiratory function and avoid the need for endotracheal re-intubation. However; there are various contraindications to non-invasive ventilation and/or tracheal re-intubation, such as recent oesophageal anastomosis, anastomotic leakage or tracheal stenting for tracheo-oesophageal fistula. A specific management strategy consisting of continuous intratracheal jet ventilation to support spontaneous respiratory function is described in two patients with contraindications to non-invasive ventilation or mask continuous positive airway pressure after major oesophageal surgery.
Survey of Anesthesiology, 2013
Trauma und Berufskrankheit, 2007
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, 2015
Die Intensivmedizin stellt den Bereich im Krankenhaus dar, in dem Patienten mit dem höchsten Risi... more Die Intensivmedizin stellt den Bereich im Krankenhaus dar, in dem Patienten mit dem höchsten Risiko für Komplikationen und dem höchsten Risiko zu versterben behandelt werden.
Praxis der Intensivmedizin, 2011
Die Intensivmedizin, 2014
Der Anaesthesist
Acute renal failure is a common complication in intensive care medicine. While the incidence of a... more Acute renal failure is a common complication in intensive care medicine. While the incidence of acute renal failure increases, mortality still remains at a high level. In Europe continuous renal replacement therapy (CRRT) has become the standard treatment for acute renal failure. Continuous renal replacement therapy has the advantage of achieving a more stable haemodynamic situation and an easier volume management compared to intermittent haemodialysis (IHD). Until now there has been no evidence to suggest that either classical IHD or CRRT is superior in reducing mortality. Using CRRT in patients with acute renal failure, an ultrafiltration rate adjusted to the patient's bodyweight at 35 ml/kg x h is recommended. A new approach in renal replacement therapy is the slow extended daily dialysis (SLEDD), which combines the advantages of CRRT and IHD. First results are promising, but further investigations are needed to show whether outcome can be improved. A final evidence-based rec...
Zeitschrift für Herz-, Thorax- und Gefäßchirurgie, 1997
... Ph. A. Schnabel R. Lange K. Amann TM Bingold H. Jakob M. Kampmann A. Koch B. Koch A. Magener ... more ... Ph. A. Schnabel R. Lange K. Amann TM Bingold H. Jakob M. Kampmann A. Koch B. Koch A. Magener H. Mehmanesh Z. Niemir EU. ... R. Lange ' H. Jakob • H. Mehmanesh EU. Sack - S. Hagl Abteilung Herzchirurgie, Chirurgische Universit/itsklinik, Heidelberg ...
European Journal of Cardio-Thoracic Surgery, 2001
Objective: The development of accelerated graft arteriosclerosis is a major cause of late death a... more Objective: The development of accelerated graft arteriosclerosis is a major cause of late death after orthotopic heart transplantation. The influence and the extent of peritransplant injury, especially of cardiomyocyte or capillary endothelial cell edema is discussed. Methods: A morphometric ultrastructural analysis of myocardial biopsies from 29 donor hearts (21 male, age 34^11 years) was performed. Right ventricular biopsies were obtained before cardioplegia (A), immediately following cardioplegia (B) (Custodiol w , Dr. F. Köhler Chemie GmbH, Alsbach-Hähnlein, Germany), before implantation (C), after 30 (D) or 60 (E) min of reperfusion and 1 week after transplantation (F). Mean ischemic time was 185^68 min. Quantitative electron microscopy was carried out in five samples per heart and time point and in 30 test fields per sample by 'random systematic sampling' and 'point and intersection counting'. As parameters for cell edema the volume density of myofibrils in cardiomyocytes and the mean barrier thickness of capillary endothelia were analyzed. P-values of less than 0.05 were regarded as significant. Significant differences in contrast to the previous values are marked by *. Results: The volume density of myofibrils (vol.%) was as follows: (B) 63.6^3.2, (C) 61.8^3.2, (D) 62.9^3.2, (E) 63.6^4.5. The mean barrier thickness (nm) was as follows: (A) 353^21, (B) 376^59, (C) 416^71*, (D) 473^45*; (E) 453^50*, (F) 379^39.
Zusammenfassung Die wesentlichen Fragen nach Herztransplantation (HTx) beinhalten Transplantatve... more Zusammenfassung Die wesentlichen Fragen nach Herztransplantation (HTx) beinhalten Transplantatversagen, akute Abstoßung, Infektionen und die chronische Rejektion. Im Rahmen der HTx wurden rechtsventrikuläre Myokardbiopsien zu folgenden Zeitpunkten entnommen: a) vor Kardioplegie, b) sofort nach Kardioplegie mit Custodiol® und Explantation, c) vor Implantation, d) nach 30 und/oder 60 min Reperfusion, e) im ersten postoperativen Monat wöchentlich und danach in größeren Intervallen. Nach Formalinfixierung
Der Chirurg
Streptococcus agalactiae, known as a pathogen that causes meningitis and septicemia in neonates, ... more Streptococcus agalactiae, known as a pathogen that causes meningitis and septicemia in neonates, emerges as an invasive organism in nonpregnant adults. This case report describes the fulminant course of a necrotizing fasciitis (NF) with streptococcal toxic shock-like syndrome (STSS) in a 76-year-old diabetic patient caused by S. agalactiae, serotype V. Chronic diseases and immunodeficiency are considered to be risk factors for the acquisition of group B streptococcal disease. Since early surgical treatment in conjunction with antimicrobial and intensive care therapy is critical for the outcome of patients with NF and/or STSS, clinicians should be aware of invasive S. agalactiae infections in adults with subcutaneous emphysema.
PLOS ONE, 2015
Organ dysfunction or failure after the first days of ICU treatment and subsequent mortality with ... more Organ dysfunction or failure after the first days of ICU treatment and subsequent mortality with respect to the type of intensive care unit (ICU) admission is poorly elucidated. Therefore we analyzed the association of ICU mortality and admission for medical (M), scheduled surgery (ScS) or unscheduled surgery (US) patients mirrored by the occurrence of organ dysfunction/failure (OD/OF) after the first 72h of ICU stay. For this retrospective cohort study (23,795 patients; DIVI registry; German Interdisciplinary Association for Intensive Care Medicine (DIVI)) organ dysfunction or failure were derived from the Sequential Organ Failure Assessment (SOFA) score (excluding the Glasgow Coma Scale). SOFA scores were collected on admission to ICU and 72h later. For patients with a length of stay of at least five days, a multivariate analysis was performed for individual OD/OF on day three. M patients had the lowest prevalence of cardiovascular failure (M 31%; ScS 35%; US 38%), and the highest prevalence of respiratory (M 24%; ScS 13%; US 17%) and renal failure (M 10%; ScS 6%; US 7%). Risk of death was highest for M- and ScS-patients in those with respiratory failure (OR; M 2.4; ScS 2.4; US 1.4) and for surgical patients with renal failure (OR; M 1.7; ScS 2.7; US 2.4). The dynamic evolution of OD/OF within 72h after ICU admission and mortality differed between patients depending on their types of admission. This has to be considered to exclude a systematic bias during multi-center trials.
Der Anaesthesist
The wide variability of clinical symptoms and the ongoing difficulties concerning the rapid and s... more The wide variability of clinical symptoms and the ongoing difficulties concerning the rapid and specific laboratory diagnosis of sepsis, contribute to the fact that sepsis primarily remains a clinical diagnosis. To contribute to a more tailored antibiotic coverage of the patient early on in the course of the disease, modern diagnostic concepts favour the qualitative and quantitative molecular biological detection of blood stream pathogens directly from whole blood. This offers a very attractive alternative to the currently applied less sensitive and much more time-consuming blood culture-based laboratory methods. Moreover, recent study results suggest an increasing impact of molecular detection methods with short turn-around times for more effective treatment and better outcomes of patients with sepsis and septic shock. In the short term, such tests will not substitute conventional blood culture despite their superior rapidity and sensitivity, mainly because of higher cost. The amaz...
Journal of intensive care, 2015
In critically ill patients, Candida spp. can often be identified in pulmonary samples. The impact... more In critically ill patients, Candida spp. can often be identified in pulmonary samples. The impact of prompt antifungal therapy in these patients is unknown. In this retrospective study, 500 adult patients with pulmonary Candida spp. colonization admitted to the intensive care unit (ICU) between 2010 and 2012 were included. The patients were analyzed according to whether or not they received antifungal therapy, which was administered at the discretion of the attending physician. Logistic regression analysis was performed to investigate the impact of antifungal therapy on hospital mortality and new onset of ventilator-associated pneumonia. In a stepwise backward elimination, the impact of age, cancer as an underlying disease, Simplified Acute Physiology Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) score were considered. After excluding 178 patients with multifocal Candida spp., isolated pulmonary Candida spp. colonization was found in 322 patients (cohort 1). Pre-ex...
Die Intensivmedizin, 2014
Surgical infections, 2015
Intestinal fatty acid binding protein (iFABP) is elevated in plasma by intestinal injury. We inve... more Intestinal fatty acid binding protein (iFABP) is elevated in plasma by intestinal injury. We investigated the influence of surgical trauma and severe sepsis caused by abdominal and pulmonary infection on plasma iFABP concentrations. Seventy-nine patients were included in this prospective observational study: 31 patients before elective major abdominal surgery (EMS), 33 patients with severe sepsis on admission to the intensive care unit (ICU), and 15 healthy volunteers who served as controls. Blood samples were taken before and after surgery for a period up to 5 d. Prior to surgery, EMS patients had increased iFABP concentrations in those patients with intestinal cancer compared with patients without intestinal cancer (217 pg/mL, interquartile range [IQR] I-III 100-369 pg/mL versus 79 pg/mL, IQR I-III: 0-182 pg/mL; p<0.01) and with controls (114 pg/mL, IQR I-III: 103-124 pg/mL; p<0.01). Surgical trauma increased iFABP levels in patients without intestinal cancer (240 pg/mL, IQR...
Der Anaesthesist, 2014
In the year 2000 a working group of the German Interdisciplinary Association for Intensive Care M... more In the year 2000 a working group of the German Interdisciplinary Association for Intensive Care Medicine (DIVI) defined a core data set on quality assurance for the first time. In the following years the participating intensive care units sent data to the registry on a voluntary basis and received an annual report on benchmarking data. Alterations in the quality in the field of intensive care medicine have so far only been published to a very low extent. This study analyzed the core date set of the DIVI between 2000 and 2010 in respect to changes in disease severity using the simplified acute physiology score (SAPS II), the sequential organ failure assessment (SOFA), the need for therapeutic interventions with the therapeutic intervention scoring system (TISS 28) and intensive care unit (ICU) mortality. Inclusion criteria were participation in the registry for at least 4 years, SAPS II, SOFA, TISS28 scores available and data on ICU discharge. A standardized mortality rate (SMR) was ...
Anaesthesia and intensive care, 2007
Intensive care unit patients are at particular risk of respiratory failure after major abdominal ... more Intensive care unit patients are at particular risk of respiratory failure after major abdominal surgery. Non-invasive ventilation or application of continuous positive airway pressure through a face mask may stabilise respiratory function and avoid the need for endotracheal re-intubation. However; there are various contraindications to non-invasive ventilation and/or tracheal re-intubation, such as recent oesophageal anastomosis, anastomotic leakage or tracheal stenting for tracheo-oesophageal fistula. A specific management strategy consisting of continuous intratracheal jet ventilation to support spontaneous respiratory function is described in two patients with contraindications to non-invasive ventilation or mask continuous positive airway pressure after major oesophageal surgery.
Survey of Anesthesiology, 2013