Publications by authors named "Alexander C Reisinger"

7 Publications

  • Page 1 of 1

Convalescent plasma therapy and mortality in COVID-19 patients admitted to the ICU: a prospective observational study.

Ann Intensive Care 2021 May 12;11(1):73. Epub 2021 May 12.

Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Background: This study aimed to quantify the potential survival benefit of convalescent plasma therapy (CVP) in critically ill patients with acute respiratory failure related to coronavirus disease-2019 (COVID-19).

Methods: This is a single-center prospective observational cohort study in COVID-19 patients with acute respiratory failure. Immediately after intensive care unit (ICU) admission patients were allocated to CVP treatment following pre-specified criteria to rapidly identify those patients potentially susceptible for this treatment. A propensity score adjustment [inverse probability of treatment weighted (IPTW) analysis] was implemented to account rigorously for imbalances in prognostic variables between the treatment groups.

Results: We included 120 patients of whom 48 received CVP. Thirty percent were female with a median age of 66 years [25th-75th percentile 54-75]. Eighty-eight percent of patients presented with severe acute respiratory failure as displayed by a median paO/FiO ratio (Horowitz Index) of 92 [77-150]. All patients required any kind of ventilatory support with more than half of them (52%) receiving invasive ventilation. Thirty-day ICU overall survival (OS) was 69% in the CVP group and 54% in the non-CVP group (log-rank p = 0.049), respectively. After weighing the time-to-event data for the IPTW, the favorable association between CVP and OS became even stronger (log-rank p = 0.035). Moreover, an exploratory analysis showed an overall survival benefit of CVP therapy for patients with non-invasive ventilation (Hazard ratio 0.12 95% CI 0.03-0.57, p = 0.007) CONCLUSION: Administration of CVP in patients with acute respiratory failure related to COVID-19 is associated with improved ICU survival rates.
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http://dx.doi.org/10.1186/s13613-021-00867-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114671PMC
May 2021

Arylesterase Activity of HDL Associated Paraoxonase as a Potential Prognostic Marker in Patients With Sepsis and Septic Shock-A Prospective Pilot Study.

Front Med (Lausanne) 2020 22;7:579677. Epub 2020 Oct 22.

Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

High-density lipoprotein (HDL) plays an essential role in the immune system and shows effective antioxidative properties. We investigated correlations of lipid parameters with the sequential organ failure assessment (SOFA) score and the prognostic association with mortality in sepsis patients admitted to intensive care unit (ICU). We prospectively recruited consecutive adult patients with sepsis and septic shock, according to sepsis-3 criteria as well as non-sepsis ICU controls. Fifty-three patients with sepsis (49% with septic shock) and 25 ICU controls without sepsis were enrolled. Dyslipidemia (HDL-C < 40 mg/l) was more common in sepsis compared to non-sepsis patients (85 vs. 52%, = 0.002). Septic patients compared to controls had reduced HDL-C (14 vs. 39 mg/l, < 0.0001), lower arylesterase activity of the antioxidative paraoxonase of HDL (AEA) (67 vs. 111 mM/min/ml serum, < 0.0001), and a non-significant trend toward reduced cholesterol efflux capacity (9 vs. 10%, = 0.091). We observed a strong association between higher AEA and lower risk of 28-day [per 10 mM/min/ml serum increase in AEA: odds ratio (OR) = 0.76; 95% CI, 0.61-0.94; = 0.01) and ICU mortality (per 10 mM/min/ml serum increase in AEA: OR = 0.71, 95% CI, 0.56-0.90, = 0.004) in the sepsis cohort in univariable logistic regression analysis. AEA was confirmed as an independent predictor of 28-day and ICU mortality in multivariable analyses. AEA discriminated well-regarding 28-day/ICU mortality in area under the receiver operating characteristic curve (AUROC) analyses. In survival analysis, 28-day mortality estimates were 40 and 69% with AEA ≥/< the 25th percentile of AEA's distribution, respectively (log-rank = 0.0035). Both compositional and functional HDL parameters are profoundly altered during sepsis. In particular, the functionality parameter AEA shows promising prognostic potential in sepsis patients.
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http://dx.doi.org/10.3389/fmed.2020.579677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642222PMC
October 2020

SuPAR levels in BAL fluid from patients with acute respiratory distress syndrome-a pilot study.

Crit Care 2020 09 25;24(1):576. Epub 2020 Sep 25.

Department of Internal Medicine, Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.

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http://dx.doi.org/10.1186/s13054-020-03299-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516241PMC
September 2020

Acute respiratory distress syndrome during a pandemic-an obvious diagnosis?

Lancet Infect Dis 2020 07;20(7):873

Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

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http://dx.doi.org/10.1016/S1473-3099(20)30468-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314448PMC
July 2020

Invasive pulmonary aspergillosis complicating COVID-19 in the ICU - A case report.

Med Mycol Case Rep 2021 Mar 11;31:2-5. Epub 2020 May 11.

Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria.

It is not yet known, if critically ill COVID-19 patients are prone to fungal infections. We report a 69-year-old patient without typical risk factors for invasive pulmonary aspergillosis (IPA), who developed IPA two weeks after onset of symptoms. Our report shows that IPA may occur in critically ill COVID-19 patients.
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http://dx.doi.org/10.1016/j.mmcr.2020.05.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211620PMC
March 2021

Manifestation of Zollinger-Ellison Syndrome With Hypovolemic Shock.

Am J Med 2020 09 19;133(9):e460-e462. Epub 2020 Feb 19.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

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http://dx.doi.org/10.1016/j.amjmed.2019.12.037DOI Listing
September 2020

Feasibility of Blood Glucose Management Using Intra-Arterial Glucose Monitoring in Combination with an Automated Insulin Titration Algorithm in Critically Ill Patients.

Diabetes Technol Ther 2019 10;21(10):581-588

Department of Anesthesiology and Intensive Care Medicine, Karl Landsteiner Privatuniversität (KPU), Universitätsklinikum St. Pölten, St Pölten, Austria.

This two-center pilot study combined for the first time an intra-arterial glucose sensor with a decision support system for insulin dosing (SGCplus system) in critically ill patients with hyperglycemia. Twenty-two patients who were equipped with an arterial line and required iv insulin therapy were managed by the SGCplus system during their medical treatment at the intensive care unit. Time to target was 111 ± 195 min (80-150 mg/dL) and 135 ± 267 min (100-160 mg/dL) in the lower and higher glucose target group. Mean blood glucose (BG) was 142 ± 32 mg/dL with seven BG values <70 mg/dL. Mean daily insulin dose was 62 ± 38 U and mean daily carbohydrate intake 148 ± 50 g/day (enteral nutrition) and 102 ± 58 g/day (parenteral nutrition). Acceptance of SGCplus suggestions was high (93%). The SGCplus system can be safely applied in critically ill patients with hyperglycemia and enables good glycemic control.
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http://dx.doi.org/10.1089/dia.2019.0082DOI Listing
October 2019