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Hardy-Thorsten Panknin

Publications and source records attributed to Hardy-Thorsten Panknin.

15 recordsLinked to original sources
PubMed2006

[Prevention of ventilator-associated pneumonia: review of national and international guidelines].

Both in the USA and in Europe the most frequent hospital-acquired infection in intensive care units is the ventilator-associated pneumonia. Particularly, patients with artificial respiration are at risk. Their risk to acquire a nosocomial pneumonia is six to twenty-one times higher than for patients breathing without artificial help. Established risk factors are, amongst others, old age, tracheotomy or reintubation, defective immune functions, already existing pulmonary infections and lifestyle-dependent factors like smoking. Recent scientific results indicate that endogenous infections are the most important reason for the development of a ventilator-associated pneumonia. Infections are initiated by microaspiration of bacteria from the oropharynx. Bacterial colonisation of the mouth is often favoured by an increased gastric pH-value, a secondary effect of the accompanying medicinal therapy. On a national as well as an international level there are evidence-based guidelines for the prevention of ventilator-associated pneumonia available. A comparison of guidelines of the US-American "Centers for Disease Control and Prevention" (CDC) with those of the German "Robert Koch-Institut" reveals deviating recommendations. Differences concern especially the changing of respiratory tubes, the use of filters and of closed humidifying systems. Additionally there are not yet recommendations for every aspect of infection prevention. However, recent studies show that regular surveillance of infections, further training of staff members and critically considering the invasive use of medical devices are able to reduce the rate of nosocomial infections and especially ventilator-associated pneumonia.

Bacterial Infections↗
PubMed2005

[How to prevent nosocomial infections? An international overview].

Nosocomial infections take the bulk of all complications emerging hospitals and they are eminent indicators for the quality of health care and nursing. One of the most prominent clinical infections are infections associated with venous catheter, ventilation, and bladder catheter. They increase the risk for sepsis and septic shocks. A survey of international studies about the prevention of hospital acquired infections advises, that the incidence can be lowered by continuous presence of hospital infection control nurses, by standardised assessment and analysis of the infection rates with targeted adaption of evidence-based hygienic requirements--also referred to as surveillance--and by an adequate number of skilled staff in nursing and health care. From a European point of view, a harmonization of the requirements for qualifying of hospital infection control nurses and implementing of a European health agency would be desirable.

Aged↗
PubMed2005

[Fever in critically ill patients: frequent causes, diagnostic procedures, and therapy].

Fever is an adaptive physiological process. In reaction to specific proteins (pyrogens) distributed by the blood the reference temperature increases, thus the organism has to produce heat. In intensive care units approximately 50 percent of fever episodes are caused by hospital acquired infections, while other episodes result from non-infectious diseases or their aetiology remain undetected. A special kind of fever is the hyperthermia following malfunctioning hypothalamic regulation after central nervous diseases or injuries. In patients with severe head injuries any increase of temperature has to be prevented as hyperthermia is associated with more adverse outcomes. If the hyperthermia can be attributed to other aetiological factors, a decrease of temperature is not desirable provided that the consequences of fever do not jeopardize the patient for further health risks. As a basis of therapy, the aetiology of fever episodes should be diagnosed taking recent scientific knowledge and guidelines into consideration. The most reliable temperature values are measured by using invasive sensors, particularly in pulmonary arterial catheters or bladder catheters. Alternatively usual thermometers can be applied, due to unreliable results excepting in the axilla.

Bacterial Infections↗