Hartmuth Nowak
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View article: AI-supported, integrative prediction of postoperative delirium- study protocol of the CONFUSED study (Preprint)
AI-supported, integrative prediction of postoperative delirium- study protocol of the CONFUSED study (Preprint) Open
BACKGROUND Postoperative delirium (POD) is a prevalent and serious complication affecting older surgical patients, characterized by cognitive disturbances and fluctuating consciousness. Despite its impact on quality of life and increased …
View article: AIMing for survival: The impact of the free and total AIM concentration in septic patients
AIMing for survival: The impact of the free and total AIM concentration in septic patients Open
Background Sepsis, a life-threatening condition caused by a dysregulated host response to infection, remains a major cause of mortality worldwide. Identifying reliable biomarkers for prognosis and treatment is urgently needed. This study i…
View article: Association Between Differential Heterogeneity of Antibiotics Consumption and Share of Resistant Pathogens and its Implication for Antibiotic Stewardship in a German Hospital Intensive Care Unit
Association Between Differential Heterogeneity of Antibiotics Consumption and Share of Resistant Pathogens and its Implication for Antibiotic Stewardship in a German Hospital Intensive Care Unit Open
Background: The rapid rise in antimicrobial resistance has become one of the 10 most pressing health problems worldwide in recent years. Antimicrobial stewardship is a beacon of hope with regard to measures to combat resistance, but is cur…
View article: Positive suggestions via headphones during general anesthesia for the improvement of vegetative & cognitive postoperative course parameters in elderly orthopedic patients – a randomized controlled double-blinded trial (POSSUDEL)
Positive suggestions via headphones during general anesthesia for the improvement of vegetative & cognitive postoperative course parameters in elderly orthopedic patients – a randomized controlled double-blinded trial (POSSUDEL) Open
Background Postoperative delirium and cognitive deficits are significant surgical complications, especially in elderly patients. The reported incidence of postoperative delirium is variable but notably high in cardiothoracic, orthopedic, a…
View article: Plasma proteomics identifies molecular subtypes in sepsis
Plasma proteomics identifies molecular subtypes in sepsis Open
View article: Machine learning identifies clinical sepsis phenotypes that translate to the plasma proteome
Machine learning identifies clinical sepsis phenotypes that translate to the plasma proteome Open
Background Sepsis therapy is still limited to treatment of the underlying infection and supportive measures. To date, various sepsis subtypes were proposed, but therapeutic options addressing the molecular changes of sepsis were not identi…
View article: Computer-Interpretable Quality Indicators for Intensive Care Medicine: Development and Validation Study
Computer-Interpretable Quality Indicators for Intensive Care Medicine: Development and Validation Study Open
Background Quality indicators (QIs) can help assess intensive care quality, identify potential for improvement, and ultimately enhance patient outcomes. Therefore, the German Interdisciplinary Association of Critical Care and Emergency Med…
View article: Impact of glucocorticoid receptor polymorphism rs6198 on sepsis survival in a prospective multicenter cohort
Impact of glucocorticoid receptor polymorphism rs6198 on sepsis survival in a prospective multicenter cohort Open
The glucocorticoid receptor (GR), particularly its isoforms GRα and GRβ, plays a crucial role in modulating inflammatory responses. The rs6198 single nucleotide polymorphism (SNP) in the NR3C1 gene, which encodes GR, has been associated wi…
View article: Improving AI-Based Clinical Decision Support Systems and Their Integration Into Care From the Perspective of Experts: Interview Study Among Different Stakeholders
Improving AI-Based Clinical Decision Support Systems and Their Integration Into Care From the Perspective of Experts: Interview Study Among Different Stakeholders Open
Background Artificial intelligence (AI)–based systems are receiving increasing attention in the health care sector. While the use of AI is well advanced in some medical applications, such as image recognition, it is still in its infancy in…
View article: The Actual Clinical Situation Ruthlessly Exposes the Challenge of Rational Care for Nosocomial and Community-Acquired Infections and Requires Even More Efforts for Satisfactory Antibiotic Stewardship
The Actual Clinical Situation Ruthlessly Exposes the Challenge of Rational Care for Nosocomial and Community-Acquired Infections and Requires Even More Efforts for Satisfactory Antibiotic Stewardship Open
Background: Antimicrobial resistance is one of the 10 most pressing health problems worldwide. Methods: First steps toward harnessing the complex dynamics of antibiotic resistance are presented. To accomplish this, we first shift down a ge…
View article: Positive suggestions via headphones during general anesthesia for the improvement of vegetative & cognitive postoperative course parameters in elderly orthopedic patients – A randomized controlled double-blinded trial (POSSUDEL)
Positive suggestions via headphones during general anesthesia for the improvement of vegetative & cognitive postoperative course parameters in elderly orthopedic patients – A randomized controlled double-blinded trial (POSSUDEL) Open
Background Postoperative delirium and cognitive deficits are significant surgical complications, especially in elderly patients. The reported incidence of postoperative delirium is variable but notably high in cardiothoracic, orthopedic, a…
View article: Plasma proteomics identifies molecular subtypes in sepsis
Plasma proteomics identifies molecular subtypes in sepsis Open
Background The heterogeneity of sepsis represents a significant challenge to the development of personalized sepsis therapies. Sepsis subtyping has therefore emerged as an important approach to this problem, but its impact on clinical prac…
View article: The protein interaction of mitochondrial transcription factors A and B2 is associated with 30-day survival in critical COVID-19
The protein interaction of mitochondrial transcription factors A and B2 is associated with 30-day survival in critical COVID-19 Open
Introduction Repair of mitochondrial damage seems pivotal for clinical recovery and determining outcome in patients with critical COVID-19. However, reliable biomarkers for non-invasively assessing mitochondrial repair in peripheral blood …
View article: Host Biomarkers and Antibiotic Tissue Penetration in Sepsis: Insights from Moxifloxacin
Host Biomarkers and Antibiotic Tissue Penetration in Sepsis: Insights from Moxifloxacin Open
Biomarker tissue correlations suggest that the penetration of moxifloxacin into tissues is a complex process influenced by factors like inflammation, tissue integrity, liver function, protein levels, and renal function. Understanding these…
View article: Machine learning identifies clinical sepsis phenotypes that translate to the plasma proteome: a prospective cohort study
Machine learning identifies clinical sepsis phenotypes that translate to the plasma proteome: a prospective cohort study Open
Background Sepsis therapy is still limited to treatment of the underlying infection and supportive measures. To date, various sepsis subtypes were proposed, but therapeutic options addressing the molecular changes of sepsis were not identi…
View article: Subphenotypes and the De Ritis ratio for mortality risk stratification in sepsis-associated acute liver injury: a retrospective cohort study
Subphenotypes and the De Ritis ratio for mortality risk stratification in sepsis-associated acute liver injury: a retrospective cohort study Open
View article: The Actual Clinical Situation Ruthlessly Exposes the Challenge of Rational Care for Nosocomial Infections and Requires Even More Efforts for Satisfactory Antibiotic Stewardship
The Actual Clinical Situation Ruthlessly Exposes the Challenge of Rational Care for Nosocomial Infections and Requires Even More Efforts for Satisfactory Antibiotic Stewardship Open
First steps toward harnessing the complex dynamics of antibiotic resistance are presented. To do this, we first shift down a gear and try to understand the actual driving dynamics behind the development of resistance in a specific clinical…
View article: Mortality-associated plasma proteome dynamics in a prospective multicentre sepsis cohort
Mortality-associated plasma proteome dynamics in a prospective multicentre sepsis cohort Open
View article: Employing artificial intelligence for optimising antibiotic dosages in sepsis on intensive care unit: a study protocol for a prospective observational study (KI.SEP)
Employing artificial intelligence for optimising antibiotic dosages in sepsis on intensive care unit: a study protocol for a prospective observational study (KI.SEP) Open
Introduction In sepsis treatment, achieving and maintaining effective antibiotic therapy is crucial. However, optimal antibiotic dosing faces challenges due to significant variability among patients with sepsis. Therapeutic drug monitoring…
View article: Problems and Barriers Related to the Use of AI-Based Clinical Decision Support Systems: Interview Study
Problems and Barriers Related to the Use of AI-Based Clinical Decision Support Systems: Interview Study Open
Background Digitalization is currently revolutionizing health care worldwide. A promising technology in this context is artificial intelligence (AI). The application of AI can support health care providers in their daily work in various wa…
View article: User-Oriented Requirements for Artificial Intelligence–Based Clinical Decision Support Systems in Sepsis: Protocol for a Multimethod Research Project
User-Oriented Requirements for Artificial Intelligence–Based Clinical Decision Support Systems in Sepsis: Protocol for a Multimethod Research Project Open
Background Artificial intelligence (AI)–based clinical decision support systems (CDSS) have been developed for several diseases. However, despite the potential to improve the quality of care and thereby positively impact patient-relevant o…
View article: High expression of L-GILZ transcript variant 1 (GILZ TV 1) is associated with increased 30-day sepsis mortality, and a high expression ratio possibly contraindicates hydrocortisone administration
High expression of L-GILZ transcript variant 1 (GILZ TV 1) is associated with increased 30-day sepsis mortality, and a high expression ratio possibly contraindicates hydrocortisone administration Open
Background Sepsis presents a challenge due to its complex immune responses, where balance between inflammation and anti-inflammation is critical for survival. Glucocorticoid-induced leucine zipper (GILZ) is key protein in achieving this ba…
View article: Predictive enrichment for the need of renal replacement in sepsis-associated acute kidney injury: combination of furosemide stress test and urinary biomarkers TIMP-2 and IGFBP-7
Predictive enrichment for the need of renal replacement in sepsis-associated acute kidney injury: combination of furosemide stress test and urinary biomarkers TIMP-2 and IGFBP-7 Open
Background In sepsis, initial resuscitation with fluids is followed by efforts to achieve a negative fluid balance. However, patients with sepsis-associated acute kidney injury (SA-AKI) often need diuretic or renal replacement therapy (RRT…
View article: Activation of the MAPK network provides a survival advantage during the course of COVID-19-induced sepsis: a real-world evidence analysis of a multicenter COVID-19 Sepsis Cohort
Activation of the MAPK network provides a survival advantage during the course of COVID-19-induced sepsis: a real-world evidence analysis of a multicenter COVID-19 Sepsis Cohort Open
Purpose There is evidence that lower activity of the RAF/MEK/ERK network is associated with positive outcomes in mild and moderate courses of COVID-19. The effect of this cascade in COVID-19 sepsis is still undetermined. Therefore, we test…
View article: User-Oriented Requirements for Artificial Intelligence–Based Clinical Decision Support Systems in Sepsis: Protocol for a Multimethod Research Project (Preprint)
User-Oriented Requirements for Artificial Intelligence–Based Clinical Decision Support Systems in Sepsis: Protocol for a Multimethod Research Project (Preprint) Open
BACKGROUND Artificial intelligence (AI)–based clinical decision support systems (CDSS) have been developed for several diseases. However, despite the potential to improve the quality of care and thereby positively impact patient-relevant …
View article: Exploring the relationship between HCMV serostatus and outcomes in COVID-19 sepsis
Exploring the relationship between HCMV serostatus and outcomes in COVID-19 sepsis Open
Background Sepsis, a life-threatening condition caused by the dysregulated host response to infection, is a major global health concern. Understanding the impact of viral or bacterial pathogens in sepsis is crucial for improving patient ou…
View article: The Association between the rs3747406 Polymorphism in the Glucocorticoid-Induced Leucine Zipper Gene and Sepsis Survivals Depends on the SOFA Score
The Association between the rs3747406 Polymorphism in the Glucocorticoid-Induced Leucine Zipper Gene and Sepsis Survivals Depends on the SOFA Score Open
The variability in mortality in sepsis could be a consequence of genetic variability. The glucocorticoid system and the intermediate TSC22D3 gene product—glucocorticoid-induced leucine zipper—are clinically relevant in sepsis, which is why…
View article: Assessing SOFA score trajectories in sepsis using machine learning: A pragmatic approach to improve the accuracy of mortality prediction
Assessing SOFA score trajectories in sepsis using machine learning: A pragmatic approach to improve the accuracy of mortality prediction Open
Introduction An increasing amount of longitudinal health data is available on critically ill septic patients in the age of digital medicine, including daily sequential organ failure assessment (SOFA) score measurements. Thus, the assessmen…
View article: Protein Interaction Assessing Mitochondrial Biogenesis as a Next Generation Biomarker in Sepsis
Protein Interaction Assessing Mitochondrial Biogenesis as a Next Generation Biomarker in Sepsis Open
View article: The Aquaporin 3 Polymorphism (rs17553719) Is Associated with Sepsis Survival and Correlated with IL-33 Secretion
The Aquaporin 3 Polymorphism (rs17553719) Is Associated with Sepsis Survival and Correlated with IL-33 Secretion Open
Sepsis is a common life-threatening disease caused by dysregulated immune response and metabolic acidosis which lead to organ failure. An abnormal expression of aquaporins plays an important role in organ failure. Additionally, genetic var…