• Electrochemiluminescence (ECLIA)
• Enzyme-linked Immunosorbend Assay (ELISA)
• Expression Analytics (qPCR, Protein Analytics)
• Gel electrophoresis
• Cell culture
• Electroneurography
• Impedance myography
• Neuromuscular Ultrasound
• Tissue bath experiments (Cooperation with Institute of Physiology)
• Software-based image analysis

Current Projects

The aim is to characterise the ischemia-reperfusion and inflammation process after induced cardiocirculatory arrest and cardiopulmonary resuscitation in the mouse model. The effects on the different organ functions (in particular liver, lung, heart and brain) will be investigated in detail with a focus on the neurological outcome.

Project management: Dr. rer. nat. Rika Bajorat, Dr. rer. nat. Lena Danckert, PD Dr. med. Johannes Ehler

- Influence of antiinflammatory and antimicrobal peptides on the neurological outcome after cardiocirculatory arrest and cardiopulmonary resuscitation

- Influence of antiinflammatory and antimicrobal peptides on the early inflammatory response after cardiocirculatory arrest and cardiopulmonary resuscitation

- Investigation of the early postischemic glucose metabolism using PET CT [18 F] FDG after cardiocirculatory arrest and cardiopulmonary resuscitation

Current Research Projects

Diagnostic and Monitoring of Intensive Care Unit - Acquired Weakness (ICU-AW) - a survey on German intensive care units

Project management: Dr. med. Felix Klawitter, PD Dr. med. Johannes Ehler

ICU-AW is a frequent neuromuscular complication in ICU patients and is relevant for the short- and long-term outcome of ICU patients due to protracted weaning, difficult mobilisation and the associated prolonged ICU stay.

To date, there are no uniform recommendations for the diagnostic procedure when ICU-AW is suspected and for further monitoring in the ICU after diagnosis. This study project is therefore intended to shed light on the current state of diagnostics and monitoring in German intensive care units. The results of this study should help to better classify the current status of diagnostics in ICU-AW and to be able to give uniform recommendations in the future.

Biomarker-guided assessment of neurocognitive impairment in patients with COVID-19 - a multicenter case-control study (Project COVID-BRAIN)
Project management: PD Dr. med. Johannes Ehler, Dr. med. Felix Klawitter, Dr. med. Gerd Klinkmann

Neurocognitive impairment became increasingly common in adult and pediatric patients with COVID-19. Prospective clinical trials combining both clinical and laboratory investigations, including specific biomarkers of neuroaxonal damage, have not been conducted in patients with COVID-19. The value of specific biomarkers of neuroaxonal injury has already been demonstrated by our group in patients with different inflammatory diseases of the CNS. Biomarkers could be of particular importance in pandemic times with increased patient numbers and limited human resources to qualitatively and quantitatively assess neurocognitive impairment and could help to predict the neurocognitive outcome of patients (ClinicalTrials.gov Identifier: NCT04359914).
Study centres and research partners:
- University Medicine Rostock
        - Department of Anaesthesiology and Intensive Care Medicine
        - Department of Infectiology (PD Löbermann) and Internal Intensive Care Medicine (Dr. Henschel)                
        - Department of Pediatrics, Neuropediatrics Section (Prof. Bertsche)
- Ludwig-Maximilians-University Munich
        - Department of Anesthesiology (Dr. Saller)
    

Neuromuscular ultrasound to assess neuromuscular complications in critically ill patients
Project management: Dr. med. Felix Klawitter, PD Dr. med. Johannes Ehler

Intensive Care Unit-Acquired Weakness (ICU-AW) is a common form of acquired, generalized neuromuscular dysfunction affecting a large number of critically ill patients and is associated with prolonged ventilation duration, prolonged intensive care treatment and increased mortality. Current clinical research is focused on new diagnostic and prognostic procedures for the detection and monitoring of ICU-AW, such as the use of neuromuscular ultrasound (NMUS). However, its role has not yet been sufficiently investigated due to the lack of data on quantitative changes over time, correlations with the severity of neuromuscular dysfunction and the clinical outcome of functionally impaired patients. Our investigations should therefore contribute to the evaluation and establishment of new diagnostic approaches involving ultrasound in neuromuscular diseases of critically ill patients.

Biomarker profiles in critically ill patients with Intensive Care Unit-Acquired Weakness (ICU-AW)
Project management: Dr. med. Felix Klawitter, PD Dr. med. Johannes Ehler

In addition to prolonged invasive ventilation, multiorgan failure, the use of muscle relaxants, corticosteroids or antibiotics, current studies point out towards the importance of humoral factors and inflammatory cytokines as one of the important pathomechanisms in patients with ICU-AW. Previous studies reported on an myofascial inflammatory response due to neutrophil infiltration and fibrin deposition and elevated plasma levels of IL-1, IL-6, IL-8, IL-10, IL-13, TNFα, IFNγ, fractaline, sICAM-1 in patients with ICU-AW, which emphasizes the importance of the humoral component of a systemic inflammatory response in the development neuromuscular dysfunction. However, the diagnostic role of these and other biomarkers for the assessment of ICU-AW has been insufficiently investigated. Further data are needed on quantitative changes of biomarker levels over time, correlations with the severity of neuromuscular dysfunction and the clinical outcome of functionally impaired patients. Therefore, this research project aims to identify new potential blood biomarkers for the diagnosis of ICU-AW and to investigate their prognostic value in critically ill patients.
Funding: Research funding of the University Medical Center Rostock - FORUN 2020, funding volume: 19.984 EURO

Evaluation of software-guided gray scale analysis for the quantification of ultrasound parameters in critically ill patients with neuromuscular dysfunction
Project management: Dr. med. Felix Klawitter, PD Dr. med. Johannes Ehler

The semi-quantitative evaluation of muscle ultrasound images is time-consuming and at least in part depended on the examiner. The aim of this project is to investigate the use of the software-guided gray scale analysis in order to improve the evaluation of sonographic findings with regard to objectivity, validity and reliability in critically ill patients with generalized neuromuscular weakness.

Detection of white matter hyperintensities using magnetic resonsance imaging in neurointensive care patients with sepsis
Project management: Dr. med. Gerd Klinkmann, PD Dr. med. Matthias Wittstock, PD Dr. med. Johannes Ehler

Neurointensive care patients commonly develop pulmonary tract infections like pneumonia, and thus are at high risk to develop sepsis. Besides cerebrovascular diseases such as ischemic and hemorrhagic stroke, cerebral homeostasis is also disturbed by sepsis and sepsis-associated encephalopathy. MRI is a useful imaging tool to detect morphological correlates of SAE -  white matter hyperintensities (WMH). To date, MRI is not routinely performed in patients with sepsis on general intensive care units due to limited ressources. Hence, the specific prevalence of WMH in sepsis is unknown. Neurointensive care patients are more commonly examined by MRI and represent a suitable cohort to investigate the prevalance of WMH in sepsis.

Completed Research Projects

Neuro-Sepsis Study (2012-2015)

Title of the study: Prospective analysis of the course of sepsis in intensive care patients regarding the neurological outcome

Monocentric study of the Clinic for Anesthesiology and Intensive Care Therapy, University Medicine Rostock (cooperation project with Prof. Martin Sauer)

ClinicalTrials.gov: NCT02442986.

CIP study (2016-2019)

Study title: Impact of Human Blood Serum From Critically Ill Patients on Human Colon Neuronal Networks

Monocentric study of the Clinic for Anaesthesiology and Intensive Care Therapy, University Medicine Rostock (cooperation project with Dr. Robert Patejdl, Oscar Langendorff Institute of Physiology)

ClinicalTrials.gov: NCT02706314

FORUN-funded project (20.000 EURO)